Nursing homes'quality and variations in state regulations Quality of care in nursing homes has been of concern for many years and continues to be of concern despite recent reforms implemented by the Centers for Medicare &Medicaid Services (CMS) - reforms of the regulatory oversight process and the publication of nursing home quality report cards on the web. The objective of this project is to contribute to the knowledge base regarding factors influencing quality of nursing home care by examining the relationships between aspects of state regulations (the """"""""state survey"""""""" process and civil monetary penalties) and several dimensions of quality.
The specific aims are to test the hypotheses that the stirngency of the state regulatory process is associated with 1) clinical quality measured by risk- adjusted health outcomes;2) staffing;and 3) quality of hotel services. This study will bridge a gap in the extant literature on the determinants of high quality nursing home care. The study will combine data obtained from a survey of state licensure offices, the Minimum Data Set (MDS), the Medicare Denominator file, and several other sources including the U.S. Census, the Bureau of Labor Statistics, and the General Accountability Office (GAO). Statistical regression techniques will be used to test the hypotheses that specific aspects of the state survey and enforcement process are associated with quality of care. Instrumental variable techniques will be used to address the potential endogeneity of quality and quality regulation. The public health implications of this study derive from the role of the information and knowledge developed by it. This study will inform state and federal policy reform efforts targeted at regulation and enforcement policies designed to promote high quality of care in nursing homes, which provide care to one of the most vulnerable segments of the U.S. population.
| Mukamel, Dana B; Haeder, Simon F; Weimer, David L (2014) Top-down and bottom-up approaches to health care quality: the impacts of regulation and report cards. Annu Rev Public Health 35:477-97 |
| Pesis-Katz, Irena; Phelps, Charles E; Temkin-Greener, Helena et al. (2013) Making difficult decisions: the role of quality of care in choosing a nursing home. Am J Public Health 103:e31-7 |
| Mukamel, Dana B; Li, Yue; Weimer, David L et al. (2013) What factors contribute to successful appeals of nursing homes' deficiencies in the informal dispute resolution process? J Am Med Dir Assoc 14:101-4 |
| Mukamel, Dana B; Weimer, David L; Harrington, Charlene et al. (2012) The effect of state regulatory stringency on nursing home quality. Health Serv Res 47:1791-813 |
| Mukamel, Dana B; Weimer, David L; Li, Yue et al. (2012) Nursing homes appeals of deficiencies: the informal dispute resolution process. J Am Med Dir Assoc 13:512-6 |
| Spector, William D; Limcangco, Maria Rhona; Ladd, Heather et al. (2011) Incremental cost of postacute care in nursing homes. Health Serv Res 46:105-19 |
| Mukamel, Dana B; Li, Yue; Harrington, Charlene et al. (2011) Does state regulation of quality impose costs on nursing homes? Med Care 49:529-34 |
| Li, Yue; Harrington, Charlene; Spector, William D et al. (2010) State regulatory enforcement and nursing home termination from the medicare and medicaid programs. Health Serv Res 45:1796-814 |
| Li, Yue; Schnelle, John; Spector, William D et al. (2010) The ""Nursing Home Compare"" measure of urinary/fecal incontinence: cross-sectional variation, stability over time, and the impact of case mix. Health Serv Res 45:79-97 |
| Mukamel, Dana B; Glance, Laurent G; Dick, Andrew W et al. (2010) Measuring quality for public reporting of health provider quality: making it meaningful to patients. Am J Public Health 100:264-9 |
Showing the most recent 10 out of 11 publications
