Pilonieta G, Weech-Maldonado RJ, Jablonski RA, Yarbrough Landry A, Lord J, Zengul F.
Abstract
Objective: To ascertain whether environmental and organizational characteristics predict the adoption of Alzheimer’s disease special care units (AD SCUs) among nursing homes. Methods: This study utilized data from two different sources: Brown University’s LTCFocus data and the Area Health Resource File from 2005 to 2019. The sample consisted of approximately 193,652 nursing home-year observations (or an average of 12,900 facilities per year). Panel logistic regression with random effects and state and year fixed effects analysis was used to examine the relationship between nursing homes' adoption of AD SCUs and environmental and organizational characteristics. Results: Bivariate analyses showed significant differences between AD SCUs adopters and non- adopters in all environmental and organizational characteristics except Medicare Advantage penetration rate. In regression analyses, nursing homes operating in a less munificent external environment and more dynamic environment were less likely to adopt AD SCUs. On the other hand, nursing homes operating in more monopolistic markets were more likely to adopt AD SCUs. In addition, organizational factors such as size, for-profit status, occupancy rate, payer mix, and nursing homes’ location were significant predictors of AD SCUs adoption. Conclusions: Findings suggest that environmental and organizational factors influenced the adoption of AD SCUs by nursing homes. Our study findings can be used by NHs administrators to make informed decisions when adopting specialized care for people with dementia.