Nurse Staffing and Deficiencies in the Largest For‐Profit Nursing Home Chains and Chains Owned by Private Equity Companies
- 30 August 2011
- journal article
- research article
- Published by Wiley in Health Services Research
- Vol. 47 (1pt1), 106-128
- https://doi.org/10.1111/j.1475-6773.2011.01311.x
Abstract
Objective To compare staffing levels and deficiencies of the 10 largest U.S. for-profit nursing home chains with five other ownership groups and chain staffing and deficiencies before and after purchase by four private equity (PE) companies. Data Sources Facilities for the largest for-profit chains were identified through Internet searches and company reports and matched with federal secondary data for 2003–2008 for each ownership group. Study Design Descriptive statistics and generalized estimation equation panel regression models examined staffing and deficiencies by ownership groups in the 2003–2008 period, controlling for facility characteristics, resident acuity, and market factors with state fixed effects. Principal Findings The top 10 for-profit chains had lower registered nurse and total nurse staffing hours than government facilities, controlling for other factors. The top 10 chains received 36 percent higher deficiencies and 41 percent higher serious deficiencies than government facilities. Other for-profit facilities also had lower staffing and higher deficiencies than government facilities. The chains purchased by PE companies showed little change in staffing levels, but the number of deficiencies and serious deficiencies increased in some postpurchase years compared with the prepurchase period. Conclusions There is a need for greater study of large for-profit chains as well as those chains purchased by PE companies.Keywords
This publication has 35 references indexed in Scilit:
- Quality of care in for-profit and not-for-profit nursing homes: systematic review and meta-analysisBMJ, 2009
- Registered Nurse Staffing Mix and Quality of Care in Nursing Homes: A Longitudinal AnalysisThe Gerontologist, 2009
- A Panel Data Analysis of the Relationships of Nursing Home Staffing Levels and Standards to Regulatory DeficienciesThe Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 2009
- Ownership Conversions and Nursing Home PerformanceHealth Services Research, 2008
- Shareholder Value and the Performance of a Large Nursing Home ChainHealth Services Research, 2007
- The Influence of Staffing Characteristics on Quality of Care in Nursing HomesHealth Services Research, 2007
- Nurse Staffing Levels and Medicaid Reimbursement Rates in Nursing FacilitiesHealth Services Research, 2006
- Relationship of Nursing Home Staffing to Quality of CareHealth Services Research, 2004
- The Rise of Chain Nursing Homes in Ontario, 1971-1996Social Forces, 1999
- The effect of Medicaid reimbursement on quality of care in nursing homesJournal of Health Economics, 1996