BACKGROUND

"Why Do Not-for-Profit Hospitals Change Ownership?"
Federation of American Health SystemsMay 1998

Article - General statistics, conversions tend to still meet community needs.

"Consolidation in a Climate That Doesn't Favor For-Profit Conversion"
Health Care Strategic ManagementJune 1997

Article - $$. Standardization, equity capital, community interests, examples.

The Investor-Owned Hospital Movement in North Carolina "Issuance of Bonds as a Capital Fundraising Tool for Hospitals." - L. Maddox
Chapter - Increased funds with longer payback time that don't put the community at risk.
The Investor-Owned Hospital Movement in North Carolina "Factors Affecting the Changeover to Investor Ownership." - J. McCullough & W. Haflett
Chapter 3 - Aging facilities, lack of capital, reducing length of stay, increased government regulation, competition have been major motivations for conversion in NC.
Aspen Institute & Federation of American Health Systems
"Analysis of the Rationale for, and Consequences of, Nonprofit and For-Profit Ownership Conversions."
Article - Motivations and disinclinations for conversion.
Health Affairs "Investing in the 21st Century Hospital."
Health Affairs "Motivations for Hospital Conversions."
Article - It comes down to money.

CHARACTERISTICS OF CONVERTING HOSPITALS

Journal of Health & Social Behavior "Determinants of Profound Organizational Change: Choice of Conversion or Closure Among Rural Hospitals.
Article - Conversion as a result of market resources, high competition, and established alternative care strategies.
Medical Care "Rural Hospital Closures. Determinants of Conversion to an Alternative Health Care Facility."
Article - Conversion to alternative care occurs with healthy economy, lack of substitute care, and non-government ownership.
Agency for Health Care Policy and Research "Hospital Mergers Are Driven Primarily By Local Merger Opportunities"
Report - Hospitals more likely to merger if market overlap is significant.