The child care industry in four major urban counties.
This article analyzes the child care industry in Tennessee and its four most populous counties: Davidson, Hamilton, Knox, and Shelby. The purpose is to document and describe the number and types of child care providers in each of these urban centers, which include Tennessee's four major cities: Nashville, Chattanooga, Knoxville, and Memphis, respectively. Also analyzed are data relating to the enrollment, revenues, and sources of revenues of child care operators who comprise this significant service industry. The article ends with an analysis of the quality of child care providers who participated in the State-sponsored quality rating survey and for whom quality data are available.
A quality child care system is crucial for the well-being of any society. During the first years of life, children learn the behaviors that can lead them to be intelligent and productive or, unfortunately, unmotivated and abject (Coffey, 2003). Research has also suggested that quality care can guide children, and therefore society, toward a more successful future (Newman et al., 2000). Children who have attended highly enriching child care, such as the Abecedarian Program and Perry Preschool, are more likely to be employed as adults (Masse & Barnett, 2002). They are also more educated, independent, and earn higher incomes while engaging in less criminal behavior than those who have not had the benefits of good early-childhood education (Schweinhart, 2003). These benefits save money in the long run, making child care a lucrative investment for society as a whole (Masse & Barnett, 2002; Oppenheim & Macgregor, 2002).
Less dramatic, but still important, are the immediate benefits of child care services to the economy. This industry generates numerous jobs, both by employing many people for its labor intensive work and by facilitating the employment of parents who are no longer forced to remain at home. Employers have also reported that offering child care services to their employees can cut costs by increasing recruitment while decreasing turnover and absenteeism, thereby boosting productivity (Rubin, 1998; Oregon, 1998). With so much at stake, careful study of the child care industry in each locality is vital. The economic and social welfare of society is endangered if children are not properly nurtured in their early years.
Child Care in Tennessee
Definition of Child Care. As defined by the State of Tennessee, child care is "the provision of supervision, protection and, at a minimum, the basic needs of at least five children, who are not related to the primary care givers, for three or more hours of the day, but less than twenty-four hours a day" (http://www.state.tn.us/humanserv/childcare.htm). The Tennessee Department of Human Services (TDHS) maintains an extensive database of child care providers, and this analysis uses a subset of the data from this database covering the period from June 1, 2003, through May 31, 2004.
Types of Providers. A child care provider may be either licensed or unlicensed in Tennessee. Licensed providers can be divided into four different types according to TDHS, the State agency that regulates child care:
1. Child Care Centers (or Centers) provide care for 13 or more children. The number and ages of children enrolled determine the number of adult staff needed. The Department of Human Services licenses over 2,400 centers, which care for over 190,000 children each day.
2. Family Child Care Homes (or Family Homes) provide care for at least five but not more than seven children. Children under 10 years of age, who are related to the care giver, must be included in the total number. Approximately 750 family homes are licensed by TDHS each year.
3. Group Child Care Homes (or Group Homes) provide care for at least 8 but not more than 12 children. Up to three additional school-age children may receive care before and after school, on school holidays and snow days, and during summer vacation. If the group home is in an occupied residence, children related to the care giver who are 10 years of age or older must be included in the total number. TDHS licenses over 600 group care homes each year.
4. Drop-In Centers provide care for 15 or more children, not to exceed 10 hours per week, and for not more than 6 hours per day for any individual child while parents or other custodians are engaged in short-term activities.
Providers may only operate without a license if they fall into an exempt category, as defined by the State, which includes summer day camps, Boys and Girls Clubs, and those that care for less than five children or operate for less than two days per week. Those smaller and informal providers are not regulated by the State unless they voluntarily register. Providers that are not exempt must be licensed by either TDHS or the Tennessee Department of Education and are subject to regulation.
