National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (2)
- Antibiotics (3)
- Antimicrobial Stewardship (2)
- Burnout (1)
- Care Coordination (2)
- Communication (2)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (3)
- Decision Making (3)
- Dementia (2)
- Digestive Disease and Health (1)
- Disparities (3)
- Education: Patient and Caregiver (1)
- Elderly (18)
- Evidence-Based Practice (1)
- Falls (2)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (2)
- Home Healthcare (1)
- Hospital Discharge (4)
- Hospitalization (1)
- Hospital Readmissions (3)
- Hospitals (3)
- Human Immunodeficiency Virus (HIV) (2)
- Injuries and Wounds (1)
- Long-Term Care (27)
- Medicaid (1)
- Medical Errors (2)
- Medicare (6)
- Medication (6)
- Mortality (1)
- Neurological Disorders (1)
- (-) Nursing Homes (54)
- Outcomes (2)
- Palliative Care (1)
- Patient-Centered Outcomes Research (2)
- Patient Experience (3)
- Patient Safety (6)
- Payment (1)
- Policy (2)
- Pressure Ulcers (2)
- Prevention (1)
- Primary Care (1)
- Provider (1)
- Provider: Nurse (1)
- Provider Performance (18)
- Public Reporting (4)
- Quality Improvement (19)
- Quality Indicators (QIs) (10)
- Quality Measures (18)
- (-) Quality of Care (54)
- Quality of Life (1)
- Racial and Ethnic Minorities (2)
- Rehabilitation (2)
- Risk (1)
- Sleep Problems (1)
- Social Media (1)
- Surgery (2)
- Surveys on Patient Safety Culture (1)
- Transitions of Care (3)
- Urinary Tract Infection (UTI) (1)
- Vulnerable Populations (1)
- Web-Based (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 54 Research Studies DisplayedSanghavi P, Chen Z
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
The purpose of this study was to evaluate the relationship between nursing home characteristics and reporting of 2 of 3 specific clinical outcomes reported by the Nursing Home Care Compare (NHCC) website: major injury falls and pressure ulcers. The researchers of this quality improvement study utilized hospitalization data for all Medicare fee-for-service beneficiaries between January 1, 2011, and December 31, 2017. Hospital admission claims for major injury falls and pressure ulcers were linked with facility-reported evaluations at the nursing home resident level. For each linked hospital claim, it was determined whether the nursing home had reported the event and rates of reporting were computed. To evaluate whether nursing homes reported similarly on both measures, the researchers estimated the relationship between reporting of major injury falls and pressure ulcers within a nursing home, and explored racial and ethnic disparities that could otherwise explain the associations. The study sample included 13,179 nursing homes where 131,000 residents experienced major injury fall or pressure ulcer hospitalizations. Of the 98,669 major injury fall hospitalizations, 60.0% were reported, and of the 39,894 stage 3 or 4 pressure ulcer hospitalizations, 67.7% were reported. Underreporting for both conditions was pervasive, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates had few correlations with facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%).
AHRQ-funded; HS026957.
Citation: Sanghavi P, Chen Z .
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
JAMA Netw Open 2023 May; 6(5):e2314822. doi: 10.1001/jamanetworkopen.2023.14822..
Keywords: Quality Measures, Quality of Care, Elderly, Disparities, Racial and Ethnic Minorities, Nursing Homes, Pressure Ulcers, Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Long-Term Care
Chen Z, Gleason LJ, Sanghavi P
Accuracy of pressure ulcer events in US nursing home ratings.
This study investigated the accuracy of the government website Nursing Home Compare (NHC) pressure ulcer measures, which are chief indicators of nursing home patient safety. The authors identified hospital admissions for pressure ulcers and linked them to the nursing home-reported data at the patient level using Medicare fee-for-service beneficiaries who were nursing home residents between 2011 and 2017. Percentages of pressure ulcers that were appropriately reported by stage, long-stay versus short-stay status, and race was calculated. Reporting rates were low for both short-stay (70.2%) and long-stay (59.7%) for stage 2-4 pressure ulcer hospitalizations. Black residents experienced more severe pressure ulcers than White residents. Correlations between claims-based measures and NHC ratings were found to be poor.
