RT Journal
A1 Feng Z, Lepore M, Clark MA, et al
T1 Geographic concentration and correlates of nursing home closures: 1999-2008
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2011
FD May 9
VO 171
IS 9
SP 806
OP 813
DO 10.1001/archinternmed.2010.492
UL http://dx.doi.org/10.1001/archinternmed.2010.492
AB 
Regulatory oversight, reinforced by market forces and an increased focus on transparency and public reporting, is designed to eliminate poorly performing nursing homes.1- 3 A small fraction of US nursing homes closes each year (not more than 2%). Perhaps this is a desired outcome, since closure is the ultimate indicator of performance failure.4 However, the operation of regulatory efforts and marketforces are not likely to result in random distribution of closures. Rather, some facility types will be affected more than others.3- 10 Equally important is whether closures are geographically concentrated such that their impact will not be uniform but instead will disproportionately affect certain communities and population subgroups more than others.