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Ownership conversions and nursing home performance.

David C Grabowski¹, David G Stevenson

¹Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899, USA. grabowski@hcp.med.harvard.edu

Health Services Research

|March 22, 2008

Summary

Nursing home ownership conversions had minimal causal impact on performance. However, nonprofit to for-profit conversions generally led to performance decline, while for-profit to nonprofit conversions showed improvement.

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Area of Science:

Health Services Research
Healthcare Management
Gerontology

Background:

Nursing home ownership conversions have increased significantly.
Concerns exist regarding the impact of these conversions on care quality.
Understanding performance changes post-conversion is crucial for policy.

Purpose of the Study:

To investigate the causal effects of ownership conversions on nursing home performance.
To analyze trends in nursing home ownership changes over time.

Main Methods:

Utilized data from 1993-2004, including Online Survey, Certification, and Reporting systems and Minimum Data Set (MDS) facility reports.
Employed regression analysis with facility fixed effects to assess pre- and post-conversion trends.

Main Results:

The rate of nursing home conversions nearly tripled from 1994 to 2004.
Regression analysis indicated minimal causal effect of ownership conversions on overall nursing home performance.
Facilities converting from nonprofit to for-profit status generally showed performance deterioration.
Facilities converting from for-profit to nonprofit status generally demonstrated performance improvement.

Conclusions:

Policy makers should monitor nursing home ownership conversions and their targets.
Results suggest that the direction of conversion (e.g., for-profit vs. nonprofit) is associated with performance changes.