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This quantitative study investigates the effect of certificate-of-need (CON) regulation on the quality of care in the nursing home industry. It uses county-level demographic data from the 48 contiguous US states that are extracted from the American Community Survey (ACS) and cover the years 2012, 2013, and 2014. In doing so, it employs a new set of service quality variables captured from a variety of county-level data sources. Instrumental variables results indicate that health survey scores for nursing homes that are computed by healthcare professionals are about 18–24% lower, depending on the type of nursing home under consideration, in states with CON regulation. We also find that the presence of CON regulation leads to a substitution of lower-quality certified nursing assistant care for higher-quality licensed practical nurse care, regardless of the type of nursing home under consideration.

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Purpose This study aims to investigate the effect of risk tolerance on the individual choice of adopting Bitcoin in the form of making and receiving payment and receiving compensation. Design/methodology/approach The study uses data collected from an anonymous survey of 225 undergraduate and graduate students to measure their risk attitude using the general risk-taking propensity scale proposed by Zhang et al. (2018) and the risk-taking index, proposed by Nicholson et al. (2018). After controlling for a variety of personal traits, the study uses logistic regression to identify the predicted probabilities and marginal effects on individual choice of adopting Bitcoin. Findings The findings of this study suggest that individuals with a higher risk-seeking attitude are more likely to choose to receive payment for goods they sell in Bitcoin and more likely to choose to receive a portion of their compensation in cryptocurrency. Individuals in the higher-income groups are more likely to adopt Bitcoin 46% and 65% than their lower 14% and 45% and middle income 4% and 18% counterparts. While there was no statistically significant difference between males and females in adopting Bitcoin, respondents between the age of 26 and 29 were more likely to adopt Bitcoin. The effect on receiving gold was slightly smaller but highly comparable to that of receiving Bitcoin, which highlights a similar perception of risk toward the Bitcoin and gold. Originality/value The study uses a new data set collected by surveying 225 individuals and two different risk measurements to identify the relationship between perceived risk and Bitcoin adoption.