Predictors of Low-Care Prevalence in Florida Nursing Homes: The Role of Medicaid Waiver Programs
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| Title: | Predictors of Low-Care Prevalence in Florida Nursing Homes: The Role of Medicaid Waiver Programs |
|---|---|
| Language: | English |
| Authors: | Hahn, Elizabeth A., Thomas, Kali S., Hyer, Kathryn, Andel, Ross, Meng, Hongdao |
| Source: | Gerontologist. Aug 2011 51(4):495-503. |
| Availability: | Oxford University Press. Great Clarendon Street, Oxford, OX2 6DP, UK. Tel: +44-1865-353907; Fax: +44-1865-353485; e-mail: jnls.cust.serv@oxfordjournals.org; Web site: http://gerontologist.oxfordjournals.org |
| Peer Reviewed: | Y |
| Page Count: | 9 |
| Publication Date: | 2011 |
| Document Type: | Journal Articles Reports - Research |
| Descriptors: | Incidence, Nursing Homes, Expenditures, Counties, Predictor Variables, Role, Health Insurance, Community Services, Case Studies, Daily Living Skills, Classification, Health Services |
| Geographic Terms: | Florida |
| DOI: | 10.1093/geront/gnr020 |
| ISSN: | 0016-9013 |
| Abstract: | Purpose of the study: To examine the relationship between county-level Medicaid home- and community-based service (HCBS) waiver expenditures and the prevalence of low-care residents in Florida nursing homes (NHs). Design and Methods: The present study used a cross-sectional design. We combined two data sources: NH facility-level data (including characteristics of the facility and its residents) and county-level market characteristics (including HCBS waiver expenditures) for 653 Florida NHs in 2007. Low-care was defined as residents who require no physical assistance in any of the 4 late-loss activities of daily living (bed mobility, toileting, transferring, and eating). We estimated a 2-level hierarchical linear model (HLM) to examine the relationship between Medicaid HCBS waiver expenditures and the prevalence of low-care residents while accounting for resident assessment, facility-, and county-level covariates. Results: All Florida counties offered 2 statewide waivers, and 33 counties offered one or more of the 4 regional Medicaid HCBS waivers in 2007. Per-month beneficiary expenditures ranged from $755 to $1,778. The average Florida NH had 120 beds, and 8.0% of its residents were classified as low-care. Results from the HLM model showed that a $10,000 increase in per-enrollee HCBS waiver expenditures was associated with a 3.5 percentage point reduction in low-care resident prevalence (p = 0.03). Implications: The findings suggest that Medicaid HCBS waiver programs may reduce the prevalence of low-care residents in NHs. Future studies should evaluate whether Medicaid HCBS waiver programs are effective in promoting community-living among low-care residents and mitigating the growth in long-term care expenditures. |
| Abstractor: | As Provided |
| Entry Date: | 2011 |
| Accession Number: | EJ934519 |
| Database: | ERIC |
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