Title: Nursing home quality: does financial performance matter?

Authors: Mei Zhao, Reid M. Oetjen, JoAnn M. Nolin, Henry J. Carretta

Addresses: Public Health Department, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, USA. ' Department of Health Management and Informatics, University of Central Florida, P.O. Box 162205, Orlando, FL 32816-2205, USA. ' Public Health Department, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, USA. ' Department of Health Administration, Virginia Commonwealth University P.O. Box 980203, Richmond, VA 23298-0203, USA

Abstract: This study explores the relationship between financial condition and selected quality measures for 1,197 nursing homes in Florida. Data sources included the Online Survey, Certification and Reporting (OSCAR) data reports and the Center for Medicare and Medicaid Services (CMS) Medicare cost report from 2002-2005. Quality measures included surveyor-reported deficiencies and facility-reported incidents of urinary catheterisation, restraint use, and pressure sores. The study conducted multivariate regression analyses using a cross-sectional time series generalised estimating equation (GEE) model to examine the effect of nursing home financial performance on each of these quality measures. Nursing homes in the lowest financial performance category had significantly higher total deficiencies, higher rates of catheterisation and higher incidences of pressure sores when compared to top performers. Policymakers need to closely monitor the financial performance of these poorest performers to ensure that they can survive financially while ensuring a safe environment and delivery of high quality care.

Keywords: nursing homes; financial performance; quality measures; USA; United States; urinary catheterisation; restraint use; pressure sores; healthcare quality; care costs.

DOI: 10.1504/IJPP.2010.030600

International Journal of Public Policy, 2010 Vol.5 No.2/3, pp.143 - 159

Published online: 26 Dec 2009 *

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