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Published on: September 30, 2020
Assisted living expansion and the market for nursing home care
David C Grabowski1, David G Stevenson, Portia Y Cornell
1Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899, USA. grabowski@med.harvard.edu
Objective:
To analyze the effect of market-level changes in assisted living supply on nursing home utilization and resident acuity.
Data Sources:
Primary data on the supply of assisted living over time were collected from 13 states from 1993 through 2007 and merged with nursing home-level data from the Online Survey Certification and Reporting System and market-level information from the Area Resource File.
Study Design:
Least squares regression specification incorporating market and time-fixed effects.
Principal Findings:
A 10 percent increase in assisted living capacity led to a 1.4 percent decline in private-pay nursing home occupancy and a 0.2-0.6 percent increase in patient acuity.
Conclusions:
Assisted living serves as a potential substitute for nursing home care for some healthier individuals with greater financial resources, suggesting implications for policy makers, providers, and consumers.
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