APPENDIX. Exhibit A1. Characteristics of free-standing nursing homes by concentration of racial/ethnic minority residents, 2010*

Size: px

Start display at page:

Download "APPENDIX. Exhibit A1. Characteristics of free-standing nursing homes by concentration of racial/ethnic minority residents, 2010*"

Gervase Kelly Norris
5 years ago
Views:

1 Li Y, Harrington C, Temkin-Greener H, You K, Cai X, Cen X, et al. Deficiencies in care at nursing homes and in racial/ethnic disparities across homes fell, Health Aff (Millwood). 2015;34(7). APPENDIX Exhibit A1. Characteristics of free-standing nursing homes by concentration of racial/ethnic minority residents, 2010* Nursing homes with concentrations of racial/ethnic minority residents that are Low (<5%) Medium (5-15%) Medium-high (15-35%) High ( 35%) Number of nursing homes Percent of total, % Concentration of minority residents, mean±sd, % 1.41± ± ± ±15.74 Number of beds, mean±sd 94.36± ± ± ±70.26 Chain affiliated, % Profit status, % For-profit Non-for-profit Government Occupancy rate, mean±sd, % 84.38± ± ± ±12.51 Percentage of Medicare residents, mean±sd 13.91± ± ± ±8.73 Percentage of Medicaid residents, mean±sd 54.45± ± ± ±15.20 Case mix index, mean±sd 0.83± ± ± ±0.11 Percentage of residents with behavioral 27.46± ± ± ±20.12 symptoms, mean±sd, % Percentage of female residents, mean±sd, % 74.12± ± ± ±13.22 Average age of residents, mean±sd 83.65± ± ± ±8.54 Nurse staffing (hours per resident data), mean±sd Registered nurse 0.42± ± ± ±0.31 Licensed practical 0.76± ± ± ±0.31 nurse Certified nursing 2.28± ± ± ±0.89 assistant Market competition 0.76± ± ± ±0.23 Note: *P<0.001 for comparisons of all characteristics across nursing home groups, based on analyses of variance for continuous variables and chi-square tests for categorical variables. SD=Standard Deviation.

2 Number <5% Minority 5-15% Minority 15-35% Minority 35% Minority Year (a) Life safety deficiencies % of nursing homes <5% Minority 5-15% Minority 15-35% Minority 35% Minority Year (b) Any G-L deficiencies Exhibit A2. Trends of (a) number of life safety deficiencies, and (b) rate of facilities with any G+ deficiencies for freestanding nursing homes, by concentration of racial/ethnic minority residents,

3 Exhibit A3. Deficiencies by nursing home concentration of racial/ethnic minority residents and year Number Unadjusted Concentration Number of life safety deficiencies of minorities Change in Number Unadjusted Adjusted Adjusted adjusted disparity disparity a disparity disparity a disparity b Low (<5%) Medium (5-15%) *** *** -0.19*** Medium-high *** *** -0.08* (15-35%) High ( 35%) *** *** -0.18** Rate of any deficiency at G level or higher Change in % Unadjusted odds ratio Adjusted odds ratio c % Unadjusted odds ratio Adjusted odds ratio c adjusted odds ratio d Low (<5%) Medium (5-15%) ** 1.12 Medium-high (15-35%) * * 1.01 High ( 35%) * Note: a Calculated as Def (IRR 1), where Def is the mean number of life safety deficiencies for nursing homes with low concentrations of minority residents in the year, and IRR is the adjusted incidence rate ratio of each other concentration group estimated from a multivariable random-effects Poisson regression that modeled deficiency number as a function of minority concentration groups, year dummies, their interactions, bed size, chain affiliation, nonprofit ownership, government ownership, occupancy rate, percentage of Medicare residents, percentage of Medicaid residents, case mix, percentage of residents with behavioral symptoms, percentage of female residents, average age of residents, staffing levels for RNs, LPNs, and CNAs, market completion, and state dummies. b Adjusted disparity of 2011 adjusted disparity of c Estimated from a multivariable random-effects logistic regression that modeled any G-L deficiencies of a facility as a function of the same independent variables described above. d Adjusted odds ratio of 2011 adjusted odds ratio of *p<0.05; **p<0.01; ***p<0.001.

4 4 3 2 Number IL CA KS WA MS AR MA TN LA TX NJ PA OK AL FL SC GA KY VA AZ IN MO OH NY NC CO MD DE CT MI WI State - 2 (a) Difference in life safety deficiencies % of nursing homes WA SC CO MD NY KY OK AL TN CA NJ GA PA IL State FL TX CT VA OH MOMS MA LA DE NC IN WI AR AZ KS MI (b) Difference in rate of having any G-L deficiencies Exhibit A4. Site-of-care differences between nursing homes with high concentrations of racial/ethnic minority residents ( 35%) and nursing homes with low minority concentrations (<5%) in (a) average number of life safety deficiencies, and (b) percent of nursing homes with any G-L deficiencies, in 2010 and by state. Note: States are not included here if in 2010, they had less than 5 nursing homes in the group of low minority concentrations (Hawaii and New Mexico) or less than 5 nursing homes in the group of high minority concentrations (Alaska, Washington DC, Iowa, Idaho, Maine, Minnesota, Montana, North Dakota, Nebraska, New Hampshire, Nevada, Oregon, Rhode Island, South Dakota, Utah, Vermont, West Virginia, and Wyoming).

5 Exhibit A5. Effect of Medicaid payment rate and case-mix method on nursing home deficiencies (main effects) and racial/ethnic disparities in deficiencies (effects of interactions) Medicaid payment or nursing home concentration of minorities Number of life safety deficiencies Adjusted Effect on deficiencies or IRR a disparities Effect b p Payment rate (in $10) Case mix payment Payment rate (in $10) Medium (5-15%) Medium-high (15-35%) High ( 35%) Case mix payment Medium (5-15%) Medium-high (15-35%) High ( 35%) Rate of any G-L deficiencies Adjusted OR c Effect on deficiencies or disparities Effect p Payment rate (in $10) Case mix payment Payment rate (in $10) Medium (5-15%) Medium-high (15-35%) High ( 35%) Case mix payment Medium (5-15%) Medium-high (15-35%) High ( 35%) Note: IRR=incidence rate ratio; OR=odds ratio. a Multivariable longitudinal ( ) random-effects Poisson regression modeled deficiency number as a function of minority concentration groups, year dummies, their interactions, Medicaid payment rate and its interactions with minority groups, case-mix payment method and its interactions with minority groups, bed size, chain affiliation, nonprofit ownership, government ownership, occupancy rate, percentage of Medicare residents, percentage of Medicaid residents, case mix, percentage of residents with behavioral symptoms, percentage of female

6 residents, average age of residents, staffing levels for RNs, LPNs, and CNAs, market completion, and state dummies. b Calculated as Def (IRR 1), where Def is the mean life safety deficiencies of all nursing homes in the sample (for main effects) or nursing homes with low concentrations of minority residents (for interactive effects), and IRR is the adjusted incidence rate ratio. c Multivariable longitudinal ( ) random-effects logistic regression modeled the likelihood of any G-L deficiencies of the nursing home as a function of the same independent variables described above.

Dashboard. Campaign for Action. Welcome to the Future of Nursing:

Dashboard. Campaign for Action. Welcome to the Future of Nursing: Welcome to the Future of Nursing: Campaign for Action Dashboard About This Dashboard: These graphs and charts show goals by which the Campaign evaluates its efforts to implement recommendations in the