Licensed and regulated child care providers report operational data to TDHS and undergo inspections to assure that the facilities are suitable for children. Data are not necessarily collected from the various unregulated providers. Some unregulated homes volunteer to be registered as "Registered Homes." Besides these self-reported data, State subsidy records are the only source of data on unregulated providers, limiting the scope of this article to only regulated providers that are licensed and unregulated providers that are subsidized.
Child Care Providers
Industry at a Glance. The data presented in Table 1 show that there are a total of 11,625 regulated and unregulated child care providers that receive State subsidies in Tennessee. Of this total, 5,337 (45 percent of total) are located in the four most populous counties, while the other 6,288 (54 percent of total), providers are located in the remainder of the State. Shelby County has 3,117 providers (26.8 percent of total), or more than the combined total of child care providers in the other three urban counties.
Table 1 also reveals that just over half (56 percent of total) of all child care providers in Tennessee are licensed. Among the four urban counties, the proportion of regulated providers tends to be higher, as best demonstrated in Davidson and Knox counties where nearly 70 percent of providers are licensed. Hamilton County, a slightly less urban county, is still above the State average with over 60 percent of its providers licensed. In Shelby County, the State's most populous county, the numbers are reversed; about 60 percent of the child care providers that receive subsidies in Shelby County are unlicensed and unregulated.
Industry by Provider Type. As defined above, the Tennessee Department of Human Services recognizes four types of regulated child care providers: Child Care Centers, Group Homes, Family Homes, and Drop-In Centers. Child Care Centers are the largest and most common type, generally caring for at least 13 children. These are often termed day cares, preschools, nursery schools, and the like. Three other types of regulated child care homes also exist: Group Homes, Family Homes, and Registered Homes. They differ primarily in size, caring for eight to twelve, five to seven, or less than five children, respectively. Group Homes and Family Homes are required to be licensed and regulated, while Registered Homes volunteer to be regulated in order to appear more credible (Vaulx, 2004). Relative to Centers, Group and Family Homes tend to be more informal, often operated by family or friends of parents during non-traditional hours (Annie, 2004). a related but less common type of provider is the Drop-In Center. Limited to only 15 children, these registered homes often provide short-term care for children of clients at businesses. Table 2 presents data on the four regulated types of child care providers and the unregulated homes in Tennessee and its four urban counties.
In Shelby County, over 70 percent of the providers are of the three types of smaller homes such as: Family Homes, Registered Homes, and Unregulated Homes. In contrast, the most prevalent type of provider in the other three urban counties is the larger Center, with the other three smaller types comprising only about 45 percent to 55 percent of all providers. Davidson County leads in the number of larger Centers, with Knox and Hamilton counties following closely behind.
Providers may also be grouped according to whether they are for-profit or non-profit and whether they are faith-based or not. These breakdowns are presented in Figures 1 and 2, respectively.
Comprising about three quarters of all providers, for-profit child care providers are clearly the most common throughout the State. Shelby County's for-profit providers comprise 80 percent of all its providers, while in the other three counties for-profits range from 70 percent to 77 percent. Faith-based child care is of limited presence in each of the four counties. Davidson County has the greatest proportion with 16 percent of providers connected to a church. In comparison, only 10 percent of providers in Shelby County are faith-based.
Child Care Enrollment. In Tennessee, over 290,000 children are enrolled in child care (Table 3). This means that approximately 29 percent of the over one million children aged 12 or under are in child care. When all providers are considered, the average enrollment size is about 25 pupils. The average size increases to 43 pupils per provider when unregulated child care is excluded.
Shelby County has over 77,000 children in child care or close to 27 percent of the State total. This level of enrollment, which is two to three times higher than that in the other three urban counties, suggests that child care is more prevalent in Shelby County than in other urban centers in the State. While it is true that Shelby County has more children under the age of 12, 42 percent of its children under 12 attend child care. In the other three urban counties that figure is only 37 percent. Shelby County differs from the rest of the State in another way--proportionately fewer of its children are in regulated child care. In Shelby County, about 94 percent of the children are in regulated child care, while in the other three urban counties about 98 percent of the children are.
