# The Measurement and Production of Quality in Long-Term Care Facilities in the US

> **NSF 01002526DB NSF RESEARCH & RELATED ACTIVIT** · National Bureau of Economic Research Inc (MA) · $557,504

## Abstract

This research examines why the quality of care delivered in U.S. skilled nursing facilities varies so widely, and whether this variation reflects differences in preferences or capabilities. Skilled nursing facilities -- commonly known as nursing homes -- serve more than one million Americans on any given day, with most care financed by public programs such as Medicare and Medicaid. Despite substantial oversight, care quality remains highly uneven, with many vulnerable patients exposed to ineffective providers. Understanding how facilities combine labor, capital, and organizational practices to produce care -- and why some achieve better outcomes than others -- is essential to informing debates about quality improvement, market regulation, and payment design. This project develops an innovative method using artificial intelligence to analyze large data sets, resulting in novel measures of patient health and facility quality. The team uses these measures to shed light on the economic forces that shape performance in this large and consequential industry. The investigators then estimate whether and how quality depends on nursing home productivity, preferences, capacity, ownership, and possible differential treatment of Medicare and Medicaid patients. The findings improve the evidence base for efforts to promote the health and welfare of older Americans.

The project develops and estimates models of quality and production in the nursing home sector to study questions related to

## Key facts

- **NSF award ID:** 2519966
- **Awardee organization:** National Bureau of Economic Research Inc (MA)
- **SAM.gov UEI:** GT28BRBA2Q49
- **PI:** Ashley Swanson
- **Primary program:** 01002526DB NSF RESEARCH & RELATED ACTIVIT
- **All programs:** Artificial Intelligence (AI)
- **Estimated total:** $557,504
- **Funds obligated:** $557,504
- **Transaction type:** Standard Grant
- **Period:** 09/01/2025 → 08/31/2028

## Primary source

NSF Award Search: https://www.nsf.gov/awardsearch/showAward?AWD_ID=2519966

## Citation

> US National Science Foundation, Award 2519966, The Measurement and Production of Quality in Long-Term Care Facilities in the US. Retrieved via AI Analytics 2026-06-06 from https://api.ai-analytics.org/grant/nsf/2519966. Licensed CC0.

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