Nursing homes have a long history of mandates from Congress to improve quality of care. The Omnibus Reconciliation Act of 1987 included provisions to improve nursing home care. These provisions called for developing The Minimum Data Set for Resident Assessment and Care Screening. Nursing Home Compare available at www.medicare.gov contains information about all 14 quality measures (QMs) collected in nursing homes. This study evaluated nursing home facility QM scores, obtained from the NHC national database, in Missouri. Staffing measures, number of hours/resident/day, for RNs, LVNs, and CNAs were evaluated to determine differences in QMs associated with staffing levels. For this study, the NHC database was downloaded in February 2004. ANOVA procedures were used to determine differences in scores associated with different levels of staffing in Missouri nursing homes. Statistical measures in 3 QMs revealed differences in-group means: Two chronic, 1) residents who loose bowel control, 2) residents whose need for help with daily activities increased, and one post-acute, 3) short stay residents with moderate to severe pain, revealed differences in means of CNAs and RN/LPN groups, respectively. ANOVA results measuring low risk residents who loose bowel control indicated significant differences in CNA groups. ANOVA for residents whose need for help with daily activities showed significant main effects in the RN and LPN groups. Finally, ANOVA for short stay residents with moderate to severe pain, indicated significant differences in LPN groups. The only significant interaction with number/residents/facility occurred in short stay residents who had moderate to severe pain. Nursing home quality measures are important to determine the level of quality nursing homes offer. Large national datasets providing data about nursing home quality play an important role in consumers’ ability to choose a nursing home or researchers’ ability to recommend best practice standards with the nursing home setting.
Session #1125 - Nursing Informatics Research: Supporting Patient Safety and Quality of Care
The 29th Annual MNRS Research Conference (April 1-4, 2005)