Report Examines Changing Nursing Home Trends in New York

Tom Dennison

A new report authored by Thomas Dennison, professor of practice in public administration and international affairs at the Maxwell School, notes that nursing homes have evolved since the ’90s from primarily providing residential care for seniors to focusing on both post-acute services and long-term care today.

Nursing homes are entering a new phase, characterized by greater integration with other components of the health care and long-term care delivery systems and by changing financial models, according to the report,  “New York’s Nursing Homes: Shifting Roles and New Challenges,” prepared for the Medicaid Institute at United Hospital Fund.

The report examines regional differences, operating costs and financial performance and provides an overview of the demographics, health characteristics and functional limitations of nursing home users. The report concludes with a discussion of considerations for policymakers and nursing home leadership.

Among the report’s findings:

• Medicaid remains the dominant payer of nursing home care in New York, covering 76 percent of nursing home days, despite an increase in Medicare admissions to nursing homes over the study period.
• Outside New York City, the number of short-stay patients has surpassed the number of long-stay residents.
• Hospitals accounted for 83 percent of nursing home admissions in 1996 and 90 percent in 2010. However, the volume of nursing home admissions from hospitals increased by 193 percent during that period.
• New York’s 6 percent decline in nursing home census between 2005 and 2010 contrasted sharply with a national increase (between 2005 and 2009) of 3 percent.
• While New York’s nursing home occupancy rate decreased from 97 percent in 1996 to 94 percent in 2010 (compared to the national average of 84 percent), the number of admissions each year per bed more than doubled, from 0.8 to 2.1.