Certificate of need and nursing home bed capacity in states.

Rapid expenditure increases raise concern with nursing home utilization, of which bed stock is an important determinant. This focuses attention on state policies to limit bed stock, particularly certificate-of-need (CON). This paper reports a cross-sectional/time-series analysis of 1981-1984 changes in state nursing home beds per aged population as functions of CON factors and of other state policy and market factors. Nursing home CON appears to constrain expansion of bed stock, older CON programs having stronger effects. Bed stock changes are positively related to dollar amounts of state CON approvals per aged population--interpreted to reflect the stringency of state CON programs.