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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

Hospitals and health care facilities/providers, 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

Continent(s) North America
Countries

United States

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/archives/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 

Data Components

Data available as Microsoft access database or csv files
Comprised of 8 files:

  • Provider Info
  • Deficiencies
  • Survey Summary
  • Quality Msr MDS
  • Quality MSR Claims
  • Ownership
  • Penalties
  • State Averages
Similar/Related Dataset(s)

Home Health Compare

Inpatient Rehabilitation Facility Compare

Selected Papers
Other Papers

Nursing home quality: a comparative analysis using CMS Nursing Home Compare data to examine differences between rural and non-rural 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

Technical

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/Nursing-Home-Compare-Claims-based-Measures-Technical-Specifications.pdf


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