Nursing homes
Study links low Medicaid pay to gaps in nursing home staffing and care
Researchers studying nearly a million long-stay residents found that homes serving more residents of color had fewer registered nurses and more serious bedsores, and that the gaps narrowed where Medicaid paid more.
Key facts
- The study covered about 9,500 nursing homes.
- Staffing gaps narrowed where Medicaid paid more.
- States paid about 82 cents per dollar of cost in earlier research.
What happened
Researchers from Miami University in Ohio and the University of Massachusetts Boston presented new findings at the LeadingAge annual meeting this week, McKnight's Long-Term Care News reported on October 29. They looked at nearly 1 million long-stay residents in about 9,500 nursing homes.
Homes serving more Black, Indigenous and other residents of color had a higher rate of serious pressure injuries, about 1.7 percentage points before adjustment, and fewer registered nurse hours, a gap that held up after the researchers accounted for other factors. They did not find a clear link to falls, pain or antipsychotic use. The differences shrank in homes where Medicaid payment was higher.
Earlier work by the same team found states paid nursing homes about 82 cents for every dollar of cost to care for Medicaid residents, and 92% of homes were paid less than their estimated costs.
What it means for families
Medicaid pays for about two of every three long-stay nursing home residents, so how much a state pays can shape staffing levels families see on the floor.
Registered nurse hours are a common measure of how closely residents are watched.
Payment is one factor among many in any single home's quality.
The researchers said higher payment categories showed smaller disparities, which suggests funding levels, not only individual homes, help explain the gaps.
New York sets its own Medicaid nursing home rates. Families can compare staffing for local homes on Medicare's Care Compare website.
What to do this week
- Check registered nurse hours for any home you are considering on Care Compare.
- Ask a home how many nurses work nights and weekends.
- Visit at different times of day.
Sources
More from Nursing homes
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