THE EFFECT OF CERTIFICATE OF NEED AND MORATORIA POLICY ON CHANGE IN NURSING-HOME BEDS IN THE UNITED-STATES

OBJECTIVES. This study examined the effects of state certificate of ne ed and/or moratorium requirements on the change in nursing home bed gr owth in states over a 13-year period. METHODS. Data were collected fro m five telephone surveys of state officials about state certificate of need and moratorium policies, state Medicaid nursing home reimburseme nt rates, and the licensed nursing home beds in each state for the 197 9 through 1993 period. Two-stage least squares regression analysis tre ated certificate of need and/or moratorium and Medicaid reimbursement rates as endogenous variables in predicting the change in nursing home beds per aged population in states. RESULTS. States that had a certif icate of need and/or moratorium did have significant reductions in the growth in nursing home beds but Medicaid nursing home reimbursement r ates were not related to change in bed stock. The percentage of the po pulation living in a metropolitan area, the personal income per 1,000 population, the percent unemployed, a state's tax effort, and time wer e positively associated with change in nursing home beds. The ratio of nursing home beds per 1,000 aged population in the previous year was a negative predictor of change in bed stock in a given year. CONCLUSIO NS. State regulatory policies have an effect on bed growth in contrast to reimbursement policies.