Medicare's Prospective Payment System for Skilled Nursing Facilities: Effects on Staffing and Quality of Care
2005 ◽
Vol 42
(4)
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pp. 351-366
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In 1998, Medicare began phasing in a new prospective payment system (PPS) for skilled nursing facilities (SNFs). This paper measures facility-level changes in nurse staffing and quality at freestanding SNFs from 1997 (pre-PPS) to 2001 (post-PPS). Findings show a positive but small association between changes in payment levels and changes in nurse staffing. Among for-profits, the elimination of cost reimbursement is associated with a large drop in nurse staffing. Additionally, the elimination of cost reimbursement is associated with worsening in one of four measures of quality of care; however, the quality results are not statistically robust.
2003 ◽
Vol 38
(6p1)
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pp. 1467-1486
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1993 ◽
Vol 150
(12)
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pp. 1799-1805
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2002 ◽
Vol 32
(2)
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pp. 315-325
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