Medicaid-Financed Institutional Services: Characteristics of Nursing Home and ICF/IID Residents and Their Patterns of Care. Appendix D. Supplementary Data Tables

08/01/2013

TABLE D.1. Length of First New Nursing Home Spells Among Aged or Disabled Medicaid Enrollees with new Medicaid-Financed Nursing Home Spells Between July 2006 and December 2006, by State
  Number of Enrollees with
  New Nursing Home Spells  
Distribution of Length of First Spell
(percentage)
  Less Than  
3 Months
  3-6 Months     6-9 Months     9-12 Months     More Than  
12 Months
All States 243,912 34.1 12.8 7.4 5.1 40.6
Alabama 3,709 29.2 12.5 5.9 4.8 47.7
Alaska 328 67.4 b b b b
Arkansas 2,675 24.1 12.8 7.9 5.7 49.5
California 24,215 47.4 12.6 6.1 3.8 30.1
Colorado 2,579 27.5 12.9 8.5 6.3 44.8
Connecticut 5,091 38.3 11.2 6.2 4.3 40.0
Delaware 574 27.7 11.3 6.6 4.5 49.8
District of Columbia   576 36.3 7.6 7.3 6.4 42.4
Florida 15,218 39.1 14.1 7.6 5.3 33.9
Georgiaa 5,954 22.6 13.3 8.0 6.0 50.0
Hawaii 777 45.3 11.2 4.2 3.9 35.4
Idaho 860 34.4 13.3 7.3 5.7 39.3
Illinois 13,388 30.9 15.1 8.7 5.6 39.7
Iowa 2,887 26.4 11.2 7.6 5.6 49.3
Kansas 2,583 24.0 12.8 8.4 6.2 48.7
Kentucky 5,614 42.1 11.1 6.3 5.6 34.9
Louisiana 5,063 24.9 13.9 9.2 6.0 45.9
Maryland 3,819 25.0 13.6 8.5 5.6 47.4
Massachusetts 9,571 39.7 13.4 6.8 4.8 35.3
Michigan 7,967 31.8 13.2 7.6 5.3 42.1
Mississippi 4,076 42.2 11.0 5.8 3.8 37.2
Missouri 6,774 36.6 11.7 6.9 4.8 39.9
Montana 846 32.7 11.0 6.9 4.5 44.9
Nebraska 2,055 37.9 12.3 7.4 4.8 37.7
Nevada 870 33.3 14.6 10.2 6.3 35.5
New Jersey 6,708 26.4 13.7 8.5 5.4 46.0
New Mexico 1,065 32.8 12.7 8.5 5.4 40.7
New York 21,539 34.5 11.9 6.7 4.8 42.1
North Carolina 7,702 31.4 12.6 7.7 5.5 42.7
North Dakota 779 24.8 12.1 6.5 6.4 50.2
Ohio 16,276 36.7 12.7 7.5 4.6 38.5
Oklahoma 3,799 30.0 12.6 7.9 5.2 44.4
Oregon 2,231 52.7 10.1 5.7 4.2 27.3
Pennsylvania 12,867 25.5 12.8 8.0 5.3 48.4
Rhode Islanda 1,531 31.1 10.7 7.6 4.8 45.9
South Carolina 2,616 29.1 12.3 8.6 5.4 44.7
South Dakota 943 27.8 12.5 6.8 5.2 47.7
Tennesseea 5,960 22.6 14.9 9.3 6.5 46.6
Texas 15,026 29.3 12.4 7.2 5.6 45.6
Vermont 643 40.1 10.7 8.1 3.9 37.2
Virginia 4,600 29.0 13.0 8.4 6.2 43.5
Washington 3,988 43.5 13.6 7.1 5.0 30.7
West Virginia 1,788 29.5 12.5 7.9 5.9 44.3
Wisconsin 5,428 33.7 13.0 7.2 4.6 41.5
Wyoming 354 32.8 9.6 7.3 6.5 43.8
SOURCE: Mathematica analysis of 2006-2007 MAX data for 44 states and the District of Columbia with representative FFS nursing home and ICF/IID data (excludes data from Arizona, Indiana, Maine, Minnesota, New Hampshire, and Utah).
NOTES: New spells in this table are spells beginning between July 1, 2006, and December 31, 2006, inclusive; spells are censored at December 31, 2007.
  1. Data for Georgia, Rhode Island, and Tennessee were included in the analysis even though total institutional care expenditures as reported by the MAX data and CMS Form 64 differed substantially (a variance across data sources of at least 33% in 2007), as there were no known data anomalies for these states believed to invalidate the MAX-based statistics.
  2. Cell sizes of less than 11 are not displayed.

