Two studies of Missouri nursing homes - a random sample of facilities and a larger, statewide analysis - suggest that high-quality LTC actually costs less than poor-quality LTC. The researchers found that larger nursing homes, in particular, can realize cost savings from quality-improvement endeavors.
Rantz, M., Hicks, L., Petroski, G.F., Madsen, R.W., Conn, V., Zwygart-Stauffacher, M., & Maas, M. (2003). High-quality nursing home care is more cost effective than low-quality care. Long-Term Care Interface, 4(9): 18-20.