Revenues and Subsidies. Between June 1, 2003, and May 31, 2004, the 11,625 child care providers in the State received more than $1.17 billion in total revenues from public and private sources (see Table 4).
In Tennessee, over 82 percent of the total revenues of child care providers came from private sources, such as payments by parents. The State subsidizes child care in two ways. It provides parents with direct subsidies to pay for the child care costs of eligible children, and it pays child care providers directly for providing good quality care. In the period June 1, 2003, through May 31, 2004, for example, State government paid $181 million in subsidies to parents and $19 million in bonuses to providers.
It is worth noting that the four major urban counties in the State received about 72 percent of the total subsidies for child care in the period from June 1, 2003, to May 31, 2004 (see Figure 3). This means that the rest of the State, though having 54 percent of the total providers, received the remaining 28 percent. Among the four urban counties, 47 percent of total State subsidies, or over $92 million, was distributed to providers in Shelby County. Davidson, Knox, and Hamilton counties received 13 percent, 6 percent, and 6 percent, respectively.
Table 5 provides more detailed information on the distribution of State subsidies among the four largest urban counties. Statewide, 73 percent of all child care providers were, to various extents, subsidized by the State. In Shelby County, 84 percent of the providers were subsidized for over $2,000 per child. The percentages of subsidized providers were lower in the other three counties, and the per-child amounts range from nearly $1,600 in Davidson County to only $900 in Knox County.
Public funding for child care in Tennessee is a mix of federal and State funds. For fiscal year 2004-05, for example, State planners have estimated that approximately $218 million will be provided for child care. Almost half the funding, or over $111 million, will be provided by the federal government through the Child Care and Development Fund, with the rest being a combination of primarily federal funds from the Temporary Assistance to Needy Families program and some State money (TDHS, 2004). Generally, somewhat over half of the enrollment in each county is subsidized. Davidson County is the exception with only 49 percent of its enrollment subsidized. For once, Shelby and Knox counties are close at 58 percent.
Child Care Quality. While a multitude of factors can influence the quality of child care, two indicators are commonly used: the child-to-staff ratio and the number of children per provider. In either case, a lower number is better because smaller child-to-staff ratios promote more staff interaction with children, and smaller enrollment size lessens the spread of communicable diseases (Fiene, 2000). The data on average enrollment and child-to-staff ratios are summarized in Table 6.
Quality, as measured by the number of children per provider and the child-to-employee ratio, varies substantially among the different types of providers across Tennessee. On average, for-profit providers have far fewer children per provider than not-for-profit ones, and their child-to-employee ratios are also much smaller--suggesting better quality. These two measures also tend to be better for unsubsidized providers than for those that are subsidized. Among the four urban counties, Shelby County's not-for-profit providers compare favorably with their counterparts in the other three urban counties. However, the same cannot be said about Shelby County's for-profit providers, who tend to have higher numbers of children per provider and higher child-to-provider ratios than the other three counties. Shelby County's unsubsidized providers have an average child-to-employee ratio of 8.6, while the other three counties are all between 7.2 and 7.3.
The Tennessee Department of Human Services incorporates a number of assessment metrics, including the two used above, into a statewide rating system known as the Star Quality Program. Depending on the result of an annual evaluation, providers can receive 1, 2, or 3 stars, with more stars signifying better quality. Among the evaluation criteria used by TDHS are the education, training, and experience of the director and staff, family involvement, and an onsite observation (University of Tennessee, 2004). The rating data are posted on the TDHS web site (http:// www.state.tn.us/humanserv/childcare.htm) and are also used to determine bonus payments to eligible providers to encourage quality improvement. The star rating data are summarized in Table 7.
