No Positive Effect Finally, the study also found that neither extensive regulation nor licensure had a positive effect on some aspects of quality, including a requirement for preservice training of staff and staff knowledge of care and monitoring as well as medication management. Further, there was little variation among homes on such issues as unmet health care needs, residents' rights, and indicators of resident satisfaction. No association was detected. Comparison between homes in States with extensive regulatory systems and homes in States with limited systems. Comparison is between licensed and unlicensed homes.
Effect varies by whether the home is licensed or unlicensed.
Effect varies by whether the home is in a State with limited or extensive regulation. Effect varies by size of home. These findings and their implications for public policy are discussed in detail in the sections that follow.