Table 3.
Relationship between Medicare Reimbursement Changes (BBA, BBRA, and BIPA) and Unadjusted Nursing Home Efficiency: Results by Staffing Category
| RN Hours/Resident Day | RN/Total Nursing Staff | |||
|---|---|---|---|---|
| N=58,529 | Estimate | SE | Estimate | SE |
| Policy variables | ||||
| BBA | −0.0046*** | 0.0007 | −0.0045*** | 0.0007 |
| BBRA | −0.0073*** | 0.0018 | −0.0070*** | 0.0018 |
| BIPA | −0.0162*** | 0.0013 | −0.0152*** | 0.0013 |
| Covariates | ||||
| Nursing staff (see separate columns) | −0.0328*** | 0.0014 | −0.0395*** | 0.0055 |
| % of Medicare residents | −0.0500*** | 0.0041 | −0.0737*** | 0.0040 |
| % of Medicaid residents | 0.0528*** | 0.0022 | 0.0598*** | 0.0022 |
| Number of beds (/100) squared | 0.0047*** | 0.0001 | 0.0046*** | 0.0001 |
| Nonprofit ownership | −0.0332*** | 0.0010 | −0.0350*** | 0.0010 |
| Government ownership | −0.0289*** | 0.0022 | −0.0312*** | 0.0022 |
| Occupancy rate | 0.0052* | 0.0026 | 0.0163*** | 0.0025 |
| Chain membership | 0.0037*** | 0.0008 | 0.0049*** | 0.0008 |
| HHI | 0.0081*** | 0.0017 | 0.0102*** | 0.0017 |
| 1999 Medicaid reimbursement/resident/day | −0.0718*** | 0.0020 | −0.0778*** | 0.0020 |
*
p<0.05
***
p<.0001.
BBA, Balanced Budget Act; BBRA, Balanced Budget Refinement Act; BIPA, Benefits Improvement and Protection Act; SE, standard error; HHI, Herfindahl–Hirschman index.