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A 3 page summation and analysis on an August 2004 study performed by Grabowski and Angelelli on the relationship between Medicaid payments and nursing home care. No additional sources cited.
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3 pages (~225 words per page)
File: D0_khmedip.rtf
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priority that should be addressed, fiscal restraints now threatened to make the problem worse. A study by Grabowski and Angelelli (2004) has recently been published that examines the effect of
Medicaid reimbursement rates on the quality of care found at nursing homes. The relationship between inferior nursing care and Medicaid payment rates is of particular importance due to the fact
that two-thirds of all nursing home expenses are dependent on Medicaid payments. Grabowski and Angelelli (2004) employed a multivariate regression model in order to determine the effect of Medicaid payment
rates, as well as other explanatory variables, on risk-adjusted pressure ulcer incidence in nursing home residents. The principal concerns of this study was to determine (1) if Medicaid payment
rates could be positively associated with risk-adjusted nursing home quality; (2) if restricted bed supply affected the relationship between Medicaid payment and risk-adjusted nursing home quality; and (3) if payment
rates and bed constraint policies are more important to nursing homes that care for a high proportion of Medicaid recipients (Grabowski and Angelelli, 2004, p. 793). The researchers obtained
nursing home data from two different sources. Data pertaining to nursing home quality was taken from Minimum Data Set (MDS) assessments (Grabowski and Angelelli, 2004). MDS encompasses resident-level information
for all persons in Medicaid certified facilities within the US. This instrument entails over 350 different data elements ranging from socio-demographic data to a checklist for the staff to indicate
the most common geriatric diagnoses (Grabowski and Angelelli, 2004). These assessments are performed when a patient is admitted, but also whenever there is significant change, and are mandated to be
at least quarterly. For the purposes of their study, Grabowski and Angelelli evaluated MDS assessment from the third quarter of 1999 (2004). Information relating to nursing home facilities themselves
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