Dissertation/Thesis Abstract

The Regulation of U.S. Nursing Homes: An Examination of State and Federal Tools and Their Effect on Providers' Performance
by Hawks, Beth A., Ph.D., American University, 2018, 175; 10841150
Abstract (Summary)

This dissertation used a mixed-methods approach to investigate both how intergovernmental relationships influence collaboration between regulators and to what extent their regulatory tools affect nursing home regulatory violations. Chapter 1 examines the impact of the five-star quality rating system and market competition on nursing home violations. Chapter 2 explores the intergovernmental relationships between state and federal regulators and whether it is facilitated by collaborative action. Chapter 3 evaluates the impact of two government tools (one direct and one indirect) and their association with regulatory compliance in nursing homes. The findings suggest that the five-star quality rating system has a positive association with nursing home providers’ regulatory compliance. Meanwhile, communication among regulators appears to be the key to collaboration, and the current structure of their regulatory regime might be inhibiting collaboration. Furthermore, the findings suggest that the direct governance tool leads to improvements in subsequent regulatory compliance as compared to the indirect tool. These three essays on the intergovernmental regulation of nursing homes and the specific regulatory tools contribute to the future policy decisions that affect the well-being of approximately 1.4 million individuals residing in nursing homes and primarily funded by the public.

Indexing (document details)
Advisor: Amirkhanyan, Anna A.
Commitee: Marcotte, David E., Meier, Kenneth J., Morrissey, Taryn W.
School: American University
Department: Public Administration and Policy
School Location: United States -- District of Columbia
Source: DAI-A 80/02(E), Dissertation Abstracts International
Subjects: Public administration, Public policy, Health care management
Keywords: Enforcement actions, Nursing homes, Regulation, Transparency
Publication Number: 10841150
ISBN: 978-0-438-38978-6
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