Factors associated with increasing nursing home closures

Area of Science:

• Health Services Research
• Gerontology
• Public Health Policy

Background:

• Nursing home closures impact long-term care access and quality.
• Understanding closure drivers is crucial for policy and resource allocation.

Purpose of the Study:

• To determine the rate of nursing home closures between 1999 and 2005.
• To examine factors associated with closures, including internal, organizational, and external characteristics.

Main Methods:

• Utilized data from state regulators on closed facilities nationwide.
• Linked closure data with the Online Survey, Certification, and Reporting (OSCAR) database.
• Analyzed internal, organizational, and market factors for nearly all U.S. nursing homes.

Main Results:

• 1,789 nursing homes closed between 1999-2005, with an increasing annual closure rate.
• Higher deficiency citations, hospital-based status, chain membership, smaller size, and market competition increased closure risk.
• High Medicaid occupancy, especially with low reimbursement rates, was linked to higher closure likelihood.

Conclusions:

• State decisions on long-term care funding and services should consider their potential impact on nursing home closures.
• Policymakers need to be aware of the factors driving closures to ensure continued access to care.