Smoke without fire: nursing facility closures in California, 1997-2001

Inquiry. 2004 Summer;41(2):189-202. doi: 10.5034/inquiryjrnl_41.2.189.

Abstract

This paper draws from a rich longitudinal California data set to analyze the scope and nature of nursing home closures between 1997 and 2001, and to present a Cox proportionate hazards model of the risks of closure that arise from a range of facility and market characteristics. When compared with the sample total of 1,482 facilities operating in the baseline year of 1997, only 56 facilities closed through 2001, involving the loss of 3.8% of facilities and 2,915 beds (2.3%). The multivariate Cox model of factors associated with closure reports that: 1) hospital-based facilities are 600% more likely to close than are free-standing homes; 2) reducing bed size by one standard deviation (52 beds) increases the risk of closure by 460%; 3) facilities with losses of 5% or worse are more than twice as likely to close; and 4) a one-standard deviation increase in the spare bed capacity measure of county competition raises the risk of facility closure by 140%.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bankruptcy
  • California
  • Data Interpretation, Statistical
  • Health Facility Closure / economics*
  • Health Facility Closure / statistics & numerical data*
  • Humans
  • Longitudinal Studies
  • Medicaid / economics
  • Medicare / economics
  • Nursing Homes / economics*
  • Nursing Homes / statistics & numerical data*
  • Public Policy
  • Risk Factors
  • Rural Population
  • Urban Population