Journal of the Indiana Academy of the Social Sciences

Document Type



This study attempts to disentangle the relationships between ownership, staffing, and nursing home quality using Indiana nursing home data. Typical Indiana nursing homes are known to be below average on health inspection and overall quality ratings. This is alarming because Indiana’s population aged 85 years or older is increasing and these individuals are likely to need long-term care services. With an ultimate goal of addressing the poor quality of long-term care institutions, this study analyzed the Nursing Home Compare data collected from 2010 to 2012 by utilizing chi- square tests, one-way ANOVAs, and correlation analysis. The results revealed that nonprofit nursing homes have superior quality and record a greater number of registered nurse and certified nursing assistant hours per resident day compared to for-profit nursing homes. In addition, higher staffing hours were positively associated with overall rating. These findings imply a possibility that higher staffing levels in nonprofit nursing homes have a mediating effect on the relationship between ownership and nursing home quality. In order to improve nursing home quality, registered nurse and certified nursing assistant staffing levels need to be boosted. Enactment of state staffing standards and the Medicaid wage pass-through policy could help to address this issue.