Money Motivates Nursing Home Discharge Decisions
A new study reviewing nursing home occupancy rates (census) and resident discharge rates finds that financial incentives significantly influence how aggressively nursing homes discharge residents. When facilities have a low census and less overall revenue, they discharge residents at much lower rates than facilities with a high census and few empty beds. The effort to maximize profit leads facilities with a high census to push out residents whose stay is paid for, in part, by Medicaid (Medi-Cal) in favor of other, higher-paying, residents. The reviewed data shows that when a facility’s census reaches about 90% of capacity, residents on Medicaid are suddenly discharged much more often, due to more “positive discharge effort” from the facility. The study provides good data backup for what we have long known: it’s not residents’ conditions that prompt nursing home discharges, it is the revenue they bring.