Are Recessions Good for Staffing in Nursing Homes? / R. Tamara Konetzka, Karen B. Lasater, Edward C. Norton, Rachel M. Werner.

Format:

Book

Author/Creator:

Konetzka, R. Tamara.

Contributor:

National Bureau of Economic Research.

Lasater, Karen B.

Norton, Edward C.

Werner, Rachel M.

Series:

Working Paper Series (National Bureau of Economic Research) no. w23402.

NBER working paper series no. w23402

Language:

English

Physical Description:

1 online resource: illustrations (black and white);

Place of Publication:

Cambridge, Mass. National Bureau of Economic Research 2017.

Summary:

The quality and cost of care in nursing homes depend critically on the number and types of nurses. Recent research suggests that the nursing supply adjusts to macroeconomic conditions. However, prior work has failed to consider the effect of macroeconomic conditions on demand for nurses through the effect on revenues. We test how county-level unemployment rates affect direct-care staffing rates in nursing homes using California data. We exploit the wide variation in the unemployment rates across counties and over time in 2005-2012. We also test whether there are heterogeneous effects of unemployment rates by facility size, staffing level, and profit status. We find that as unemployment rates increase, staffing by registered nurses (RNs) decreases but staffing by licensed practical nurses (LPNs) increases. The increase in LPNs is larger in large nursing homes, nursing homes with higher staffing levels, and in for-profit nursing homes. We also find that as unemployment rates increase, nursing home revenue decreases. While the effect of macroeconomic conditions on nursing supply may be important for cost and quality of care, the mechanism is not simple, direct, or homogeneous for all types of nurses and nursing homes.

Notes:

Print version record

May 2017.