Quality of Mandatory Data Reporting by US Nursing Homes during the COVID-19 Pandemic: The Role of For-Profit Ownership

Abstract

Organizations often respond to external pressures with decoupling, appearing to conform to new institutional demands without substantially changing their behavior. Within the decoupling literature, little attention has been paid to decoupling in response to formal pressures, including policy changes. To help fill this gap, I introduce the concept of symbolic disclosure, whereby organizations respond to mandatory reporting requirements by disclosing complete but inaccurate data. I adapt different dimensions of data quality to assess disclosure quality and theorize how profit-orientation might interact with the different incentives to comply with mandatory disclosure requirements. I then test these hypotheses in the COVID- 19 nursing home empirical context using regression analysis. I find that compliance with mandatory disclosure requirements is generally high, but that for-profit facilities are more likely to submit complete but inaccurate data compared to their not for-profit counterparts. These results suggest that for-profit nursing homes may be practicing symbolic disclosure in this context. There are multiple different dimensions of data quality — namely timeliness, completeness and accuracy — and it is important to incentivize all of them to reduce the risk of symbolic disclosure.