Trends and Factors in Nursing Home Closures

What are the long-term trends in US nursing home closures and ownership transitions and how are facility characteristics associated with different types of operational change? In this cohort study of 33 110 US nursing home locations from 1985 to 2025, nearly half of the facilities followed simple entry-exit patterns, while approximately one-fifth remained operational despite ownership changes. Organizational restructuring, including change of ownership and within-facility capacity reconfiguration, became more common over time and was more prevalent than permanent facility closure or market exit. These findings suggest that nursing home closures often reflect broader organizational restructuring rather than true market exit, highlighting the importance of incorporating ownership transitions and capacity changes into nursing home policy and oversight.

Corresponding Author: Joohyun Chung, PhD, MStat, RN, Elaine Marieb College of Nursing, University of Massachusetts Amherst, 224 Skinner Hall, 651 N Pleasant St, Amherst, MA 01003 (joohyunchung@umass.edu).

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