Evidence map›Paper›PMID 39074916›Full record

ArticleJournal of the American Geriatrics Society2024

Nursing Home Compare star ratings before versus after a change in nursing home ownership.

Kira L Ryskina, Emily Tu, Junning Liang, Seiyoun Kim, Rachel M Werner

Abstract readComparative Study
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Evaluating Differences in Disaster-Related Staffing for Nursing Homes by Ownership Status.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026
    Article
  2. Nursing Home Profit Status and Pain Among Residents Living With Dementia.Pain management nursing : official journal of the American Society of Pain Management Nurses · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kira L RyskinaDivision of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Emily TuDivision of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Junning LiangDivision of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Seiyoun KimLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Rachel M WernerDivision of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Funding

Post-acute care of older adults: the role of skilled nursing facility specialistsR01AG066841 · NIA · UNIVERSITY OF PENNSYLVANIA · PI RYSKINA, KIRA L · 2020 to 2024
$2.0M
NIA NIH HHS R01 AG066841NIA NIH HHS R01AG066841
6 · The paper itself

Abstract

backgroundEfforts to increase transparency and accountability of nursing homes, and thus improve quality, now include information about changes in nursing home ownership. However, little is known about how change in ownership affects nursing home quality.

methodsWe conducted a retrospective cohort study of 15,471 U.S. nursing homes between January 2016 and December 2022, identifying all changes in ownership during that period. We used logistic regression to measure the association between nursing home characteristics and the odds of a change in ownership. A difference-in-differences model with multiple time periods was used to examine the impact of a change in ownership on the Medicare Nursing Home Compare 5-star ratings.

resultsOne in five (23%) facilities changed ownership between 2016 and 2022. Nursing homes that were urban, for-profit, part of a chain, located in the South, had >50 beds, lower occupancy, higher percentage of stays covered by Medicaid, higher percentage of residents with non-white race, or a 1-star (poor) rating were more likely to undergo a change in ownership. There was a small statistically significant decrease in 5-star ratings after a change in ownership (-0.09 points on a 5-point scale; 95% CI -0.13 to -0.04; p < 0.001), driven primarily by a decrease in staffing ratings (-0.19 points; 95% CI -0.24 to -0.14; p < 0.001), and health inspections ratings (-0.07 points; 95% CI -0.11 to -0.03; p = 0.001). This was mitigated by an increase in quality measure ratings (0.15 points; 95% CI 0.10-0.20; p < 0.001).

conclusionNursing Home Compare ratings decreased slightly after a change in facility ownership, driven by lower staffing and health inspection ratings and mitigated somewhat by higher quality measure ratings. These conflicting trends underscore the need for transparency around changes in facility ownership and a better understanding of consequences of changes in ownership that are salient to patients and families.

Indexed as

MedicareNursing HomesOwnershipAgedFemaleHomes for the AgedHumansMaleMedicaidQuality Indicators, Health CareQuality of Health CareRetrospective StudiesUnited States5‐star ratingschange of ownershipnursing homepublic report cardsquality of care

Identifiers

PMID39074916
PMCPMC11461114

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.