New York’s Top-Rated Nursing Homes Less Likely to Admit Poor Patients

Five-star nursing homes in the state of New York are less likely to admit low-income residents than one-star facilities in the state, according to an investigation by The Buffalo News published on Sunday.

Using data from the state Department of Health (DOH) from 2017, the publication found that those who enter New York nursing homes on Medicaid from their first day — almost 22,000 people — were twice as likely to be admitted to one-star nursing homes than to five-star homes.

In the western part of the state, those patients were more than four times as likely to go to a one-star nursing home.

People who started out in a nursing home with Medicare coverage fared somewhat better; they were slightly more likely to end up in top-rated nursing homes, rather than in the worst-rated homes, according to the publication’s findings.

Operators of five-star nursing homes in Western New York told The Buffalo News that their Medicaid admissions were low because most of their residents are seniors admitted for rehabilitative services after an acute stay, which are usually covered by Medicare regardless of the resident’s income level.

“There is no barrier to individuals with Medicaid coverage at any of our facilities — including our highest rated,” Chuck Hayes, a spokesman for the Elderwood chain of nursing homes, told The Buffalo News.

Medicaid admission rates do not reflect a facility’s true connection with the Medicaid population, he argued, as rehab patients have much shorter lengths of stay and are typically private pay or Medicare. The higher turnover for these patients leads to higher rates of admissions, he told the publication.

At Elderwood at Lancaster, a five-star home, 1% of new admissions were Medicaid residents in 2017.

Chris Luterek, vice president for business development for the Absolut Care nursing home chain, disputed the idea that five-star homes have a different model than one-star ones; Absolut runs both five-star and one-star nursing facilities.

“It is every nursing home’s business model to take sub-acute patients,” he told The Buffalo News. “That is typically a higher payer than straight Medicaid.”

While top-rated, five-star nursing homes in New York admit more people on Medicaid than one-star nursing homes, this is a reflection of the fact that there are twice as many five-star homes as one-star ones, the publication observed. In 2017, 7% of new residents at New York nursing facilities were Medicaid admissions at five-star nursing homes, while 15% of new residents were Medicaid admissions at one-star facilities.