Medicaid monopoly reinforces split between poor, rich facilities.
Older Americans Report, June, 2004
Researchers at Brown University this week painted a picture of a bifurcated long-term care system, with poor residents concentrated in nursing homes where the quality of care is inferior. A nursing home group said the findings point to the need for enhanced Medicaid funding. And one observer says the problem is compounded by a lack of competition within the low-income sector, leaving Medicaid-dependent institutions with little incentive to improve.
About 40 percent of blacks live in what Brown professor Vincent Mor calls lower-tier nursing homes--places where at least 85 percent of residents are on Medicaid, less than 10 percent are private pay and less than 8 percent are on Medicare. In contrast, only about 9 percent of white nursing home residents live in...
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