title: Concentrated poverty and nursing home bed supply in Chicago.
abstract: This study explores whether poverty areas of Chicago have fewer nursing home beds and unique staffing patterns. Using 1990 census data and Illinois's 1994 Long-Term Care Facility Survey, census tracts were compared by need for long-term care, bed supply, and nursing home characteristics. While facilities cluster on the north side, and the number of beds follow the elderly, the supply of beds per elderly is actually greater in tracts with high proportions of poverty, disability, and African American residents due, in part, to the predominance of larger facilities. Ironically, economic segregation may work together with Medicaid's policy of serving the poorest to increase the supply of beds to those who might otherwise remain unserved. Nursing homes in the poorest communities have high percentages of Medicaid residents, are larger, and employ fewer staff per resident; homes with a high Medicaid population are more likely to employ LPNs, which may reflect labor supply differences.
authors.affiliation: DePaul University, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Reed
authors.forename: S
authors.initials: S
authors.lastname: Andes
authors.forename: R A
authors.initials: RA
authors.lastname: Tobias
mesh_terms: D000368:Aged; D001513:Beds / Q000600:supply & distribution; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D019352:Censuses; D002641:Chicago; D016330:Frail Elderly; D006276:Health Facility Size / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D008484:Medicaid; D020380:Needs Assessment / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D011204:Poverty Areas; D012044:Regression Analysis; D017062:Small-Area Analysis; D014505:Urban Population; D000078329:Workforce