People with Alzheimer’s and related dementias are more likely to be admitted to low-rated facilities, investigators have found.

The retrospective study analyzed data from 2,777 facilities operating in urban areas across 41 states between 2011 and 2014. Beyond a link between ratings and admissions, the researchers assessed the influence of market-level wages for certified nursing assistants and state Medicaid behavioral and mental health add-on policies. Quality measures were based on Nursing Home Compare ratings published by the Centers for Disease Control and Prevention. 

Highly rated operations had 3% fewer newly admitted residents with Alzheimer’s than low-quality facilities, reported first author Di Yan, MS, from University of Rochester, New York. CNA pay was also a factor. A one dollar increase in hourly wage was linked to a 0.9% decrease in the prevalence of these adults among newly admitted residents. In contrast, state Medicaid behavioral and mental health add-on policy conferred a 2.5% increase in the prevalence of Alzheimer’s in high-quality, but not low-quality facilities.

The effect size of the link is modest and appears to be influenced by the pay and add-on policies, Yan and colleagues concluded. If the results are confirmed, Yan and team foresee future interventions that incentivize high-quality operators to admit more of these residents.

The study was published in JAMDA.