State-imposed limits on Medicaid reimbursement for nursing facility care

Objectives. Nursing cost-center limits were examined, along with their effects on Medicaid. Methods. A national survey of Medicaid nursing facility reimbursement provided data on cost centers for nursing, administration, and capi tal, whether in specific, larger, or multiple cost centers. Results. Most states impose nursing and administration limits. Far fewer states impose capital limits, but only capital limits may be related to constraint of reimbursement rates. Conclusions. Shifting toward limiting capital costs, or simply eliminating cost-center limits, might accommodate cost control while removing negative constraints on direct resident care.