TABLE D.2. HCBS Use Among Aged or Disabled Enrollees with New Nursing Home Spells Between July 2006 and December 2007, by State
    Percentage of First New  
Spells Beginning in 2007
Preceded by HCBS Use
in 2006
  Percentage of First New Spells  
Beginning and Ending During the
First Half of 2007 Preceded
by HCBS Use in 2006
  Percentage of First New  
Spells Ending in 2006
Followed by HCBS Use
in 2007
All States 22.6 30.3 27.2
Alabama 33.3 29.3 34.6
Alaska 20.8 30.4 27.7
Arkansas 24.9 32.5 18.2
California 33.6 40.2 34.0
Colorado 29.0 36.3 30.2
Connecticut 29.4 42.6 45.4
Delaware 16.7 23.8 25.8
District of Columbia   16.9 19.7 23.6
Florida 10.8 16.2 12.1
Georgiaa 10.8 12.1 7.4
Hawaii 13.2 18.3 18.2
Idaho 35.8 43.3 37.9
Illinois 14.8 21.6 15.5
Iowa 30.2 43.3 40.0
Kansas 22.0 35.1 24.6
Kentucky 24.6 25.5 27.3
Louisiana 5.2 7.6 5.2
Maryland 9.1 11.8 11.1
Mississippi 15.7 21.3 19.3
Missouri 30.5 41.0 38.3
Nebraska 24.4 30.2 30.0
Nevada 16.9 21.2 17.2
New Jersey 19.6 25.3 18.1
New Mexico 25.0 35.3 29.5
New York 31.0 40.7 39.4
North Carolina 30.1 35.4 26.3
North Dakota 19.2 25.6 19.7
Ohio 21.1 31.7 34.9
Oklahoma 27.5 38.1 25.0
South Carolina 17.3 20.1 10.7
South Dakota 15.7 19.9 15.6
Tennesseea 3.8 5.7 6.0
Vermont 30.6 35.0 45.2
Virginia 20.3 25.0 31.3
Washington 33.0 37.8 39.5
West Virginia 16.2 24.1 18.3
Wisconsin 14.4 22.7 23.0
Wyoming 23.9 36.6 31.0
SOURCE: Mathematica analysis of 2006-2007 MAX data and the ACS 2007 Public Use Microdata Sample for 37 states and the District of Columbia with representative FFS nursing home and ICF/IID data and valid HCBS data (excludes data from Arizona, Indiana, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, Oregon, Pennsylvania, Rhode Island, Texas, and Utah).
NOTES: New spells in this table are spells beginning between July 1, 2006, and December 31, 2006, inclusive; spells are censored at December 31, 2007. HCBS includes 1915(c) waiver services, personal care services, residential care services, home health, adult day services, and private duty nursing services.
  1. Data for Georgia and Tennessee were included in the analysis even though total institutional care expenditures as reported by the MAX data and CMS Form 64 differed substantially (a variance across data sources of at least 33% in 2007), as there were no known data anomalies for these states believed to invalidate the MAX-based statistics.

TABLE D.3. Change in the Percentage of Very Short and Very Long Nursing Home Stays Associated with an Increase in State Policy Variables, Trimmed Data
Policy Change Change in the Percentage
of First New Spells
  Lasting Less Than 3 Months  
(percentage points)
Change in the Percentage
of First New Spells
  Lasting More Than 12 Months  
(percentage points)
States Excluded on
  the Trimming Process  
A 10 percentage point increase in the percentage of Medicaid LTC expenditures allocated to HCBS +1.7 -1.8 Alaska & Mississippi
A 10 percentage point increase in the percentage of LTC users' total Medicaid expenditures accounted for by HCBS users +3.7 -3.0 Kentucky & Mississippi
A 10 percentage point increase in the percentage of Medicaid LTC recipients using HCBS +2.0 -2.0 Alaska & Tennessee
A 10 percentage point increase in the percentage of potential Medicaid LTC recipients using HCBS   +4.0 -2.7 California & Tennessee
An increase of 10 in the number of nursing home beds per 1,000 elderly -1.5 +1.5 Alaska & Iowa
SOURCE: Mathematica analysis of 2006-2007 MAX data for 37 states and the District of Columbia with representative FFS nursing home and ICF/IID data and valid HCBS data (excludes data from Arizona, Indiana, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, Oregon, Pennsylvania, Rhode, Island, Texas, and Utah). Nursing home bed data were obtained from Houser et al. (2009) at http://assets.aarp.org/rgcenter/il/d19105_2008_ats_1.pdf (page 65).
NOTE: New spells in this table are spells beginning between July 1, 2006, and December 31, 2006, inclusive; spells are censored at December 31, 2007. HCBS includes 1915(c) waiver services, personal care services, residential care services, home health, adult day services, and private duty nursing services. The states with the highest and lowest values for each state policy variable were excluded from calculations.

