{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T03:11:20Z","timestamp":1785553880818,"version":"3.56.0"},"reference-count":55,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Care Res Rev"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>This study estimates the effect of nursing home closure on occupancy, net profit margin, and operating margin of nearby nursing homes. We use national nursing home data from 2009 to 2019 from Medicare cost reports, Medicare Provider of Services (POS), and LTCfocus.org data. Using the Callaway and Sant\u2019Anna difference-in-differences model, we compare the changes in occupancy, net profit margin, and operating margin between incumbent nursing homes in markets with any closure and nursing homes in markets without a closure, overall, and across rurality. Our findings suggest that nursing home closure improves the occupancy rates of remaining nursing homes in the same market in rural areas but there is little evidence of effects in metropolitan and micropolitan areas. Nursing home regulators and local officials should consider the long-term care market heterogeneity when considering interventions targeted at nursing home closure.<\/jats:p>","DOI":"10.1177\/10775587241296182","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T06:53:51Z","timestamp":1731999231000},"page":"153-164","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of Nursing Home Closures on Occupancy and Finances of Nearby Nursing Homes"],"prefix":"10.1177","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2120-7118","authenticated-orcid":false,"given":"Lili","family":"Xu","sequence":"first","affiliation":[{"name":"The University of Iowa, Iowa City, USA"},{"name":"University of Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hari","family":"Sharma","sequence":"additional","affiliation":[{"name":"The University of Iowa, Iowa City, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7784-9908","authenticated-orcid":false,"given":"George L.","family":"Wehby","sequence":"additional","affiliation":[{"name":"The University of Iowa, Iowa City, USA"},{"name":"National Bureau of Economic Research, Cambridge, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"key":"bibr1-10775587241296182","author":"American Health Care Association &amp; National Center for Assisted Living","year":"2022","journal-title":"Nursing home closures: By the numbers"},{"key":"bibr2-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1093\/aepp\/pps006"},{"key":"bibr3-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1017\/S174413311300025X"},{"key":"bibr4-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1002\/hec.2959"},{"key":"bibr5-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1093\/joclec\/nhu017"},{"key":"bibr6-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeconom.2020.12.001"},{"key":"bibr7-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1177\/1077558704271728"},{"key":"bibr8-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2009.00954.x"},{"key":"bibr9-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1177\/0164027518824117"},{"key":"bibr10-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.01.006"},{"key":"bibr11-10775587241296182","volume-title":"Medicaid expenditures for long-term services and supports in FY 2016","author":"Eiken S.","year":"2018"},{"key":"bibr12-10775587241296182","unstructured":"Hunter H. (2018). A Report on Shortfalls in Medicaid Funding for Nursing Center Care. Hansen Hunter & Company, PC. https:\/\/rochesterbeacon.com\/wp-content\/uploads\/2021\/08\/HansenHunter-study.pdf"},{"key":"bibr13-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeconom.2021.03.014"},{"key":"bibr14-10775587241296182","doi-asserted-by":"publisher","DOI":"10.5034\/inquiryjrnl_45.01.58"},{"key":"bibr15-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2012.01425.x"},{"key":"bibr16-10775587241296182","doi-asserted-by":"publisher","DOI":"10.2190\/HS.41.4.g"},{"key":"bibr17-10775587241296182","author":"Healy J","year":"2019","journal-title":"The New York Times"},{"key":"bibr18-10775587241296182","doi-asserted-by":"publisher","DOI":"10.5430\/jha.v4n3p25"},{"key":"bibr19-10775587241296182","unstructured":"Kacik A. (2019). Rural nursing homes face closure as occupancy wanes. Modern Healthcare. https:\/\/www.modernhealthcare.com\/operations\/rural-nursing-homes-face-closure-occupancy-wanes"},{"key":"bibr20-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.20.6.114"},{"key":"bibr21-10775587241296182","unstructured":"Leys T. (2023, January 25). Wave of rural nursing home closures grows amid staffing crunch. Kaiser Health News. https:\/\/khn.org\/news\/article\/wave-of-rural-nursing-home-closures-grows-amid-staffing-crunch\/"},{"key":"bibr22-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1111\/iere.12137"},{"key":"bibr23-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-6296(03)00060-2"},{"key":"bibr24-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1177\/0046958018793285"},{"key":"bibr25-10775587241296182","first-page":"271","volume":"33","author":"McKay N. L.","year":"1996","journal-title":"Inquiry"},{"key":"bibr26-10775587241296182","author":"Medicaid and CHIP Payment and Access