Trends in ownership structures of U.S. nursing homes and the relationship with facility traits and quality of care (2013-2022)
- Collection:
- Health Policy and Services Research
- Series Title(s):
- ASPE research brief
- Author(s):
- Stevenson, David G. (David George), author Peterson, Hannah, author Skinner, Robert, (Of Vanderbilt School of Medicine), author Ndrianasy, Estrella, author Braun, Robert Tyler, author Unruh, Mark, author Fernandez, Rahul, author
- Contributor(s):
- United States. Department of Health and Human Services. Office of Behavioral Health, Disability, and Aging Policy, issuing body.
- Publication:
- Washington, D.C. : Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Behavioral Health, Disability, and Aging Policy, November 13, 2023
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Nursing Homes -- organization & administration Ownership -- trends Quality of Health Care United States
- Genre(s):
- Technical Report
- Abstract:
- The role of ownership has been a longstanding concern in the nursing home sector, especially around the role of for-profit companies in providing care. Investment by private equity (PE) firms and real estate investment trusts (REITs) has sparked recent scrutiny over concerns on the potential impact on nursing home quality, further fueled by the presence of complex ownership structures and challenges in ensuring ownership transparency. We examined PE, REIT, and chain ownership trends from 2013 through 2022. We describe investment trends over the study period and examine their relationship with nursing home staffing and survey performance. PE investment increased early in the study period through 2017 but has declined since then to represent around 5% of all facilities. REIT investment steadily increased over the study period, before leveling off during COVID-19 to 9% of all facilities nationwide. Over the study period, PE and REIT invested facilities are similar to other for-profit facilities in terms of their size, resident acuity, and payer mix. However, PE facilities appear to be lower quality on average, based on star ratings. In our difference-in-differences analyses examining the impact of PE and REIT investment in nursing homes, we find that PE investment results in a 12% relative decline in registered nurse (RN) hours per resident day (HPRD) compared to other for-profit facilities and a 14% relative increase (i.e., worsening) in their deficiency score index. We see a similar pattern for REIT invested facilities, with a 7% relative decline in RN HPRD and a 14% relative increase in deficiency score index.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (17 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918750683806676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918750683806676