Nursing Home Quality of Care in For-profit and Non-for-profit Organizations

Document Type


Presentation Date

Summer 6-19-2014

Conference Name

2014 Summer Conference for Public Policy

Conference Location

Jeju. South Korea.


This study investigates the effects of market conditions on nursing home performance controlling for ownership, staffing, and certification types. Methods: This study collects 489 Indiana nursing homes across 92 Indiana counties in the U.S. from Nursing Home Compare (NHC) database reported from 2010 to 2012. Most county characteristics data associated with market demand and supply of nursing homes are obtained from the U.S. Census Bureau database. Utilizing Hierarchical Cluster Analyses, local nursing home markets, geographically defined as counties, are categorized into excess supply, balanced, and excess demand markets. The magnitude of balanced markets is again coded as small, medium, and high. Generalized Ordered Logit and Probit Models are utilized for nursing home performance investigation. Greater competition in excess supply markets helps to enhance nursing home quality. Nursing homes in small balanced markets (Low-Low and Medium-Medium supply-demand markets compared to High-High markets) tend to have better quality. The analysis also shows that ownership does not matter, but staffing levels positively affect overall nursing home performance. To improve nursing home quality, policy makers need to develop policies that encourage market competitions, increase staffing levels, and reduce information gap between providers and consumers. Further studies are warranted to generalize the findings of this study.


nursing home quality, market cluster


Public Affairs, Public Policy and Public Administration

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