AHRQ-funded; HS026957.
Citation: Chen Z, Gleason LJ, Sanghavi P .
Accuracy of pressure ulcer events in US nursing home ratings.
Med Care 2022 Oct;60(10):775-83. doi: 10.1097/mlr.0000000000001763.
AHRQ-funded; HS026957..
AHRQ-funded; HS026957..
Keywords: Elderly, Nursing Homes, Long-Term Care, Pressure Ulcers, Quality Measures, Quality of Care, Patient Safety
Konetzka RT, Davila H, Brauner DJ
The quality measures domain in Nursing Home Compare: is high performance meaningful or misleading?
The Federal Centers for Medicare and Medicaid Services publishes a Nursing Home Compare (NHC) web site that provides information to compare nursing homes across the nation. Since NHC began reporting the percent of nursing home residents suffering adverse outcomes, the negative outcomes decreased dramatically. However, the validity of scores has been questioned for nursing homes that score well on facility-reported measures but scored poorly on inspections. The study purpose was to determine whether nursing homes with these “discordant” scores are better than nursing homes that score poorly across all domains. The researchers analyzed national data from 2012- 2016, conducted in-depth interviews and observations of 12 nursing homes in 2017 to 2018, and studied nursing home performance trajectories over time. Both qualitative and quantitative methods were utilized and interpreted together. The study found that facilities identified as discordant took part in more quality improvement (QI) activities than those identified as poor performers, but those QI activities were lower-resource improvements and not of the type and scope that would impact improvements across other quality domains. It was determined that the poor-performing facilities appeared to lack the leadership and staff continuity required for even low-resource improvements. The study concluded that while high performance on quality measures using facility-reported data is mostly meaningful, and the quality measures domain should continue to be utilized in Nursing Home Compare, facilities identified as discordant still have quality defects.
AHRQ-funded; HS024967.
Citation: Konetzka RT, Davila H, Brauner DJ .
The quality measures domain in Nursing Home Compare: is high performance meaningful or misleading?
Gerontologist 2022 Feb 9;62(2):293-303. doi: 10.1093/geront/gnab054..
Keywords: Nursing Homes, Long-Term Care, Provider Performance, Quality Indicators (QIs), Quality Measures, Quality of Care
Yount N, Zebrak KA, Famolaro T
Linking patient safety culture to quality ratings in the nursing home setting.
This study examined the relationship between scores on the AHRQ Surveys on Patient Safety Culture™ (SOPS®) Nursing Home Survey (NH SOPS) and Centers for Medicare and Medicaid Services Nursing Home Five-Star Quality Ratings. The authors used data on 186 nursing homes to conduct multiple regression analyses predicting the Five-Star Quality Ratings from the NH SOPS survey measures. Five NH SOPS measures were related to the Overall, Health Inspections, and Quality Five-Star Ratings; four NH SOPS measures were related to at least two of the four Five-Star Quality Ratings and three SOPS measures were related to one Five-Star Rating. No NH SOPS measures were significantly associated with the Staffing Five-Star Rating.
AHRQ-funded; 233201500026I.
Citation: Yount N, Zebrak KA, Famolaro T .
Linking patient safety culture to quality ratings in the nursing home setting.
J Appl Gerontol 2022 Jan;41(1):73-81. doi: 10.1177/0733464820969283..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Safety, Nursing Homes, Long-Term Care, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care
Davila H, Shippee TP, Park YS
Inside the black box of improving on nursing home quality measures.
This qualitative study investigated how nursing homes (NHs) interact with quality measures (QMs) used by Nursing Home Compare (NHC) as part of its 5-star rating system. Semistructured interviews were conducted with 110 NH personnel and 23 NH provider association representatives. Observations of organizational processes in 12 NHs in three states were also done. The authors found that most NHs are working to improve the quality of care they provide, not merely to improve their QM scores. They also found limitations with the QMs, suggesting that the QMs on their own may not accurately reflect the quality of care that NHs provide. The findings suggest several changes to improve NHC.
