Nursing homes with a higher percentage of Medicaid-covered patients are usually found to provide fewer nursing hours. A study published in the Journal of the American Medical Directors Association discusses how Medicaid underpayments are directly related to staffing levels, regardless of a facility’s ownership status. John Bowblis, PhD, and Christopher S. Brunt, PhD, economists on the study, analyzed the 2023 Medicare Cost Reports and Payroll-Based Journal data. After examining 11,559 freestanding nursing homes, they found that facilities with fewer Medicaid-covered patients provided more resident care than those with a higher percentage, at 82%. The economists went on to point out that these staffing issues are due to “financial resource constraints,” as McKnight’s LTC News shares. As nursing staff levels decrease, Medicaid payer mix increases, and the same holds for registered nurses, licensed practical nurses, and nursing aides.
The study also found that, in terms of for-profit and nonprofit facilities, both spend a greater amount of revenue on nursing care; however, nonprofits are more likely to cut staffing more harshly when the Medicaid mix of patients increases. Researchers say that this is due to for-profits having lower staff levels and therefore are unable to cut staff below the state requirements. The underlying issues of the study highlight the need for the states and federal government to increase their funding for nursing homes to improve staffing, working conditions, and abilities. For the sake of these residents in nursing homes who deserve the best care possible, administrators and lawmakers need to fix the issues at hand. The researchers concluded that staffing issues in nursing homes cannot be separated from funding issues and must be addressed in consideration of all relevant factors.
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