Although it is commonly thought that a very high proportion of private-pay nursing home patients become eligible for Medicaid during their stay, few national studies have been conducted to determine the extent of Medicaid “spend-down.” The discharged resident survey of the 1985 National Nursing Home Survey was analyzed to determine the extent of spend-down among elderly nursing home patients during a single nursing home episode, the proportion of patients who remained Medicaid or private payers throughout their stay, and how the measures varied by patient characteristics. Overall, during a single nursing home episode only 10 percent of nursing home patients who entered as private payers received Medicaid at discharge. Roughly one-third of nursing home patients remained on Medicaid throughout their stay, and another third remained private payers throughout their stay.
Research Article|June 01 1990
Estimating the Extent of Medicaid Spend-Down in Nursing Homes
J Health Polit Policy Law (1990) 15 (3): 607-626.
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Denise A. Spence, Joshua M. Wiener; Estimating the Extent of Medicaid Spend-Down in Nursing Homes. J Health Polit Policy Law 1 June 1990; 15 (3): 607–626. doi: https://doi.org/10.1215/03616878-15-3-607
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