Increasing Medicare days in nursing homes promotes long-stay resident health

RESEARCH TRIANGLE PARK, NC— Health quality outcomes of long-stay nursing home residents can improve significantly by increasing the amount of Medicare-covered patient days in nursing homes, according to a new study by researchers at RTI International and the University of Southern California, Los Angeles. 

The study, published in Health Affairs, found that more Medicare-covered patient days in a nursing home was associated with a decrease in daily pain among long-stay residents, a reduced percentage of long-stay residents who experienced worsening pressure ulcers, and improving performance in daily life activities among long-stay residents.

"Maintaining a supply of high-quality nursing homes is necessary to meet national health care demands," said Michael Lepore, Ph.D., senior health policy and health services researcher at RTI. "Our findings reinforce the argument that financial investment in nursing homes, such as increases in Medicaid payment rates, may be key to improving quality for long-stay residents."

Researchers examined data from approximately 12,000 nursing homes nationwide from 2007 to 2010. During this time period, the amount of days covered by Medicare increased from 14.84 to 16.83 days among these nursing homes. 

As Medicare-covered days increased, the study found that health outcomes significantly improved among long-stay residents who had been in a nursing home for longer than 100 days. The percentage of long-stay residents with daily pain decreased from approximately 5 percent to 3.38 percent. An increase in Medicare-covered days was also associated with a decline in residents experiencing worsening pressure ulcers, as well as an improvement in performing daily life activities. 

The study also found that having more registered nurse hours per resident was correlated with significant improvements in health outcomes. 

"These findings reflect those of previous research showing that overall quality is better in nursing homes with greater financial resources," Lepore said. "Our findings support the argument that greater financial investments, particularly those that afford nursing homes more registered nurse hours, would help improve nursing home quality."