Table 3.
Private Investment Deals and Nursing Home Outcomes, Adjusted† Regression Results (For-Profit Chain Facilities Only‡) (N = 56,461)
| Model 1: Pre/Postterm | Model 2: Set of Pre- and Postterms§ | ||||||
|---|---|---|---|---|---|---|---|
| Facility Variables | Post | Pre 2 | Pre 1 | Deal | Post 1 | Post 2 | Post 3+ |
| Occupancy (%) | 0.4 | 1.4*** | 1.2*** | 1.0** | 1.2*** | 1.2*** | 0.4 |
| Percent Medicaid (%) | 0.4 | 1.0*** | 0.7** | 0.5 | 0.8** | 0.8** | 0.8** |
| Percent Medicare (%) | −0.3 | −0.03 | −0.02 | −0.2 | −0.2 | −0.2 | −0.5* |
| Registered nurses (hours per resident day) | 0.03** | −0.005 | 0.02 | 0.04* | 0.03* | 0.05* | 0.03 |
| Licensed practical nurses (hours per resident day) | −0.002 | −0.007 | −0.01 | −0.006 | −0.003 | −0.006 | −0.009 |
| Nurse aides (hours per resident day) | −0.04** | −0.04* | −0.02 | −0.03 | −0.07*** | −0.07** | −0.05** |
| Financial variables | |||||||
| Total operating expenses¶ | 2.01*** | 4.55*** | 4.91*** | −10.76*** | 6.84*** | 7.40*** | 8.82*** |
| Total revenue¶ | −4.87*** | 3.15*** | −0.32 | −23.75*** | −2.82** | 2.60* | 2.78* |
| Current ratio <1 | 3.65*** | 0.51*** | 0.47*** | 1.00 | 2.89*** | 2.74*** | 4.97*** |
| Current ratio ≥1 and <2 | 1.47*** | 1.13* | 0.83** | 1.03 | 1.47*** | 1.95*** | 1.53*** |
| Current ratio ≥2 | 0.27*** | 1.44*** | 2.07*** | 1.10 | 0.35*** | 0.24*** | 0.14*** |
| Negative operating margin | 1.92*** | 0.88 | 1.72*** | 2.07*** | 2.12*** | 2.14*** | 2.08*** |
| Operating margin >0% and ≤5% | 0.93 | 1.78*** | 1.60*** | 1.51*** | 0.97 | 1.03 | 1.13* |
| Operating margin >5% | 0.56*** | 0.56*** | 0.37*** | 0.32*** | 0.50*** | 0.45*** | 0.41*** |
| Debt servicing cost = 0†† | 0.38*** | 1.37*** | 0.92 | 0.48*** | 0.37*** | 0.40*** | 0.36*** |
| Debt servicing cost >0 and <10 | 1.97*** | 0.78*** | 1.23** | 0.93 | 1.75*** | 2.02*** | 3.00*** |
| Debt servicing cost ≥10 | 2.18*** | 0.75*** | 0.85 | 3.06*** | 2.44*** | 1.96*** | 1.42*** |
Note.
Adjusted models controlling for bed size, presence of dementia special care unit, facility-level acuity index, limitations in activities of daily living, and a county-level Herfindahl index measuring market concentration. Adjusted models also include facility-level fixed effects and year dummies. All continuous variables were estimated using least squares regression with robust standard errors clustered at the facility level, and the results are presented as coefficients. All models with dichotomous outcomes were estimated using conditional logistic regression, and the results are presented as odds ratios.
Analyses limited to nursing homes that were part of a for-profit chain.
Debt servicing cost = 100 × (cash on hand/(debt interest + debt principal)).
The comparison group for each Model 2 regression is observations three or more years prior to the deal.
Standardized per bed-day and adjusted to 2013 dollars.
Statistically significant at 10% level;
Statistically significant at 5% level;
Statistically significant at 1% level.