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. 2015 Oct;72(5):562-79.
doi: 10.1177/1077558715588436. Epub 2015 May 27.

The Role of Severe Dementia in Nursing Home Report Cards

R Tamara Konetzka  1 , Daniel J Brauner  2 , Marcelo Coca Perraillon  2 , Rachel M Werner  3
Affiliations

The Role of Severe Dementia in Nursing Home Report Cards

R Tamara Konetzka et al. Med Care Res Rev. 2015 Oct.

Abstract

Health care report cards are intended to improve quality, but there may be considerable heterogeneity in who benefits. In this article, we examine the intended and unintended effects of quality reporting for nursing home residents with severe dementia relative to other residents, using a difference-in-differences design to examine selected reported and unreported quality measures. Our results indicate that prior to public reporting, nursing home residents with severe dementia were at significantly higher risk of poor outcomes on most reported quality measures. After public reporting was initiated, outcomes for nursing home residents with severe dementia did not consistently improve or worsen. We see no evidence that individuals with severe dementia are being avoided by nursing homes, despite their potential negative impact on quality scores, but we do find an increase in coding of end-stage disease. Additional risk-adjustment, stratification, or additional quality measures may be warranted.

Keywords: dementia; long-term care; nursing homes; public reporting; quality.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Nursing home quality by dementia status among chronic-care nursing home residents.
See this image and copyright information in PMC

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