AHRQ-funded; HS024967.
Citation: Davila H, Shippee TP, Park YS .
Inside the black box of improving on nursing home quality measures.
Med Care Res Rev 2021 Dec;78(6):758-70. doi: 10.1177/1077558720960326..
Keywords: Nursing Homes, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Provider Performance, Long-Term Care
de Cordova PB, Johansen ML, Zha P
Does public reporting of staffing ratios and Nursing Home Compare ratings matter?
This study’s objective was to examine the association between publicly available staffing ratios and the Five-Star Quality Ratings from Nursing Home Compare over time. Findings showed that decreasing the number of residents assigned to a registered nurse in nursing homes resulted in an increase in staffing ratings. Mandatory public reporting held nursing homes accountable for quality outcomes but did not improve staffing ratios. Recommendations included continuing to focus on improving quality in nursing homes, which may improve staffing ratios across shifts.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Johansen ML, Zha P .
Does public reporting of staffing ratios and Nursing Home Compare ratings matter?
J Am Med Dir Assoc 2021 Nov;22(11):2373-77. doi: 10.1016/j.jamda.2021.03.011..
Keywords: Nursing Homes, Quality of Care, Provider Performance
Olivieri-Mui B, McGuire J, Griffith J
Exploring the association between the quality of HIV care in nursing homes and hospitalization.
Persons living with HIV/AIDS (PLWH) are living long enough to need age-related and HIV-related nursing home (NH) care. Nursing home quality of care has been associated with risk for hospitalization, but it is unknown if quality of HIV care in NHs affects hospitalization in this population. In this study, the investigators assessed HIV care quality with four national measures adapted for the NH setting.
AHRQ-funded; R36 HS025662.
Citation: Olivieri-Mui B, McGuire J, Griffith J .
Exploring the association between the quality of HIV care in nursing homes and hospitalization.
J Healthc Qual 2021 May-Jun;43(3):174-82. doi: 10.1097/jhq.0000000000000277..
Keywords: Elderly, Human Immunodeficiency Virus (HIV), Nursing Homes, Long-Term Care, Quality of Care, Quality Measures
Hanlon JT, Perera S, Schweon S
Improvements in antibiotic appropriateness for cystitis in older nursing home residents: a quality improvement study with randomized assignment.
This study evaluated the impact of an educational quality improvement initiative on the appropriateness of antibiotic prescribing restricted to uncomplicated cystitis in older noncatheterized nursing home residents. This 1-year case-control study used 25 participating nursing homes that were randomized to the intervention or usual care group by strata that included state, urban/rural status, bed size, and geographic separation. A total of 75 cases of cystitis were found in the intervention groups and 92 in the control groups. The intervention group had a nonsignificant 21% reduction in the risk of antibiotic prescribing. There was a favorable comparison in appropriateness of duration. However, the intervention group had more problems with drug-drug interactions than the control group (8% vs 1%). There were also more problems with dosage in the intervention group. Both groups had similar rates of problems with choice or effectiveness (44% vs 45%). The most common antibiotic class that was prescribed inappropriately was quinolones.
AHRQ-funded; R18 HS023779.
Citation: Hanlon JT, Perera S, Schweon S .
Improvements in antibiotic appropriateness for cystitis in older nursing home residents: a quality improvement study with randomized assignment.
J Am Med Dir Assoc 2021 Jan;22(1):173-77. doi: 10.1016/j.jamda.2020.07.040..