Statewide, almost 25 percent of the providers received the highest rating of 3 stars during the period from July 1, 2003, to May 31, 2004, with subsidized providers having a slightly higher percentage earning this distinction than did unsubsidized providers. Shelby County has the lowest percentage of providers with 3 stars and the highest percentage of providers that earned no stars. Unsubsidized providers in Knox County are an exception in this case, as more of them failed to earn any stars than did providers in any of the other three counties, a fact that agrees with its high average enrollment number.
Discussion and Conclusion
This article has provided a description of the child care industry in Tennessee and its four major urban counties using data provided by the Tennessee Department of Human Services. It analyzed the size of enrollment in the different types of child care establishments and the sources of their revenues. It also reported the quality of child care based on available information. A number of observations emerge from the analysis.
Shelby County is by far the largest county in the State, and it should be no surprise that it has the most providers. At over 3,000 providers, however, there are far more providers per capita and per child than in the other urban counties. This concentration of supply is due, in part, to the existence of nearly 1,900 unregulated child care providers, which is more than six times as many as in the next largest county, Davidson.
It is possible that the large number of child care providers in Shelby County may simply be the result of economics and demographics--that there are more people in Shelby County who are likely to work during nights or weekends, times when most regulated child care providers are closed. African-Americans and single mothers often work these non-traditional shifts (Presser, 2004). For many, the only choice is unregulated care.
A consequence of having a large number of unregulated providers is that the children served may be at a disadvantage when compared to children in regulated providers, which are held to a higher standard of quality. A closer examination of unregulated homes might determine if it is advisable to shift children into registered care, possibly by encouraging more providers to operate during nights and weekends or by restarting Shelby County's now defunct registered home program. Efforts might also be focused on improving the quality of licensed providers. Urban counties such as Shelby and Davidson are suffering from problems, such as low educational attainment, poverty, and crime, that high quality child care is most effective at remedying (Census, 2000; Morgan Quitno, 2003).
It might also be fruitful to assess why various types of providers are good in one county and not in another. For example, what are the factors that cause the not-for-profit providers in Shelby to have good quality ratios and average enrollment numbers in comparison to the other counties? Unlike for-profit providers in other urban counties, for-profit providers in Shelby County appear to be worse and little is known about the reason. Also of interest is the relationship between the excellent Star ratings of Knox County and its often poor child-to-staff ratios and average enrollment. Providers in Knox County may have better characteristics and/or practices that allow them to give children excellent care despite being somewhat short on staff or having a large number of children at each provider. If these questions are answered, the resultant information might help providers in other areas increase their quality of care while economizing the use of resources.
For more information on this article contact Dr. Cyril Chang at (901) 678-3565.
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Rubin, Robert E. 1998. "Investing in Child Care: Challenges Facing Working Parents and the Private Sector Responses." U.S. Department of the Treasury. Retrieved from http://www.treas.gov/press/releases/report3110.htm/
Schweinhart, Lawrence J. 1993. "High-Quality Preschool Program Found to Improve Adult Status." High/ Scope Educational Research Foundation. Retrieved from http://www.highscope.org/Research/PerryProject/PerryAge40SumWeb.pdf/
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Snoderly, Joan M. 2002. "Determing Child Care Market Rates in the State of Tennessee." Retrieved from http://www.state.tn.us/humanserv/ccp3C.pdf/
Tennessee Department of Human Services. "Child Care Services." Retrieved from http://www.state.tn.us/ humanserv/childcare.htm/
--. "Child Care and Development Fund Plan for Tennessee, FY 2004-2005." Retrieved from http://www.state.tn.us/humanserv/childcare-plan. pdf/
University of Tennessee, College of Social Work. 2004. "The Tennessee Star-Quality Child Care Program." Retrieved from http://www.tnstarquality.org/html/ star-quality.htm/
Vaulx, Angeline, Child Care Program Evaluator. Telephone Interview. 6 July 2004.