Commission","year":"2023","journal-title":"Estimates of Medicaid nursing facility payments relative to costs"},{"key":"bibr27-10775587241296182","unstructured":"Notification of Facility Closure\u2014CMS\n                      . (n.d.). https:\/\/www.cms.gov\/Medicare\/Provider-Enrollment-and-Certification\/SurveyCertificationGenInfo\/Downloads\/Survey-and-Cert-Letter-13-50.pdf"},{"key":"bibr28-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1016\/0167-6296(88)90022-7"},{"key":"bibr29-10775587241296182","doi-asserted-by":"publisher","DOI":"10.2307\/1928100"},{"key":"bibr30-10775587241296182","unstructured":"Olenski A. (2022). Reallocation and the (in)efficiency of exit in the U.S. nursing home industry. https:\/\/andrewolenski.github.io\/files\/olenski_jmp.pdf"},{"key":"bibr31-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2010.01197.x"},{"key":"bibr32-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1632"},{"key":"bibr33-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1097\/HMR.0b013e31825729ab"},{"key":"bibr34-10775587241296182","unstructured":"Pugh T. (2021). Bankruptcies, closures loom for nursing homes beset by pandemic. https:\/\/news.bloomberglaw.com\/health-law-and-business\/bankruptcies-closures-loom-for-nursing-homes-beset-by-pandemic"},{"key":"bibr35-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.12961"},{"issue":"1","key":"bibr36-10775587241296182","first-page":"25","volume":"17","author":"Scanlon W. J.","year":"1980","journal-title":"Inquiry"},{"key":"bibr37-10775587241296182","unstructured":"Sharma H., Baten R. B. A., Ullrich F., MacKinney A. C., Mueller K. J. (2021). Trends in nursing home closures in nonmetropolitan and metropolitan counties in the United States, 2008-2018. https:\/\/www.ruralhealthresearch.org\/publications\/1410"},{"key":"bibr38-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001648"},{"key":"bibr39-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1177\/1077558717739214"},{"key":"bibr40-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.03.024"},{"key":"bibr41-10775587241296182","unstructured":"Sharma H., Xu L., Ullrich F., MacKinney C., Mueller K. J. (2022). Nursing homes in rural America: A chartbook. https:\/\/www.ruralhealthresearch.org\/publications\/1509"},{"key":"bibr42-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.01.120"},{"key":"bibr43-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1177\/0019793915586380"},{"key":"bibr44-10775587241296182","doi-asserted-by":"crossref","unstructured":"Song L. D., Sagha\ufb01an S. (2020). The spillover effects of hospital closures on the efficiency and quality of other hospitals. https:\/\/scholar.harvard.edu\/files\/saghafian\/files\/hospital_closure_manuscript_nonblind.pdf","DOI":"10.2139\/ssrn.3318609"},{"key":"bibr45-10775587241296182","unstructured":"StataCorp L. L. C. (2021). Stata statistical software. Release 17 [Software]. https:\/\/www.stata.com\/"},{"key":"bibr46-10775587241296182","unstructured":"Stulick A. (2022, June 9). Nursing home closures hit smaller markets as financial, staffing crisis deepens across industry. Skilled Nursing News. https:\/\/skillednursingnews.com\/2022\/06\/nursing-home-closures-hit-smaller-markets-as-financial-staffing-crisis-deepens-across-industry\/"},{"key":"bibr47-10775587241296182","doi-asserted-by":"publisher","DOI":"10.2307\/1061491"},{"key":"bibr48-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1177\/0164027515622244"},{"key":"bibr49-10775587241296182","unstructured":"USDA ERS\u2014Urban Influence Codes\n                      . (n.d.). https:\/\/www.ers.usda.gov\/data-products\/urban-influence-codes\/"},{"key":"bibr50-10775587241296182","doi-asserted-by":"publisher","DOI":"10.5465\/ambpp.2010.54497520"},{"key":"bibr51-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1177\/0046958018825191"},{"key":"bibr52-10775587241296182","unstructured":"Welch W. P., Ruhter J., Bosworth A., Lew N. D., Sommers B. D. (2022). Changes of ownership of hospital and skilled nursing facilities: An analysis of newly-released CMS data. https:\/\/aspe.hhs.gov\/reports\/changes-ownership-hospital-skilled-nursing-facilities"},{"key":"bibr53-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14125"},{"key":"bibr54-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnab050"},{"key":"bibr55-10775587241296182","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2008.12.014"}],"container-title":["Medical Care Research and Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10775587241296182","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10775587241296182","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10775587241296182","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:33:19Z","timestamp":1777685599000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10775587241296182"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,19]]},"references-count":55,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/10775587241296182"],"URL":"https:\/\/doi.org\/10.1177\/10775587241296182","relation":{},"ISSN":["1077-5587","1552-6801"],"issn-type":[{"value":"1077-5587","type":"print"},{"value":"1552-6801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,19]]}}}