Do Changes in Hospital Ownership Affect Staffing?
In the brief, Do Changes in Hospital Ownership Affect Staffing Ratios? the NC Rural Health Research Program examines whether hospital ownership changes—specifically transitions between government or nonprofit ownership and for-profit status—are associated with differences in staffing levels, an important indicator of care quality and local economic impact.
Using CMS HCRIS data from 2011–2023, we analyzed 1,917 hospital-year observations from 162 rural hospitals that experienced an ownership change.
In rural hospitals, for-profit ownership was associated with lower staffing ratios in some regression models, suggesting potential implications for patient care. However, a difference-in-differences analysis including both rural and urban hospitals found no significant relationship between ownership conversions and staffing ratios.
Due to mixed findings and a small sample of converting hospitals, results should be interpreted cautiously. Future research is needed to understand how contextual factors—such as financial performance or the circumstances surrounding ownership change—shape workforce impacts.
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