 Group homes in the non-profit sector are often operated by other than the providers involved in state or private, for-profit involuntary care.The nursing facility industry holds the position, often with its affiliated hospitals, that it decides on involuntary treatment of elders, which involves issues such as visitations.Nursing homes have had a very long history of reviews and complaints including to the federal level of the Government Accountability Office (GAO) in the US and have been the subject of major reform efforts.