Government Intervention in Nursing Homes: Assessing Ownership Dynamics and Quality of Care Under Non-State Government Owned Supplemental Payment Programs

Job Market Paper

Abstract:

Using a stacked difference-in-differences approach, I compare states with NSGO-SP programs to those without, over a fifteen-year period. The findings reveal that NSGO-SP programs lead to modest increases in citations and deficiency points, indicating a decline in care quality among NHs in states without stringent participation limits. The study also differentiates between NHs that were already government-owned and those that converted due to the program. For baseline NSGO NHs, the supplemental payments slightly improved quality, reducing citations and deficiency points. However, NHs that converted to government ownership experienced a substantial increase in citations and deficiency points, suggesting a significant deterioration in care quality.

The results underscore the unintended consequences of financial incentives in long-term care, particularly the risk of incentivizing ownership conversions that negatively impact care quality. These findings have important implications for federal, state, and local policymakers, highlighting the need for careful design and implementation of supplemental payment programs to avoid adverse effects on care quality.

Recommended citation: Fisher, Megdalynn. "Government Intervention in Nursing Homes: Assessing Ownership Dynamics and Quality of Care Under Non-State Government Owned Supplemental Payment Programs" work in progress.