TABLE D.4. Use of Nursing Homes and ICFs/IID by Aged or Disabled Enrollees with Multiple Spells Between July 2006 and December 2007
  Number of Enrollees
with Multiple Spells
Percentage of Enrollees with Multiple
Spells Who Had Spells in
Both Nursing Homes & ICFs/IID
Percentage of ICF/IID
Spells Followed Immediately
by Nursing Home Spell
Percentage of ICF/IID Spells
Followed Within 60 Days
by Nursing Home Spell
Percentage of Nursing
Home Spells Followed
Immediately by ICF/IID Spell
Percentage of Nursing Home
Spells Followed Within 50
Days by ICF/IID Spell
All States 42,677 2.3 15.6 28.6 1.2 1.9
SOURCE: Mathematica analysis of 2006-2007 MAX data for 44 states and the District of Columbia with representative FFS nursing home and ICF/IID data (excludes data from Arizona, Indiana, Maine, Minnesota, New Hampshire, and Utah).
NOTES: New spells are spells beginning on or after July 1, 2006. Spells are censored at December 31, 2007. The percentages of ICF/IID spells were computed relative to the total number of ICF/IID spells for those enrollees with multiple spells of institutional care between July 1, 2006, and December 31, 2007, and similarly for the percentages of nursing home spells.

TABLE D.5. Length of First New ICF/IID Spells Among Aged or Disabled Medicaid Enrollees with New Medicaid-Financed ICF/IID Spells Between July 2006 and December 2006
    Number of Enrollees with  
New ICF/IID Spells
Distribution of Length of First Spell
(percentage)
  Less Than  
3 Months
  3-6 Months     6-9 Months     9-12 Months     More Than  
12 Months
All States 2,908 13.4 6.1 5.2 4.0 71.3
SOURCE: Mathematica analysis of 2006-2007 MAX data for 44 states and the District of Columbia with representative FFS nursing home and ICF/IID data (excludes data from Arizona, Indiana, Maine, Minnesota, New Hampshire, and Utah).
NOTES: New spells in this table are spells beginning between July 1, 2006, and December 31, 2006, inclusive; spells are censored at December 31, 2007. Alaska, Oregon, and Vermont had no reported ICF/IID spells beginning between July and December 2006.

TABLE D.6. HCBS Use Among Aged and Disabled Enrollees with New ICF/IID Spells Between July 2006 and December 2007, by State
  Percentage of First New Spells
Beginning in 2007 Preceded
by HCBS Use in 2006
Percentage of First New Spells
Beginning and Ending During the
First Half of 2007 Preceded
by HCBS Use in 2006
Percentage of First New Spells
Ending in 2006 Followed by
HCBS Use in 2007
All States 42.4 54.0 52.7
Alabama 50.0 0.0 100.0
Alaska b b b
Arkansas 16.9 100.0 8.3
California 39.3 34.0 20.0
Colorado 75.0 100.0 66.7
Connecticut 57.5 100.0 81.8
Delaware b b b
District of Columbia   17.6 0.0 50.0
Florida 42.5 0.0 0.0
Georgiaa 17.6 33.3 60.0
Hawaii b b b
Idaho 48.4 33.3 28.6
Illinois 50.4 45.0 33.3
Iowa 72.5 100.0 100.0
Kansas 66.7 50.0 50.0
Kentucky 77.6 100.0 100.0
Louisiana 18.8 10.0 33.3
Maryland 27.3 0.0 100.0
Mississippi 23.8 38.5 26.7
Missouri 43.9 33.3 0.0
Nebraska 28.0 50.0 33.3
Nevada b b b
New Jersey 35.3 16.7 28.6
New Mexico 30.4 50.0 0.0
New York 61.0 75.8 64.0
North Carolina 52.7 28.6 40.0
North Dakota 72.4 33.3 0.0
Ohio 41.6 43.5 50.0
Oklahoma 21.5 50.0 25.0
South Carolina 70.5 62.5 66.7
South Dakota 34.4 100.0 50.0
Tennesseea 13.6 0.0 0.0
Vermont b b b
Virginia 45.8 71.4 72.7
Washington b b b
West Virginia 26.0 50.0 0.0
Wisconsin 63.0 69.1 89.1
Wyoming b b b
SOURCE: Mathematica analysis of 2006-2007 MAX data and the ACS 2007 Public Use Microdata Sample for 37 states and the District of Columbia with representative FFS nursing home and ICF/IID data and valid HCBS data (excludes data from Arizona, Indiana, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, Oregon, Pennsylvania, Rhode Island, Texas, and Utah).
NOTES: New spells in this table are spells beginning between July 1, 2006, and December 31, 2006, inclusive; spells are censored at December 31, 2007. HCBS includes 1915(c) waiver services, personal care services, residential care services, home health, adult day services, and private duty nursing services. Alaska and Vermont had no reported ICF/IID spells beginning between July and December 2006.
  1. Data for Georgia and Tennessee were included in the analysis even though total institutional care expenditures as reported by the MAX data and CMS Form 64 differed substantially (a variance across data sources of at least 33% in 2007), as there were no known data anomalies for these states believed to invalidate the MAX-based statistics.
  2. Cell sizes of less than 11 are not displayed.

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