Table 2.
Effects of PPS and BBRA on Staffing Hours per Resident-Day (N=60,283)
| Variable | RN Hours | RN+LPN Hours | Nurse-Aide Hours |
|---|---|---|---|
| Constant | 0.393*** | 1.100*** | 1.632*** |
| (0.047) | (0.065) | (0.070) | |
| Policy Effects | |||
| PPS × Very Low Medicare | −0.159*** | −0.254*** | −0.016 |
| (0.027) | (0.046) | (0.049) | |
| PPS × Low Medicare | −0.160*** | −0.259*** | −0.031 |
| (0.027) | (0.046) | (0.049) | |
| PPS × Medium Medicare | −0.195*** | −0.266*** | −0.032 |
| (0.032) | (0.052) | (0.058) | |
| PPS × High Medicare | −0.122* | −0.400*** | −0.086 |
| (0.062) | (0.080) | (0.072) | |
| BBRA × Very Low Medicare | 0.046*** | 0.080*** | −0.012 |
| (0.016) | (0.028) | (0.030) | |
| BBRA × Low Medicare | 0.037** | 0.064** | −0.012 |
| (0.015) | (0.028) | (0.030) | |
| BBRA × Medium Medicare | 0.043** | 0.069** | −0.031 |
| (0.018) | (0.031) | (0.037) | |
| BBRA × High Medicare | −0.053 | 0.051 | −0.101** |
| (0.049) | (0.065) | (0.051) | |
| Main Effects/Time Trends | |||
| PPS | 0.170*** | 0.247*** | 0.031 |
| (0.031) | (0.050) | (0.052) | |
| BBRA | −0.032** | −0.041 | 0.060** |
| (0.015) | (0.027) | (0.028) | |
| Very Low Medicare | 0.0363*** | 0.033*** | 0.001 |
| (0.0087) | (0.013) | (0.015) | |
| Low Medicare | 0.0610*** | 0.078*** | −0.001 |
| (0.0097) | (0.014) | (0.017) | |
| Medium Medicare | 0.125*** | 0.163*** | 0.032 |
| (0.013) | (0.018) | (0.021) | |
| High Medicare | 1.242*** | 1.698*** | 0.277*** |
| (0.036) | (0.045) | (0.035) | |
| Year 1998 | −0.0051 | 0.0026 | −0.0102 |
| (0.0044) | (0.0063) | (0.0066) | |
| Year 1999 | −0.0157** | 0.025*** | 0.007 |
| (0.0071) | (0.010) | (0.011) | |
| Year 2000 | −0.057*** | −0.030** | −0.025 |
| (0.011) | (0.015) | (0.016) | |
| Facility Characteristics | |||
| For-profit facility | −0.0653*** | −0.096*** | −0.212*** |
| (0.0080) | (0.011) | (0.012) | |
| Government facility | −0.052*** | −0.012 | 0.106*** |
| (0.017) | (0.022) | (0.022) | |
| Chain facility | −0.0089 | −0.0116 | −0.0833*** |
| (0.0063) | (0.0083) | (0.0093) | |
| Hospital-based facility | 0.391*** | 0.550*** | 0.039* |
| (0.021) | (0.027) | (0.022) | |
| Total number of beds | −0.00034*** | −0.00048*** | −0.00018** |
| (0.00006) | (0.00008) | (0.00008) | |
| Percent private-pay | 0.00080*** | 0.00106*** | 0.00219*** |
| (0.00020) | (0.00029) | (0.00029) | |
| Facility offers ventilator care | −0.023 | −0.041 | −0.042 |
| (0.026) | (0.032) | (0.031) | |
| Facility offers physical therapy | −0.022 | −0.066* | 0.052 |
| (0.022) | (0.036) | (0.040) | |
| Facility offers occupational therapy | 0.031** | 0.033 | 0.024 |
| (0.015) | (0.022) | (0.022) | |
| ADL index | −0.0217*** | −0.0152*** | 0.0481*** |
| (0.0031) | (0.0038) | (0.0038) | |
| Skilled services index | 0.358*** | 0.801*** | 0.168*** |
| (0.028) | (0.034) | (0.030) | |
| Percent depressed | −0.034** | −0.066*** | 0.024 |
| (0.014) | (0.019) | (0.020) | |
| Percent with psychiatric diagnosis | −0.185*** | −0.178*** | −0.191*** |
| (0.017) | (0.024) | (0.028) | |
| Percent with dementia | −0.210*** | −0.227*** | 0.059** |
| (0.016) | (0.023) | (0.026) | |
| County Characteristics | |||
| High-competition county | 0.0305*** | 0.0238** | 0.016 |
| (0.0074) | (0.0098) | (0.011) | |
| Low-competition county | −0.0117 | −0.078*** | 0.004 |
| (0.0083) | (0.012) | (0.012) | |
| High-demand county | −0.0174*** | −0.0358*** | −0.0179* |
| (0.0061) | (0.0085) | (0.0093) | |
| Low-demand county | 0.0371*** | 0.0860*** | 0.0501*** |
| (0.0062) | (0.0083) | (0.0093) | |
| Percent of people in poverty | −0.00132 | −0.0060*** | 0.0014 |
| (0.00082) | (0.0011) | (0.0012) | |
| Population (1,000) per square mile | 0.00652*** | −0.0009 | −0.0028** |
| (0.00092) | (0.0011) | (0.0014) | |
| Median household income ($1,000s) | 0.00483*** | 0.00150** | 0.00051 |
| (0.00047) | (0.00060) | (0.00067) | |
| R-squared | 0.58 | 0.59 | 0.15 |
Notes: Regression uses state fixed effects. Robust standard errors in parentheses.
*
significant at 10%;
**
significant at 5%;
***
significant at 1%.