Private equity acquisition of nursing homes ^ Implication for quality and finance

描述(由申请人提供)：私募股权收购养老院：对质量和财务的影响。私募股权公司(P.E)在过去几年里收购了多家大型养老院连锁店；到2007年，它拥有10家最大连锁店中的6家。批评人士称，体育疗养院为了追求利润而损害了护理质量，并呼吁加强监管。养老院的质量是一个重要的公众关切，因为美国一些最脆弱公民的福祉岌岌可危；此外，该行业的主要支付者政府对养老院的业绩及其持续的财务可行性有着强烈的兴趣。然而，关于体育场馆所有权对养老院质量的所谓影响的经验证据仍然有限，而且往往相互矛盾。这项拟议的研究将遵循以下研究目标：1)根据多纳贝迪安的结构-过程-结果(SPO)框架，考察私募股权收购对养老院质量的影响。2)分析私募股权收购对养老院财务业绩(即成本、收入和利润率)的影响。这项研究的数据来自五个不同的来源：2000-2008年研究期间的在线调查、认证和报告(OSCAR)、疗养院比较数据集、布朗大学的长期护理重点数据集、医疗保险成本报告和区域资源文件(ARF)。样本将包括位于加利福尼亚州、佛罗里达州、伊利诺伊州、纽约和德克萨斯州的养老院。主要的独立变量将是私人股本所有权。它将编码为养老院所有权的二分变量(0或1)，表示该养老院是否由私募股权拥有。对于研究目标1，质量将像唐纳贝迪安的结构-过程-结果(SPO)框架一样可视化，并被建模为私募股权所有权的函数。对于研究目标2，财务业绩将通过多个变量(成本、收入和利润率)来衡量，这些变量表示为私人股本所有权的函数。这项拟议的研究将增加我们对私募股权对养老院绩效影响的理解。这将有助于制定适当的政策回应，并有助于保护一些最脆弱的美国人的利益和生活质量。 公共卫生相关性：私募股权收购养老院：对质量和财务的影响。由于私人股本对养老院的投资不断增加，以及据称这对养老院业绩的影响，政策界对此表示担忧。据称，私人股本过度关注短期盈利能力，可能会对养老院的质量及其长期财务生存能力产生不利影响。因此，本研究记录了私募股权对养老院绩效的影响，具有重要的政策和监管意义。

DESCRIPTION (provided by applicant): Private equity acquisition of nursing homes: Implications for quality and finance. Private equity (P.E) has acquired multiple large nursing home chains within the last few years; by 2007, it owned six of the 10 largest chains. Critics have alleged that P.E nursing homes compromise quality of care in pursuit of profits and have called for greater regulatory oversight. Nursing home quality is an important public concern because the well-being of some of the nation's most vulnerable citizens is at stake; in addition, the industry's principal payer government has a strong interest in nursing home performance and its continued financial viability. However, the empirical evidence on the purported impact of P.E ownership on nursing home quality remains limited and often contradictory. The proposed research will be guided by the following research aims: 1) To examine the impact of private equity acquisition on nursing home quality as visualized by Donabedian's Structure-Process-Outcome (SPO) framework. 2) To analyze the impact of private equity acquisition on nursing home financial performance (i.e. costs, revenues, and margins). The data for this study comes from five different sources: Online Survey, Certification and Reporting (OSCAR), Nursing Home Compare dataset, Brown University's Long-Term Care Focus dataset, Medicare Cost Reports, and Area Resource File (ARF) for the study period 2000-2008. The sample will consist of nursing homes located in California, Florida, Illinois, New York, and Texas. The primary independent variables would be Private equity ownership. It would coded as a dichotomous variable (0 or 1) for nursing home ownership expressing whether the said nursing home is owned by private equity or not. For research aim 1, quality would be as visualized as Donabedian's Structure- Process-Outcome (SPO) framework and modeled as a function of private equity ownership. For research aim 2, financial performances would be measured by multiple variables (costs, revenues and margins) expressed as a function of private equity ownership. The proposed study will increase our understanding of the impact of private equity ownership on nursing home performance. This will facilitate the framing of appropriate policy responses, and help protect the interests and quality of life of some of the most vulnerable Americans. PUBLIC HEALTH RELEVANCE: Private equity acquisition of nursing homes: Implications for quality and finance. Concern has been raised in policy circles due to increasing private equity investments in nursing homes and its purported impact on their performance. Private equity is said to be excessively focused on short-term profitability with possible detrimental effects on nursing home quality and their long-term financial viability. Therefore, this research documenting the effect of private equity ownership on nursing home performance has important policy and regulatory implications.