Keywords: Elderly, Nursing Homes, Long-Term Care, Antibiotics, Medication, Quality Improvement, Quality of Care, Urinary Tract Infection (UTI), Decision Making
Mangrum R, Stewart MD, Gifford DR
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
The goal of this study was to create a uniform definition of omission of care in US nursing homes. Lack of a uniform definition has made efforts to prevent them challenging. Subject matter experts and a broad range of nursing home stakeholders were brought together in iterative rounds of engagement to identify key concepts and aspects of omissions of care and develop a consensus-based definition. The concise definition decided on was: “Omissions of care in nursing homes encompass situations when care–either clinical or nonclinical–is not provided for a resident and results in additional monitoring or intervention or increases the risk of an undesirable or adverse physical, emotional, or psychosocial outcome for the resident."
AHRQ-funded; 233201500014I.
Citation: Mangrum R, Stewart MD, Gifford DR .
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
J Am Med Dir Assoc 2020 Nov;21(11):1587-91.e2. doi: 10.1016/j.jamda.2020.08.016..
Keywords: Elderly, Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care, Medical Errors, Adverse Events, Patient Safety, Risk, Patient-Centered Outcomes Research
Alexander GL, Madsen R, Deroche CB
Ternary trends in nursing home information technology and quality measures in the United States.
This survey investigated whether improvements in nursing home information technology (NH IT) increases quality measures. Nursing home administrators were surveyed from 2014 to 2017. Nine dimensions/domains and total IT sophistication were measured. A total of 815 Year 1 surveys were completed. It was found that for every 10 units increase in administrative activity of IT use, a decrease of 1.3% occurred in the percentage of low-risk long-stay residents with bowel or bladder incontinence.
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen R, Deroche CB .
Ternary trends in nursing home information technology and quality measures in the United States.
J Appl Gerontol 2020 Oct;39(10):1134-43. doi: 10.1177/0733464819862928..
Keywords: Nursing Homes, Health Information Technology (HIT), Quality Measures, Quality Improvement, Long-Term Care, Quality of Care
Nace DA, Hanlon JT, Crnich CJ
A multifaceted antimicrobial stewardship program for the treatment of uncomplicated cystitis in nursing home residents.
This study describes the result of implementing a multifaceted antimicrobial stewardship program to reduce antibiotic use in nursing homes for urinary tract infections that are unlikely cystitis. Reduction in antibiotic use decreases incidence of Clostridioides difficile (C difficile) infections, as well as adverse drug reactions and antimicrobial drug resistance. This one-year case-control study included 12 intervention nursing homes and 13 control group nursing homes. The intervention nursing homes received a 1-hour introductory webinar, pocket-sized educational cards, tools for system change, and educational clinical vignettes addressing the diagnosis and treatment of suspected uncomplicated cystitis. Additionally, they received a monthly coaching call as well as a quarterly feedback report. In the intervention nursing homes, fewer unlikely cystitis cases were treated with antibiotics and C difficile infection rates were also lower. There was no increase in all-cause hospitalizations or deaths due to the intervention.
AHRQ-funded; HS023779.
Citation: Nace DA, Hanlon JT, Crnich CJ .
A multifaceted antimicrobial stewardship program for the treatment of uncomplicated cystitis in nursing home residents.
JAMA Intern Med 2020 Jul;180(7):944-51. doi: 10.1001/jamainternmed.2020.1256..
Keywords: Antimicrobial Stewardship, Antibiotics, Nursing Homes, Elderly, Quality Improvement, Quality of Care, Medication
Crystal S, Jarrín OF, Rosenthal M
National partnership to improve dementia care in nursing homes campaign: state and facility strategies, impact, and antipsychotic reduction outcomes.
This study examines the success of the national partnership campaign to reduce prescription of antipsychotic medications to elderly nursing home residents with dementia. Antipsychotic medications have been shown to increase mortality. Use of these medications had increased 23.9% in dementia patients by 2011. The campaign reduced use by 40.1% to 14.3% by the second quarter of 2019. The campaign measured progress with public reporting of quality measures, increased regulatory scrutiny, and accompanying state and facility initiatives. Sedative-hypnotic medication use also decreased in tandem with antipsychotic reduction suggesting that the campaign increased attention to the use of other risky psychotropic medications.
