The Relationship of Nursing Home Medicaid Census to Nurses’ Assessments of Care Quality and Work Environment

Abstract

Medicaid is the largest payer of nursing home (NH) care in the U.S., yet there are long-standing concerns that Medicaid payments are insufficient to cover actual costs of care and contribute to poor care quality. Prior work has shown that low Medicaid reimbursement rates impair administrators’ abilities to employ sufficient nursing staff, but it is unclear how Medicaid funding may contribute to administrators’ abilities to ensure that other elements of safe nursing work environments are in place. In this study, we examined the relationship of nursing home (NH) Medicaid census to nurse ratings of care quality and work environment.