The Effect of Certificate of Need and Moratoria Policy on Change in Nursing Home Beds in the United States

Charlene Harrington, James H. Swan, John A. Nyman, Helen Carrillo

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

OBJECTIVES. This study examined the effects of state certificate of need and/or moratorium requirements on the change in nursing home bed growth in states over a 13-year period. METHODS. Data were collected from five telephone surveys of state officials about state certificate of need and moratorium policies, state Medicaid nursing home reimbursement rates, and the licensed nursing home beds in each state for the 1979 through 1993 period. Two-stage least squares regression analysis treated certificate of need and/or moratorium and Medicaid reimbursement rates as endogenous variables in predicting the change in nursing home beds per aged population in states. RESULTS. States that had a certificate of need and/or moratorium did have significant reductions in the growth in nursing home beds but Medicaid nursing home reimbursement rates were not related to change in bed stock. The percentage of the population living in a metropolitan area, the personal income per 1,000 population, the percent unemployed, a state's tax effort, and time were positively associated with change in nursing home beds. The ratio of nursing home beds per 1,000 aged population in the previous year was a negative predictor of change in bed stock in a given year. CONCLUSIONS. State regulatory policies have an effect on bed growth in contrast to reimbursement policies.

Original languageEnglish (US)
Pages (from-to)574-588
Number of pages15
JournalMedical care
Volume35
Issue number6
DOIs
StatePublished - Jun 1997

Keywords

  • Certificate of need
  • Medicaid reimbursement
  • Nursing homes
  • State policies

Fingerprint Dive into the research topics of 'The Effect of Certificate of Need and Moratoria Policy on Change in Nursing Home Beds in the United States'. Together they form a unique fingerprint.

Cite this