Reinventing long-term care: the effect of policy changes on trends in nursing home reimbursement and resident characteristics--Florida, 1989-1997.

Abstract

This study investigated how changes in Medicare and Medicaid policies affected skilled nursing facility (SNF) revenue streams and resident characteristics in Florida during the 1990s. We used a series of ordinary least squares (OLS) regression models to analyze state-provided administrative data and Online Survey Certification and Reporting (OSCAR) data for all Florida SNFs. We found that Florida SNFs responded differently to the growing gap in reimbursement between Medicaid and other payers, depending on their profit status. As the reimbursement gap grew, for-profit SNFs maximized their revenues by admitting fewer Medicaid paying residents, whereas nonprofit facilities increased their percentage of Medicaid admissions. Changes in patterns of reimbursement altered the composition of Florida SNF residents in terms of age, physical status, length of stay, and place of discharge.