AHRQ-funded; HS023464; HS022406; HS023258; HS021112.
Citation: Crystal S, Jarrín OF, Rosenthal M .
National partnership to improve dementia care in nursing homes campaign: state and facility strategies, impact, and antipsychotic reduction outcomes.
Innov Aging 2020 Jun 2;4(3):igaa018. doi: 10.1093/geroni/igaa018..
Keywords: Elderly, Nursing Homes, Long-Term Care, Dementia, Neurological Disorders, Quality Improvement, Quality of Care, Medication, Mortality
Olivieri-Mui B, McGuire J, Griffith J
Assessing the quality of human immunodeficiency virus care in nursing homes.
Quality of human immunodeficiency virus (HIV) care in nursing homes (NHs) has never been measured. In this cross-sectional study, the investigators assessed the quality of human immunodeficiency virus care in nursing homes. This study provides previously unknown baseline metrics on NH HIV care quality and highlights significant challenges when measuring HIV care in NHs.
AHRQ-funded; HS025662.
Citation: Olivieri-Mui B, McGuire J, Griffith J .
Assessing the quality of human immunodeficiency virus care in nursing homes.
J Am Geriatr Soc 2020 Jun;68(6):1226-34. doi: 10.1111/jgs.16359..
Keywords: Elderly, Human Immunodeficiency Virus (HIV), Nursing Homes, Long-Term Care, Quality of Care
Campbell Britton M, Petersen-Pickett J, Hodshon B
Mapping the care transition from hospital to skilled nursing facility.
Researchers used process mapping to illustrate the sequence of events involved with hospital discharge and admission to a skilled nursing facility (SNF). These transitions are often associated with breakdowns in communication that may place patients at risk for adverse events. A quality improvement (QI) team worked with frontline staff at an academic medical center and two local SNFs in the northeastern United States. The final process map included care management, medicine, nursing, admissions and physical therapy service staff. The process map showed numerous activities that need to be coordinated between care teams, and highlighted specific opportunities for improving communication between different teams.
AHRQ-funded; HS023554.
Citation: Campbell Britton M, Petersen-Pickett J, Hodshon B .
Mapping the care transition from hospital to skilled nursing facility.
J Eval Clin Pract 2020 Jun;26(3):786-90. doi: 10.1111/jep.13238..
Keywords: Transitions of Care, Care Coordination, Quality Improvement, Communication, Hospital Discharge, Hospitals, Nursing Homes, Quality of Care
Ryskina KL, Andy AU, Manges KA
Association of online consumer reviews of skilled nursing facilities with patient rehospitalization rates.
The purpose of this study was to: 1.) assess the association between rehospitalization rates and online ratings of skilled nursing facility (SNFs); 2.) Compare the association of rehospitalization with ratings from a review website vs Medicare Nursing Home Compare (NHC) ratings; and 3.) Identify specific topics consistently reported in reviews of SNFs with the highest vs lowest rehospitalization rates using natural language processing.
AHRQ-funded; HS026116.
Citation: Ryskina KL, Andy AU, Manges KA .
Association of online consumer reviews of skilled nursing facilities with patient rehospitalization rates.
JAMA Netw Open 2020 May;3(5):e204682. doi: 10.1001/jamanetworkopen.2020.4682..
Keywords: Nursing Homes, Hospital Readmissions, Provider Performance, Quality of Care, Medicare, Elderly
Ogletree AM, Mangrum R, Harris Y
AHRQ Author: Bergofsky L Perfetto D
Omissions of care in nursing home settings: a narrative review.
This review aimed to (1) examine existing definitions of omissions of care in the healthcare environment and associated characteristics and (2) outline adverse events that may be attributable to omissions of care among nursing home populations. The investigators concluded that definitions of omissions of care for nursing homes varied in scope and level of detail. Substantial evidence connected omissions of care with an array of adverse events in nursing home populations.
AHRQ-authored; AHRQ-funded; 233201500014I.
Citation: Ogletree AM, Mangrum R, Harris Y .
