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Health Serv Res. 1977 Winter; 12(4): 396–406.
PMCID: PMC1072013

A model for certification of need for long-term-care beds.


A model relating bed supply and utilization is presented in the context of the match between need and service, which is controlled by the screening process that allows or denies access to beds. The conventional cost-minimization approach to certification of need, that of seeking to reduce inappropriate use, is contrasted with a service-delivery approach that seeks to promote appropriate use of facilities. The model expresses the quality of the screening process and the sensitivity and specificity of utilization in terms of bed supply, utilization, and need for service, which allows it to be used for needs assessment. The model is applied to data on supply and use of beds in Massachusetts skilled nursing facilities, with screening quality estimated by Monte Carlo methods; the results suggest that need and bed supply are positively associated and that the regional variation in skilled-nursing beds in Massachusetts may reflect real variations in need.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Willemain TR, Farber ME. Nursing homes and the Roemer-Feldstein hypothesis. Med Care. 1976 Oct;14(10):880–883. [PubMed]
  • Zimmer JG. Characteristics of patients and care provided in health-related and skilled nursing facilities. Med Care. 1975 Dec;13(12):992–1010. [PubMed]

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