Ownership conversions and nursing home performance.
OBJECTIVE
To examine the effects of ownership conversions on nursing home performance.


METHODS
Online Survey, Certification, and Reporting system data from 1993 to 2004, and the Minimum Data Set (MDS) facility reports from 1998 to 2004.


METHODS
Regression specification incorporating facility fixed effects, with terms to identify trends in the pre- and postconversion periods.


RESULTS
The annual rate of nursing home conversions almost tripled between 1994 and 2004. Our regression results indicate converting facilities are generally different throughout the pre/postconversion years, suggesting little causal effect of ownership conversions on nursing home performance. Before and after conversion, nursing homes converting from nonprofit to for-profit status generally exhibit deterioration in their performance, while nursing homes converting from for-profit to nonprofit status generally exhibit improvement.


CONCLUSIONS
Policy makers have expressed concern regarding the implications of ownership conversions for nursing home performance. Our results imply that regulators and policy makers should not only monitor the outcomes of nursing home conversions, but also the targets of these conversions.
Grabowski
David C
DC
Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899, USA. grabowski@hcp.med.harvard.edu
Stevenson
David G
DG
D003953:Diagnosis-Related Groups / Q000191:economics; D017598:Efficiency, Organizational; D006269:Health Facilities, Proprietary / Q000191:economics* / Q000706:statistics & numerical data; D006275:Health Facility Planning / Q000191:economics; D006801:Humans; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000191:economics* / Q000592:standards* / Q000706:statistics & numerical data; D009939:Organizations, Nonprofit / Q000191:economics* / Q000706:statistics & numerical data; D010067:Ownership / Q000191:economics* / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000191:economics; D011785:Quality Assurance, Health Care / Q000191:economics / Q000706:statistics & numerical data; D012044:Regression Analysis; D012189:Retrospective Studies; D014481:United States