Cyril F. Chang, Ph.D., Professor of Economics and Director of the Methodist LeBonheur Center for Healthcare Economics, Folgelman College of Business and Economics, The University of Memphis; Dennis R. Wilson, Ph.D., Sparks Bureau of Business and Economic Research, Folgelman College of Business and Economics, The University of Memphis; and Kyle I. Carlson, Folgelman College of Business and Economics, The University of Memphis
Figure 1. Child Care Providers in Tennessee and Its Four Major Urban Counties, By Ownership Type, June 1, 2003-May 31, 2004 For-Profit Not-for-Profit Knox (Knoxville) 76.8% 23.2% Hamilton (Chattanooga) 74.2% 25.8% Davidson (Nashville) 69.9% 30.1% Shelby (Memphis) 79.8% 20.2% Tennessee 76.8% 23.2% Note: Table made from bar graph. Figure 2. Faith-Based Versus Non-Faith-Based Child Care Providers in Tennessee and Its Four Major Urban Counties, June 1, 2003-May 31, 2004 Faith-Based Non-Faith-Based Knox (Knoxville) 12.3% 87.7% Hamilton (Chattanooga) 10.5% 89.5% Davidson (Nashville) 16.2% 83.8% Shelby (Memphis) 10.0% 90.0% Tennessee 9.5% 90.5% Note: Table made from bar graph. Figure 3. Total Child Care Subsidy Payments in Tennessee and Its Four Major Urban Counties, June 1, 2003-May 31, 2004 Rest of the State $56,623,301 28.0% Knox (Knoxville) $12,655,906 6.0% Hamilton (Chattanooga) $12,626,240 6.0% Davidson (Nashville) $26,028,554 13.0% Shelby (Memphis) $92,384,930 47.0% Note: Table made from pie chart. Table 1. Number of Child Care Providers in Tennessee and Its Four Major Urban Countries, 2004 Shelby Davidson Tennessee (Memphis) (Nasville) Number of Providers 11,625 3,117 956 % of Tennessee 100.0% 26.8% 8.2% Licensed 6,508 1,244 655 % of Tennessee 56.0% 39.9% 68.5% Unregulated 5,117 1,873 301 % of Tennessee 44.0% 60.1% 31.5% Hamilton Knox (Chattanooga) (Knoxville) Number of Providers 655 609 % of Tennessee 5.6% 5.2% Licensed 411 420 % of Tennessee 62.7% 69.0% Unregulated 244 189 % of Tennessee 37.3% 31.0% Table 2. Child Care Providers in Tennessee and Its Four Major Urban Counties, by Provider Type, 2004 Shelby Davidson Tennessee (Memphis) (Nashville) Centers 3,904 874 409 % of Tennessee 33.6% 28.0% 42.8% Family Homes 1,003 321 23 % of Tennessee 8.6% 10.3% 2.4% Group Homes 814 10 118 % of Tennessee 7.0% 0.3% 12.3% Registered Homes 787 39 105 % of Tennessee 6.8% 1.3% 11.0% Homes (Unregulated) 5,117 1,873 301 % of Tennessee 44.0% 60.1% 31.5% Total 11,625 3,117 956 % of Tennessee 100.0% 100.0% 100.0% Hamilton Knox (Chattanooga) (Knoxville) Centers 218 232 % of Tennessee 33.3% 38.1% Family Homes 59 56 % of Tennessee 9.0% 9.2% Group Homes 47 35 % of Tennessee 7.2% 5.7% Registered Homes 87 97 % of Tennessee 13.3% 15.9% Homes (Unregulated) 244 189 % of Tennessee 37.3% 31.0% Total 655 609 % of Tennessee 100.0% 100.0% Table 3. Analysis of Child Care Enrollment in Tennessee and Its