This paper studies acquisitions of nursing home facilities by chains. We first test alternative ‘cream-skimming’ and ‘turn-around’ arguments concerning nursing home acquisitions. We then consider post-acquisition changes in nursing home health performance, differentiating effects of the...

Nursing home care is arguably the largest financial risk for the elderly without private or social insurance coverage. The annual out-of-pocket expenditure can easily exceed $70,000. Despite the substantial financial burdens on the elderly, the understanding of nursing home self-pay prices is...