Note: Adjusted linear models included SNF for-profit status, part of chain, the percentage of residents supported by Medicaid, volume of residents, certified nursing assistant hours per day per resident, licensed practical nurse per hour per resident per day, and registered nurse per hour per day per resident and ZIP-code fixed effects. Staffing measures were not included in the star rating models since CMS already uses these measures in the composite score. MA concentration is a binary indicator, low <26.5% and =>26.5 based on distribution.