Four Major Urban Counties, June 1, 2003-May 31, 2004 Shelby Davidson Tennessee (Memphis) (Nashville) Total Enrollment 290,858 77,085 34,368 % of Tennessee 100.0% 26.5% 11.8% Total Providers 11,625 3,117 956 % of Tennessee 100.0% 26.8% 8.2% Average Enrollment Per Provider 25 25 36 Youths (12 or Younger) 1,010,580 185,354 93,891 % of Tennessee 100.0% 18.3% 9.3% Providers Per 1,000 Youths 11.5 16.8 10.2 Percent of Youths (12 Or Younger) Enrolled 28.8% 41.6% 36.6% Enrollment at Regulated Providers 279,770 72,712 33,696 % of Total Enrollment 96.2% 94.3% 98.0% Average Enrollment Per Regulated Provider 43 58 51 Hamilton Knox (Chattanooga) (Knoxville) Total Enrollment 19,044 23,839 % of Tennessee 6.5% 820.0% Total Providers 655 609 % of Tennessee 5.6% 5.2% Average Enrollment Per Provider 29 39 Youths (12 or Younger) 51,199 61,802 % of Tennessee 5.1% 6.1% Providers Per 1,000 Youths 12.8 9.9 Percent of Youths (12 Or Younger) Enrolled 37.2% 38.6% Enrollment at Regulated Providers 18,543 23,418 % of Total Enrollment 97.4% 98.2% Average Enrollment Per Regulated Provider 45 56 Table 4. Revenues of All Subsidized Child Care Providers in Tennessee and Its Four Major Urban Counties, June 1, 2003-May 31, 2004 Shelby Davidson Tennessee (Memphis) (Nashville) Subsidized Enrollment State Subsidies $ 181,324,038 $ 84,335,159 $ 23,347,510 Co-Payments from $ 10,562,411 $ 3,446,743 $ 1,174,795 Parents Bonus Payments from the State $ 18,994,893 $ 8,049,771 $ 2,681,044 Revenue-Subsidized Enrollment $ 210,881,342 $ 95,831,673 $ 27,203,349 Revenue-Unsubsidized Enrollment $ 960,572,028 $217,085,569 $115,811,489 Total Revenues $1,171,453,370 $312,917,242 $143,014,838 Hamilton Knox (Chattanooga) (Knoxville) Subsidized Enrollment State Subsidies $11,453,069 $11,219,569 Co-Payments from $ 505,287 $ 777,534 Parents Bonus Payments from the State $ 1,173,171 $ 1,436,337 Revenue-Subsidized Enrollment $ 1,313,152 $13,433,440 Revenue-Unsubsidized Enrollment $64,674,726 $84,188,648 Total Revenues $77,806,253 $97,622,088 Table 5. Subsidies to Regulated and Unregulated Child Care Providers in Tennessee and Its Four Major Urban Counties, June 1, 2003-May 31, 2004 Shelby Davidson Tennessee (Memphis) (Nashville) All Providers 11,625 3,117 956 Subsidized Providers 8,536 2,628 638 % of Providers Subsidized 73.4% 84.3% 66.7% Total Subsidized and Unsubsidized Enrollment 290,858 77,085 34,368 Total Subsidized Enrollment 167,222 45,050 16,708 % of Enrollment Subsidized 57.5% 58.4% 48.6% Total Subsidies Including Bonus Payments $200,318,931 $92,384,930 $26,028,554 Total Co-Payments $ 10,562,411 $ 3,446,743 $ 1,174,795 Total Receipts from Subsidized Enrollment $210,881,342 $95,831,673 $27,203,349 Subsidy Per Provider $ 23,468 $ 35,154 $ 40,797 Subsidy Per Subsidized Child $ 1,198 $ 2,051 $ 1,558 Co-Payment Per Subsidized Child $63 $77 $70 