Higher Quality Nursing Homes Admit Fewer Residents With Alzheimer Disease

High-quality nursing homes are less likely than low-quality facilities to admit residents with Alzheimer disease and related dementias, according to a study published online in the Journal of the American Medical Directors Association. 

“Future studies are needed to better understand reasons leading to these associations so that effective interventions can be developed to incentivize high-quality nursing homes to more readily serve residents with Alzheimer disease and related dementias,” wrote researchers from the University of Rochester School of Medicine in New York. 

The retrospective cohort study looked at the prevalence of newly admitted nursing home residents with Alzheimer disease and related dementias at 2777 urban nursing homes in 41 states between 2011 and 2014. Researchers determined nursing home quality based on each facility’s Nursing Home Compare star rating.

After adjusting for market and state-level factors as well as nursing home-level aggregated resident characteristics, researchers found a 3% lower prevalence of newly admitted residents with Alzheimer disease and related dementias in high-quality facilities compared with low-quality nursing homes. 

The study also assessed the extent that market-level wages for certified nursing assistants and state Medicaid behavioral and mental health add-on policy affected associations. Findings showed a $1 increase in the hourly wage for certified nursing assistants was linked with a 0.9-percentage point drop in the prevalence of newly admitted residents with Alzheimer disease and related dementias. Meanwhile, state Medicaid behavioral and mental health add-on policy was associated with a 2.5-percentage point boost in the prevalence of residents with Alzheimer disease and related dementias in high-quality nursing homes. 

—Jolynn Tumolo

Reference:

Yan D, Wang S, Temkin-Greener H, Cai S. Quality of Nursing Homes and Admission of Residents With Alzheimer's Disease and Related Dementias: The Potential Influence of Market Factors and State Policies [published online ahead of print, 2020 Jun 18]. J Am Med Dir Assoc. 2020;S1525-8610(20)30358-3. doi:10.1016/j.jamda.2020.04.028