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State-imposed limits on Medicaid reimbursement for nursing facility care.

J H Swan, C Harrington, S K de Wit and M Zhong

Department of Public Health Sciences, Wichita State University, KS 67260-0043, USA.

OBJECTIVES: Nursing cost-center limits were examined, along with their effects on Medicaid. METHODS: A national survey of Medicaid nursing facility reimbursement provided data on cost centers for nursing, administration, and capital, whether in specific, larger, or multiple cost centers. RESULTS: Most states impose nursing and administration limits. Far fewer states impose capital limits, but only capital limits may be related to constraint of reimbursement rates. CONCLUSIONS: Shifting toward limiting capital costs, or simply eliminating cost-center limits, might accommodate cost control while removing negative constraints on direct resident care.

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