Estimating Nursing Home Quality with Selection

47 Pages Posted: 21 Apr 2022

Date Written: March 10, 2022


We estimate a Bayesian model of nursing home quality using variational inference. We then conduct three exercises. First, we examine the correlates of quality, finding that public report cards have near-zero correlation. Second, we show that higher quality nursing homes fared better during the pandemic: a one standard deviation increase in quality corresponds to 2.4% fewer Covid-19 cases. Finally, we show that a 10% increase in the Medicaid reimbursement rate raises quality, leading to a 1.85 percentage point increase in 90-day survival. Such a reform would be highly cost-effective even under conservative estimates of the quality-adjusted statistical value of life.

Funding Information: Olenski gratefully acknowledges support from the National Science Foundation Graduate Research Fellowship.

Declaration of Interests: None to declare.

Keywords: snf, nursing homes, covid, medicaid, variational inference

JEL Classification: J11, J18, L15

Suggested Citation

Olenski, Andrew and Sacher, Szymon, Estimating Nursing Home Quality with Selection (March 10, 2022). Available at SSRN: or

Andrew Olenski

Columbia University

3022 Broadway
New York, NY 10027
United States

Szymon Sacher (Contact Author)

Columbia University ( email )

420 W. 118th Street
New York, NY 10027
United States

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