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. 2022 Feb 9;62(2):181-189.
doi: 10.1093/geront/gnab105.

Factors Associated With Assisted Living Facility Closure

Joseph W June  1   2 , Debra Dobbs  1   2 , Victor Molinari  1 , Hongdao Meng  1   2 , John R Bowblis  3   4 , Kathryn Hyer  1   2
Affiliations

Factors Associated With Assisted Living Facility Closure

Joseph W June et al. Gerontologist. .

Abstract

Background and objectives: Assisted living facilities (ALFs) have experienced rapid growth in the past few decades. The expansion in the number of ALFs may cause markets to become oversaturated, and a greater risk of unprofitable ALFs to close. However, no studies have investigated ALF closure. This study adapted a model developed for the nursing home market for the ALF market to examine the organizational, internal, and external factors associated with closure.

Research design and methods: Data on 1,939 ALFs operating in 2013 from Florida were used to estimate a logistic regression to examine the organizational, internal, and external factors that were associated with closure between 2013 and 2015.

Results: During the 2-year study period, 141 ALFs (7.3%) closed. Significant factors associated with increased odds of closure included fewer beds, not accepting Medicaid, and more deficiencies. Two factors (market concentration and population density) were marginally significant.

Discussion and implications: The results of this study confirm the usefulness of a model that includes organizational, internal, and external factors to predict ALF closure. These outcomes highlight the concerns that closure can affect access to community-based long-term care, especially for rural older adults, and indicate an expansion of Medicaid acceptance in ALFs could be protective against closure.

Keywords: Assisted living; Economics; Long-term care; Quality.

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