Omissions of care in nursing home settings: a narrative review.
J Am Med Dir Assoc 2020 May;21(5):604-14. doi: 10.1016/j.jamda.2020.02.016..
Keywords: Nursing Homes, Long-Term Care, Adverse Events, Medical Errors, Patient Safety, Quality of Care
Sanghavi P, Pan S, Caudry D
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
The purpose of this study was to assess the accuracy of nursing home self-report of major injury falls on the Minimum Data Set (MDS). They linked inpatient claims for major injury falls with MDS assessments. The investigators concluded that the nursing home-reported data used for the Nursing Home Compare (NHC) falls measure may be highly inaccurate.
AHRQ-funded; HS026957.
Citation: Sanghavi P, Pan S, Caudry D .
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
Health Serv Res 2020 Apr;55(2):201-10. doi: 10.1111/1475-6773.13247..
Keywords: Falls, Nursing Homes, Quality Measures, Quality Indicators (QIs), Quality of Care, Elderly, Public Reporting, Injuries and Wounds
White EM, Aiken LH, Sloane DM
Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction.
The objective of this cross-sectional study was to examine the relationships between work environment, care quality, registered nurse (RN) burnout, and job dissatisfaction in nursing homes. In this study, the investigators linked 2015 RN4CAST-US nurse survey data with LTCfocus and Nursing Home Compare. They indicate that their results suggest that the work environment is an important area to target for interventions to improve care quality and nurse retention in nursing homes.
AHRQ-funded; HS000011.
Citation: White EM, Aiken LH, Sloane DM .
Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction.
Geriatr Nurs 2020 Mar-Apr;41(2):158-64. doi: 10.1016/j.gerinurse.2019.08.007..
Keywords: Elderly, Nursing Homes, Burnout, Provider: Nurse, Provider, Quality of Care, Provider Performance
Fashaw SA, Thomas KS, McCreedy E
Thirty-year trends in nursing home composition and quality since the passage of the Omnibus Reconciliation Act.
In 1987, the Omnibus Reconciliation Act (OBRA) called for a dramatic overhaul of the nursing home (NH) quality assurance system. This study examined trends in facility, resident, and quality characteristics since passage of that legislation. The investigators indicated that the 30th anniversary of OBRA provided a unique opportunity to reflect, consider lessons learned, and think about the future of this and other sectors of long-term care
AHRQ-funded; HS000011.
Citation: Fashaw SA, Thomas KS, McCreedy E .
Thirty-year trends in nursing home composition and quality since the passage of the Omnibus Reconciliation Act.
J Am Med Dir Assoc 2020 Feb;21(2):233-39. doi: 10.1016/j.jamda.2019.07.004..
Keywords: Nursing Homes, Quality of Care, Long-Term Care, Policy
Simpson KR, Lyndon A, Spetz J
A 2-year pragmatic trial of antibiotic stewardship in 27 community nursing homes.
The purpose of this study was to determine associations between missed nursing care and nurse staffing during labor and birth, and exclusive breast milk feeding at hospital discharge. Exclusive breast milk feeding is a national quality indicator of inpatient maternity care. Nurses have substantial responsibility for direct support of infant feeding during the childbirth hospitalization. The investigators indicate that the results support exclusive breast milk feeding as a nurse-sensitive quality indicator.
AHRQ-funded; HS022846.
Citation: Simpson KR, Lyndon A, Spetz J .
A 2-year pragmatic trial of antibiotic stewardship in 27 community nursing homes.
J Am Geriatr Soc 2020 Jan;68(1):46-54. doi: 10.1111/jgs.16059..
Keywords: Antibiotics, Medication, Antimicrobial Stewardship, Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care
Sharma H, Konetzka RT, Smieliauskas F
The relationship between reported staffing and expenditures in nursing homes.
AHRQ-funded; HS024967.
Citation: Sharma H, Konetzka RT, Smieliauskas F .
The relationship between reported staffing and expenditures in nursing homes.
