Medicaid in Residential Care. Multivariate Analysis of Facility Medicaid Participation


This study conducted a multivariate logistic regression analysis of predictors of Medicaid participation by RCFs. The Medicaid state plan personal care and the coverage category for both HCBS waiver and state plan personal care were statistically significant predictors of Medicaid participation. Somewhat surprisingly, state coverage of RCF services only through HCBS waivers was not a statistically significant predictor of Medicaid participation, suggesting that the need to serve persons with a nursing home level of care may be a deterrent to participation. The odds that a facility will participate in Medicaid are lower if the facility is located in an urban area. The odds of participating in Medicaid also decrease as the percentage of residents with Alzheimer's disease or other dementia increases in a facility. Moreover, the odds of a facility participating in Medicaid decline as the number of residential care beds in the facility increases (i.e., the larger the facility, the less likely it is to accept Medicaid residents). The direct care staff ratio, for-profit ownership, being part of a chain, and having a high percentage of high-privacy units were not statistically significant predictors of Medicaid participation.

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