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Determinants of performance failure in the nursing home industry

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  • Zinn, Jacqueline
  • Mor, Vincent
  • Feng, Zhanlian
  • Intrator, Orna

Abstract

This study investigates the determinants of performance failure in U.S. nursing homes. The sample consisted of 91,168 surveys from 10,901 facilities included in the Online Survey Certification and Reporting system from 1996 to 2005. Failed performance was defined as termination from the Medicare and Medicaid programs. Determinants of performance failure were identified as core structural change (ownership change), peripheral change (related diversification), prior financial and quality of care performance, size and environmental shock (Medicaid case mix reimbursement and prospective payment system introduction). Additional control variables that could contribute to the likelihood of performance failure were included in a cross-sectional time series generalized estimating equation logistic regression model. Our results support the contention, derived from structural inertia theory, that where in an organization's structure change occurs determines whether it is adaptive or disruptive. In addition, while poor prior financial and quality performance and the introduction of case mix reimbursement increases the risk of failure, larger size is protective, decreasing the likelihood of performance failure.

Suggested Citation

  • Zinn, Jacqueline & Mor, Vincent & Feng, Zhanlian & Intrator, Orna, 2009. "Determinants of performance failure in the nursing home industry," Social Science & Medicine, Elsevier, vol. 68(5), pages 933-940, March.
    • Handle: RePEc:eee:socmed:v:68:y:2009:i:5:p:933-940
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    Cited by:

    1. Vargas, Robert, 2016. "How health navigators legitimize the Affordable Care Act to the uninsured poor," Social Science & Medicine, Elsevier, vol. 165(C), pages 263-270.
    2. Davis, Jullet A. & Weech-Maldonado, Robert & Lapane, Kate L. & Laberge, Alex, 2014. "Contextual determinants of US nursing home racial/ethnic diversity," Social Science & Medicine, Elsevier, vol. 104(C), pages 142-147.
    3. Forder, Julien & Allan, Stephen, 2014. "The impact of competition on quality and prices in the English care homes market," Journal of Health Economics, Elsevier, vol. 34(C), pages 73-83.

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