Boerstler H, Carlough T, Schlenker R E
University of Colorado, Denver.
J Health Polit Policy Law. 1991 Fall;16(3):553-72. doi: 10.1215/03616878-16-3-553.
The way in which states reimburse for nursing home capital costs can create incentives for nursing home owners to use the home primarily as a vehicle for real estate speculation, with potentially adverse consequences for patient care. In order to help promote and control the stability, adequacy, and quality of capital investment in long-term care, an increasing number of states are using a fair-rental approach for calculating capital reimbursement. In this article we compare the fair-rental approach with traditional cost-based capital reimbursement in terms of administration and policy. We discuss issues of concern to the state (cost and reimbursement design options) and the investor (after-tax cash flows, rate of return, etc.). Our analysis suggests that fair-rental systems may be superior to traditional cost-based reimbursement in promoting and controlling industry stability, while at the same time providing an adequate return to investors, without incurring long-term increases in the costs of administering programs.
各州偿还疗养院资本成本的方式可能会促使疗养院所有者主要将疗养院用作房地产投机的工具，这可能会对患者护理产生不利影响。为了帮助促进和控制长期护理资本投资的稳定性、充足性和质量，越来越多的州正在采用公平租金法来计算资本偿还。在本文中，我们从管理和政策方面将公平租金法与传统的基于成本的资本偿还进行了比较。我们讨论了州（成本和偿还设计选项）和投资者（税后现金流、回报率等）关注的问题。我们的分析表明，公平租金制度在促进和控制行业稳定性方面可能优于传统的基于成本的偿还方式，同时为投资者提供足够的回报，且不会导致项目管理成本的长期增加。
