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. 1980 Fall;2(2):33-45.

Nursing home levels of care: problems and alternatives

C E Bishop, A L Plough, T R Willemain

Nursing home levels of care: problems and alternatives

C E Bishop et al. Health Care Financ Rev. 1980 Fall.

Abstract

Providers and recipients of nursing home care under Medicaid are currently classified into two levels of care to facilitate appropriate placement, care, and reimbursement. The inherent imprecision of the two level system leads to problems of increased cost to Medicaid, lowered quality of care, and inadequate access to care for Medicaid recipients. However, a more refined system is likely to encounter difficulties in carrying out the functions performed by the broad two-level system, including assessment of residents, prescription of needed services, and implementation of service plans. The service type-service intensity classification proposed here can work in combination with a three-part reimbursement rate to encourage more accurate matching of resident needs, services, and Medicaid payment, while avoiding disruption of care.

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Figures

Figure 1
Figure 1. Presumed Ideal Relationship Between Debility and Services
Figure 2
Figure 2. Distortions Introduced By Two Levels Of Care
Figure 3
Figure 3. Illustrating Three Different Approaches To Relating Debility to Services
See this image and copyright information in PMC

References

    1. Allison-Cook S, Thornberry H. Factors Affecting Nursing Home Medical Review. Medical Care. 1977 Jun;15(No. 6):494–504. - PubMed
    1. Bishop CE. Nursing Home Cost Studies and Reimbursement Issues. Health Care Financing Review. 1980 Spring;1(No. 3):47–64. - PMC - PubMed
    1. Bright M. Demographic Background for Programing for Chronic Diseases in the United States. In: Lilienfeld Abraham, Gifford Alice J., editors. Chronic Diseases and Public Health. John Hopkins Press; Baltimore, Maryland: 1966.
    1. Congressional Budget Office. Budget Issue Paper Appendix B. Washington: Congressional Budget Office; 1977. Long-Term Care for the Elderly and Disabled.
    1. Densen P, Jones E, McNitt B. An Approach to the Assessment of Long-Term Care. Final Report, DHEW Research Grant HS-01162. 1976 Dec 13;

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