Abstract
The New York Quality Assurance System (NYQAS) was designed to assure high-quality nursing home care in New York. Among its many incentives, NYQAS may change the likelihood that elderly with heavy-care needs will be admitted to nursing homes. This article addresses that hypothesis. Data for descriptive and multivariate analyses come from the RUGs-II Patient Review Instrument and the Medicare and Medicaid Automated Certification System files for 1986-1990. The descriptive analyses focus on functional ability in new nursing home residents before and after NYQAS. The multivariate analyses adjust for pre-NYQAS, RUGs-related trends in casemix, resident demographics, and nursing home characteristics that influence casemix. The results suggest a significant but small decrease in functional status at admission during the post-NYQAS era.
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