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Rehabilitation Dataset Directory: Dataset Profile


Dataset: Nursing Home Compare ()

Basic Information
Dataset full name: Nursing Home Compare
Dataset acronym
Summary The Centers for Medicare and Medicaid Services (CMS) launched a quality rating system for Medicare and Medicaid certified nursing homes (skilled nursing and long-term care facilities) on December 2008. This ongoing data collection aims to assist consumers (including patients) in selecting nursing homes by evaluating outcomes and deficiencies. The Nursing Home Compare uses a “five star rating” system, which is a composite measure derived from health inspection findings of these facilities, staffing (e.g., availability of nursing staff per resident per day), and quality measures (e.g., falls, pain, functional status, hospital readmissions).

Note that no patient level data is available. All data is aggregated at the national, state and individual Nursing Home level.
Key Terms Skilled Nursing care, swing beds, nursing home quality of care, nursing home staffing information, regulatory compliance, long-stay quality outcomes, short-stay quality outcomes, MDS dataset
Study Design Longitudinal
Data Type(s) Administrative
Sponsoring Agency/Entity Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS)
Health conditions/Disability measures
Health condition(s) NA
Disability Measures NA
Measures/outcomes of interest
Topics State and regional variations in nursing home quality outcomes. Nursing home quality measures
Longitudinal assessment of nursing homes’ improvement in quality outcomes
Short-stay resident measures: Proportion with: Functional status, hospital readmissions, emergency room visits, discharge to community, new or worsened pressure ulcers.
Long-stay residents measures: Proportion reporting: Falls, urinary tract infections, moderate to severe pain, pressure ulcers, functional status independence/improvement, weight loss, need for help with daily activities increased, depressive symptoms
Health and fire inspection deficiencies at nursing homes, staffing numbers per resident and association with quality care, short and long stay outcomes.
Sample
Sample Population All Medicare and Medicaid-certified nursing homes
Sample Size/Notes 15,652 (January 2017) Medicare and Medicaid participating nursing homes included
Number of Nursing homes varies year to year
Unit of Observation Facility
Geographic Coverage National
Geographic specificity Individual Nursing home facilities
Data Collection
Data Collection Mode Administrative claims data
Inspection reports / observational assessment
Observational assessment and medical records review of patients (MDS data)
Years Collected December 2008-present
Data Collection Frequency Quarterly
Strengths and limitations
Strengths Data includes all Medicare and Medicaid-certified nursing homes and are ideal for doing research on regional and state variation on quality outcomes.
Data can be linked with other CMS datasets.
Risk-adjusted composite measures for quality outcomes allow for meaningful comparisons.
Comparisons can be made on national/state/facility level for different time periods.
Limitations Patient-level data not available, only summaries at the nursing home level.
Potential bias could be introduced in staffing data and MDS quality outcomes since they are self-reported by nursing homes.
In 2016 and 2017 several changes made to the quality measure (QM) domain of the Five Star Nursing Home Quality Rating System including five new measures and methodological changes which may raise issues when comparing across years of data.
Data details
Primary Website https://www.medicare.gov/nursinghomecompare/search.html
Data Access Current period data:
https://data.medicare.gov/data/nursing-home-compare

Archived data:
https://data.medicare.gov/data/archives/nursing-home-compare
Data Access Requirements Public Use Dataset
Summary Tables/reports National and State averages:
https://data.medicare.gov/Nursing-Home-Compare/State-Averages/xcdc-v8bm
Dataset components (where applicable) 1. Data available as Microsoft access database or csv files
Comprised of 8 files:
ProviderInfo
Deficiencies
SurveySummary
QualityMsrMDS
Quality MSR Claims
Ownership
Penalties
StateAverages
Selected papers
Technical Quality measures and risk-adjustment specifications: Design for Nursing Home Compare Five-Star Quality Rating System: Technical Users’ Guide January 2017
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/usersguide.pdf

Quality measures technical information page:
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIQualityMeasures.html

Nursing Home Compare Quality Measure Technical Specification
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/New-Measures-Technical-Specifications-DRAFT-04-05-16-.pdf
Other Papers Nursing home quality: a comparative analysis using CMS Nursing Home Compare data to examine differences between rural and nonrural facilities.
https://www.ncbi.nlm.nih.gov/pubmed/23583002

Use Of Nursing Home Compare Website Appears Limited By Lack Of Awareness And Initial Mistrust Of The Data
https://www.ncbi.nlm.nih.gov/pubmed/27044972



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The Rehabilitation Research Cross-dataset Variable Catalog has been developed through the Center for Large Data Research & Data Sharing in Rehabilitation (CLDR). The Center for Large Data Research and Data Sharing in Rehabilitation involves a consortium of investigators from the University of Texas Medical Branch, Cornell University's Yang Tan Institute (YTI), and the University of Michigan. The CLDR is funded by NIH - National Institute of Child Health and Human Development, through the National Center for Medical Rehabilitation Research, the National Institute for Neurological Disorders and Stroke, and the National Institute of Biomedical Imaging and Bioengineering. (P2CHD065702).

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