Orewa GN, Davlyatov GK, Pradhan R, Lord J.
Abstract
Obesity is a growing concern in the delivery of high-quality nursing home care. Obese nursing home residents often require specialized equipment and resources. High Medicaid nursing homes have limited financial ability and may lack the necessary equipment and staff to address the needs of obese residents. However, there are variations across high Medicaid nursing homes with respect to the availability of obesity-related specialized resources. Therefore the purpose of this research was to explore the organizational and market factors associated with the availability of such resources in high-Medicaid nursing homes. Survey and secondary data sources from 2017-2018 were utilized. Data on the availability of obesity-related specialized resources was collected via mail surveys sent to Directors of Nursing in high-Medicaid nursing homes. The survey was merged with Brown University’s Long Term Care Focus (LTCFocus), Nursing Home Compare, and Area Health Resource File. The dependent variable was the composite score of obesity-related specialized resources, ranging from 0-19. An ordinary least square regression with propensity score weights (to adjust for potential survey non-response bias), and appropriate organizational/market level control variables were used for our analysis. Results suggest that payer mix (>Medicare residents) and facilities with a higher proportion of obese residents were positively associated with the availability of obesity-related specialized resources. Policymakers may consider incentives for high-Medicaid nursing homes, for example, by boosting Medicaid payments to help these facilities address the specific needs of obese residents.