ASSESSING CONTRIBUTORS TO COST OF CARE IN NURSING-HOMES

In 1994 12.7% of the population was 65 and over, while 10.6% were 85 a nd over.Expenditures for nursing homes reached $72.3 billion in 1994 ( much of which is tax-supported) accounting for 8.7% of all personal he alth money spent. Data from the 1993 Missouri Medicaid cost reports fo r 403 nursing homes were reviewed to determine differences in costs pe r resident day (PRD) and discover which factors most influenced these differences. Mid-sized facilities with 60-120 beds reported the lowest resident-related PRD costs. PRD expenses for aides and orderlies were higher in tax-exempt facilities, which was thought to be related to t heir ''more altruistic'' mission. Investor-owned facilities showed sig nificantly greater administrative costs PRD, which may relate to highe r administrative salaries and fancier offices. The authors suggest fur ther study that would incorporate location, occupancy rate, quality of care, case mix, and payer mix data.