Wage Determination of Registered Nurses in Proprietary and Nonprofit Nursing Homes

Abstract

This study explores why registered nurses employed in nonprofit nursing homes earn higher wages than those employed in proprietary facilities. Previous studies have explained this finding in a property rights context, where higher wages were posited to result from the weaker incentives for cost minimization accompanying nonprofit status. This paper tests an alternative explanation of sectoral wage differences which is predicated on the reason for the coexistence of for-profit and nonprofit firms in a given industry. Informational constraints concerning the quality of care are posited to cause the long-term health care market to fail to provide care at the upper levels of a quality of care continuum. Nonprofits are viewed as a response to this form of market failure, acting to fulfill customers demand for higher quality (and higher cost) long-term care, with attendant demand for higher quality nurses than in for-profit homes. Both the observed sectoral pattern in selectivity, and wage decompositions based on selectivity corrected wage regressions, call into question the property right explanation yet are consistent with an asymmetric information explanation.