Shareholder Value and the Performance of a Large Nursing Home Chain

OBJECTIVE: To analyze corporate governance arrangements and quality and financial performance outcomes among large multi-facility nursing home corporations (chains) that pursue stakeholder value (profit maximization) strategies. STUDY DESIGN: To establish a foundation of knowledge about the focal phenomenon and processes, we conducted an historical (1993-2005) case study of one of the largest chains (Sun Healthcare Inc.) that triangulated qualitative and quantitative data sources. DATA SOURCES: Two main sets of information were compared: (1) corporate sources including Sun's Security Exchange Commission (SEC) Form 10-K annual reports, industry financial reports, and the business press; and (2) external sources including, legal documents, press reports, and publicly available California facility cost reports and quality data. PRINCIPAL FINDINGS: Shareholder value was pursued at Sun through three inter-linked strategies: (1) rapid growth through debt-financed mergers; (2) labor cost constraint through low nurse staffing levels; and (3) a model of corporate governance that views sanctions for fraud and poor quality as a cost of business. CONCLUSIONS: Study findings and evidence from other large nursing home chains underscore calls from the Institute of Medicine and other bodies for extended oversight of the corporate governance and performance of large nursing home chains

The Effects of Integrated Pollution Prevention and Control (IPPC) Regulation on Company Management and Competitiveness

In the literature there are several studies about the effects of environmental policies and regulations on the management and competitiveness of businesses. Some of these studies focus on the Integrated Pollution Prevention and Control (IPPC) Directive, but only a few investigate the effects of IPPC permits in depth. This paper aims to bridge this gap by illustrating the results of cross-country empirical research. We analyse 225 IPPC permits of companies located in seven European regions and issued by different competent authorities. Results show differences in terms of requirements, emission limit values and monitoring frequencies, which are not always justifiable by the flexibility afforded by the Directive. These differences have different impacts on the competitive strategies and environmental management of companies within the same sector but located in different countries. We explore how some differences could influence company costs, contributing to the literature debate about the effects of direct regulation on competitiveness