Co-Payments (Subsidized) and Co-Payments 5.0% 3.6% 4.3% Hamilton Knox (Chattanooga) (Knoxville) All Providers 655 609 Subsidized Providers 497 472 % of Providers Subsidized 75.9% 77.5% Total Subsidized and Unsubsidized Enrollment 19,044 23,839 Total Subsidized Enrollment 12,198 14,026 % of Enrollment Subsidized 64.1% 58.8% Total Subsidies Including Bonus Payments $12,626,240 $12,655,906 Total Co-Payments $ 505,287 $ 777,534 Total Receipts from Subsidized Enrollment $13,131,527 $13,433,440 Subsidy Per Provider $ 25,405 $ 26,813 Subsidy Per Subsidized Child $ 1,035 $ 902 Co-Payment Per Subsidized Child $ 41 $ 55 Co-Payments (Subsidized) and Co-Payments 3.8% 5.8% Table 6. Quality of Child Care Providers in Tennessee and Its Four Major Urban Counties Shelby Davidson Tennessee (Memphis) (Nashville) Average Number of Children Per Licensed Provider Not-for-Profit 66.9 76.5 81.2 For-Profit 26.0 39.9 27.6 Subsidized 43.8 52.0 45.3 Unsubsidized 42.0 69.5 58.7 Average Children-to- Employee Ratio Not-for-Profit 11.2 8.8 8.1 For-Profit 6.7 7.4 6.0 Subsidized 8.3 8.0 7.4 Unsubsidized 7.4 8.6 7.2 Hamilton Knox (Chattanooga) (Knoxville) Average Number of Children Per Licensed Provider Not-for-Profit 81.1 110.6 For-Profit 20.0 28.0 Subsidized 45.7 47.1 Unsubsidized 44.2 74.9 Average Children-to- Employee Ratio Not-for-Profit 9.5 9.6 For-Profit 6.1 6.9 Subsidized 9.0 9.6 Unsubsidized 7.3 7.3 Table 7. Star Ratings of Licensed Child Care Providers in Tennessee and Its Four Major Urban Counties Shelby Davidson Hamilton Tennessee (Memphis) (Nashville) (Chattanooga) All Providers 0 Stars 12.8% 17.0% 11.8% 8.8% 1 Star 1.8% 1.3% 2.3% 2.2% 2 Stars 13.5% 13.1% 15.0% 13.1% 3 Stars 24.9% 22.4% 28.4% 24.6% Not Eligible 3.0% 4.1% 0.9% 4.6% Not Evaluated 44.0% 42.0% 41.7% 46.7% Total 100.0% 100.0% 100.0% 100.0% Subsidized 0 Stars 16.4% 22.1% 15.3% 11.7% 1 Star 2.1% 1.5% 2.8% 2.3% 2 Stars 16.7% 16.6% 17.8% 16.4% 3 Stars 26.3% 27.1% 30.8% 27.7% Not Eligible 3.8% 5.9% 1.1% 5.5% Not Evaluated 34.6% 26.8% 32.2% 36.3% Total 100.0% 100.0% 100.0% 100.0% Unsubsidized 0 Stars 8.5% 8.5% 7.6% 3.9% 1 Star 1.4% 0.9% 1.7% 1.9% 2 Stars 9.7% 7.2% 11.6% 7.7% 3 Stars 23.2% 14.5% 25.6% 19.4% Not Eligible 2.0% 1.1% 0.7% 3.2% Not Evaluated 55.3% 67.9% 52.8% 63.9% Total 100.0% 100.0% 100.0% 100.0% Knox (Knoxville) All Providers 0 Stars 12.6% 1 Star 0.2% 2 Stars 12.1% 3 Stars 31.2% Not Eligible 0.0% Not Evaluated 43.8% Total 100.0% Subsidized 0 Stars 13.5% 1 Star 0.3% 2 Stars 10.4% 3 Stars 32.2% Not Eligible 0.0% Not Evaluated 43.9% Total 100.3% Unsubsidized 0 Stars 10.7% 1 Star 0.8% 2 Stars 16.0% 3 Stars 29.0% Not Eligible 0.0% Not Evaluated 43.5% Total 100.0%
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|Author:||Chang, Cyril F.; Wilson, Dennis R.; Carlson, Kyle I.|
|Date:||Jun 22, 2005|
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