Search

Despite elders' overwhelming preference for home-based care, rural elders use nursing homes at higher rates than their urban counterparts. Little is known about how rural and urban home care users differ. We used administrative data to compare the characteristics of urban and rural elders (age 60+) admitted to Michigan's Home and Community Based Services (HCBS) Waiver Program (N=6,655). Rural elders were more likely to have an acute illness immediately preceding HCBS admission (31.7% vs. 19.6%, p

Recent studies have highlighted an inverse relationship between proprietary status and quality of care in US nursing homes. One interpretation of this is that proprietary homes direct resources to profit at the expense of quality. Using data from OSCAR and the California Department of Health Services on 1098 free-standing Californian nursing homes, we investigated the relationship between quality and profit, controlling for a range of other explanatory variables. Quality was measured both in terms of total deficiencies issued by CMS surveyors and total serious deficiencies issued. Multivariate analyses revealed that profit levels were significantly related to the number of serious deficiencies issued (controlling for other variables) but not total deficiencies. Other variables found to significantly predict quality were ethnic mix of patients, percentage of patients funded under Medicaid, facility size, occupancy level and location. When these factors were controlled for, proprietary status did not significantly predict quality.