Med Care Res Rev 2019 Dec 1;76(6):758-83. doi: 10.1177/1077558717739214..
Keywords: Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care, Provider Performance, Medicare
Li Y, Cen X, Cai X
Perceived patient safety culture in nursing homes associated with "Nursing Home Compare" performance indicators.
This study examined the association between the use of “Nursing Home Compare” performance indicators and improved patient safety culture in nursing homes. A survey was conducted in 2017 using AHRQ’s Survey on Patient Safety Culture for Nursing Homes which collects data on 12 core domains of safety culture scores. Out of 2254 nursing homes sampled, there was a response rate of 36%. It was found that for every 10 percentage points increase in overall positive response rate for safety culture, there was an association with 0.56 fewer health care deficiencies, 0.74 fewer substantiated complaints, reduced fines by $2285.20, and 20% increased odds of being designed as 4-star or 5-star.
AHRQ-funded; HS024923.
Citation: Li Y, Cen X, Cai X .
Perceived patient safety culture in nursing homes associated with "Nursing Home Compare" performance indicators.
Med Care 2019 Aug;57(8):641-47. doi: 10.1097/mlr.0000000000001142..
Keywords: Surveys on Patient Safety Culture, Patient Safety, Nursing Homes, Quality Indicators (QIs), Quality Measures, Quality of Care, Provider Performance
Perraillon MC, Brauner DJ, Konetzka RT
Nursing home response to Nursing Home Compare: the provider perspective.
This paper examined the validity of quality ratings of nursing homes with Nursing Home Compare (NHC) and assessed the views of nursing home administrators and staff. There was a conflict found between improving ratings and competing goals of maximizing profits and avoidance of litigation. Since the NHC is self-reported there is controversy on its validity due to self-reporting bias.
AHRQ-funded; HS018718.
Citation: Perraillon MC, Brauner DJ, Konetzka RT .
Nursing home response to Nursing Home Compare: the provider perspective.
Med Care Res Rev 2019 Aug;76(4):425-43. doi: 10.1177/1077558717725165..
Keywords: Long-Term Care, Nursing Homes, Provider Performance, Quality of Care, Quality Improvement
Bain AM, Werner RM, Yuan Y
Do hospitals participating in accountable care organizations discharge patients to higher quality nursing homes?
This study examined whether hospitals participating in Medicare's Shared Saving Program increased use of highly rated skilled nursing facilities (SNFs) or decreased the use of low-rated SNFs after initiation of accountable care organization (ACO) contracts, compared with non-ACO hospitals. The findings indicate that, after joining an ACO, the percentage of hospital discharges going to a high-quality SNF increased slightly; the probability of discharge from ACO-participating hospitals to low-quality SNFs did not change significantly in comparison with non-ACO hospitals.
AHRQ-funded; HS024266.
Citation: Bain AM, Werner RM, Yuan Y .
Do hospitals participating in accountable care organizations discharge patients to higher quality nursing homes?
J Hosp Med 2019 May;14(5):288-89. doi: 10.12788/jhm.3147..
Keywords: Elderly, Hospital Discharge, Hospitals, Medicare, Nursing Homes, Quality of Care
Li Y, Cai X, Wang M
Social media ratings of nursing homes associated with experience of care and "Nursing Home Compare" quality measures.
This study compared the ratings of nursing homes on social media sites as compared to a quality-measure based rating system. Four popular social media sites (Facebook, Yelp, Google Consumer Reviews, and caring.com) were compared to ratings on the Nursing Home Compare (NHC) site at 196 nursing homes in Maryland. There was a positive correlation between ratings for the same nursing home for social media and NHC.
AHRQ-funded; HS024923.
Citation: Li Y, Cai X, Wang M .
Social media ratings of nursing homes associated with experience of care and "Nursing Home Compare" quality measures.
BMC Health Serv Res 2019 Apr 27;19(1):260. doi: 10.1186/s12913-019-4100-7..
Keywords: Nursing Homes, Quality of Care, Quality Measures, Social Media