A study published this week in JAMA Network Open that focused on nursing home ownership changes found that shifting owners may not be the reason behind ensuing lower care quality at the facilities.
The authors wanted to see which nursing home characteristics were linked to changes in ownership. The authors also wanted to know if evolutions in ownership were related to differences in residents’ outcomes during short stays.
Researchers from the University of Washington Department of Rehabilitation Medicine looked at 11,004 nursing homes in the US between 2016 and 2019. They evaluated Medicare data and focused on three markers with regard to transitions in ownership: How the ownership shifts affected emergency department visits, hospital readmissions and community discharges.
Of all the nursing homes assessed, 13.26% switched owners during the study period. In 2019 alone, 36% of nursing homes changed hands. Nonprofit and government facilities had lower chances of transferring ownership compared to for-profit nursing homes. Nursing facilities that were part of a chain had higher odds of changing owners compared to those that were not part of a chain. Nursing homes in urban areas with lower occupancy rates, larger proportions of people on Medicaid and lower staff ratings had higher odds of shifting owners.
The team didn’t find associations between changing owners and hospital readmissions or community discharge rates. But a change in owners was linked to a 32% increase in emergency department visits, but only in the short term. These results indicate that a change in owners may not be a cause of lower quality in the nursing home.
Ownership changes in nursing homes are not rare; they’re quite frequent. Between 2016 and 2021, there were 3,254 skilled nursing facilities sold in the US. Nursing homes with lower profit margins may be more likely to change hands, but this study didn’t look at cost data.
In recent years, the Centers for Medicare & Medicaid Services has made an effort to share more details on nursing home ownership.
