Jacqueline Zinn, PhD Walter J. McNerney Distinguished Professor of Health Industry Management, Professor of Management and Strategy, Kellogg Graduate School of Management, Temple University

Abstract:
There is a long history of quality problems in US nursing homes, resistant to reform in spite of numerous regulatory initiatives, increases in funding and mandates for increased staffing. While the public perception is that of a uniformly poor quality industry, it has been frequently noted that a small proportion of nursing facilities across the country manifest most of the problems. However, to date the stratification of the industry into homes unable to meet resident needs and those facilities providing adequate, or even excellent care, has not been fully examined. In this paper we provide evidence for a two-tiered system of nursing home care, stratified on the basis of the number, type and quality of services provided. Our research indicates that this is a long-standing feature of the nursing home industry, and that recent market and regulatory events have reinforced stratification. As important, our study documents the transformation of the nursing home industry and uncovers highly suggestive evidence that the poor and frail residents served by the providers left behind are at risk for receiving sub-standard care.

Biosketch:
Dr. Zinn is an associate professor and director of the program in Healthcare Management, Department of Risk, Insurance and Healthcare Management, Fox School of Business and Management at Temple University, Philadelphia PA. She teaches strategic management and health care administration. Her research has examined the influence of market competition on quality and access in hospitals, nursing homes and home health agencies. She has investigated the association between organizational characteristics and quality in health care settings, comparing severity-adjusted outcomes of care. In the field of laboratory medicine, she has explored the application of various consensus development techniques to evaluate laboratory performance. She is the 1996 recipient of the John D. Thompson Prize for research achievement, and is a 1997 co-recipient of a Robert Wood Johnson Clinical Investigator Award. Dr. Zinn is an adjunct fellow of the Leonard Davis Institute for Health Economics and a Fellow at the Institute on Aging, University of Pennsylvania. She is a past chair of the Healthcare Management Division of the Academy of Management. She served as director of the Doctoral Program in Healthcare Management from 1994-2000, and has personally chaired or advised on over twenty dissertations in the fields of international strategy, healthcare systems, and public health.