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Low-rated nursing homes are more likely to admit people with Alzheimer’s and related dementias, investigators 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, first author Di Yan, of the University of Rochester reported.

CNA pay was also a factor. A $1 increase in hourly wage was linked to a 0.9% decrease in the prevalence of these adults among newly admitted residents. In contrast, a 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.

Study results were published in JAMDA