Will Quality Measures Debunk Quality Care in the Nursing Home Industry?

This research analyzes publicly available information on the quality of services delivered by healthcare organizations. The accessibility and transparency of healthcare data is exponentially growing. Due to the complexity of different provider groups in healthcare, the focus is on the nursing home industry. A key objective of this research is to explore any association among the government-defined quality ratings, cost-effectiveness, and quality care provided by a nursing home. Quality and performance metrics for all nursing homes that receive reimbursements from CMS is in the public domain. The CMS purports that nursing homes with high overall star ratings provide excellent healthcare to their residents. A surprising result from this study found high-quality-rated nursing homes with more nurse hours per resident provided lower quality care than nursing homes, which had lower nursing hours per resident. The research also suggests that healthcare organizations, such as nursing homes, acquire business analytics (BA) capabilities for specific government metrics.

Certificate-Of-Need Regulation and Healthcare Service Quality: Evidence from the Nursing Home Industry

This quantitative study investigates the effect of certificate-of-need (CON) regulation on the quality of care in the nursing home industry. It uses county-level demographic data from the 48 contiguous US states that are extracted from the American Community Survey (ACS) and cover the years 2012, 2013, and 2014. In doing so, it employs a new set of service quality variables captured from a variety of county-level data sources. Instrumental variables results indicate that health survey scores for nursing homes that are computed by healthcare professionals are about 18–24% lower, depending on the type of nursing home under consideration, in states with CON regulation. We also find that the presence of CON regulation leads to a substitution of lower-quality certified nursing assistant care for higher-quality licensed practical nurse care, regardless of the type of nursing home under consideration.