Special care units and their influence on nursing home occupancy characteristics

Background: There has been a steady increase in the number of special care units (SCUs) in nursing homes. In 2006, 4,370 (i.e., 29%) nursing homes reported having an SCU. One belief is that SCUs in nursing homes developed to provide better resident care. However, few studies have examined the impact of opening an SCU on the nursing home, rather than the impact on residents. Purpose: In this research, we use national data over a period of 15 years (1991-2006) to examine whether opening either an Alzheimer's SCU or subacute SCU subsequently influences the overall nursing home occupancy, Medicare occupancy, or private-pay occupancy. Methodology/Approach: The 1991 through 2006. On-line Survey Certification of Automated Records was the primary data source used in this investigation. Using multivariate regression, overall occupancy, Medicare occupancy, and private-pay occupancy variables were examined 1, 2, and 3 years prior to opening of an SCU and 1, 2, and 3 years postopening of an SCU. Findings: Opening either an Alzheimer's SCU or subacute SCU had a positive impact on both the overall occupancy and private-pay occupancy of a facility. In addition, opening a subacute SCU had a positive impact on Medicare occupancy. These positive changes occur within a year of opening the SCU and increase each year thereafter. Practice Implications: The improvements in occupancy and payer-mix identified could mean the difference between operating in the black as opposed to making a loss. Thus, the findings have substantial practice implications for nursing homes.