This research brief follows a cohort of nursing home residents over a three-year period-- beginning with their first ever admission to a nursing home --in order to determine their stay patterns and changes in their payment source during the study period. Findings from this study suggest that irrespective of who pays for the nursing home care, almost six out of ten admissions led to a discharge within three months. The discharge patterns continue such that only one in every three and one in every five newly admitted residents remain in the nursing home after six and nine months respectively.

This study also indicates that the discharge rate was higher among Medicare and private pay residents compared to Medicaid residents. By the end of the first year, one-third of those residents who were initially private payers and who were still in a nursing home came to rely on Medicaid to pay for their care. The proportion of residents switching to Medicaid increased to over one-half by the end of second year and to two-thirds by the end of the third year. However, this proportion at the end of the third year accounts for only 5% of all those who were initially admitted as private pay residents. With the expansion of long-term care options, it appears that individuals with long-term care needs limit their nursing home use either to short-term care or to longer stays (when all other settings are inadequate). Many residents continue to pay for their nursing home care privately as long as their stay is not exceedingly long.

Research Brief (PDF 146KB)