Table 3 Multivariate logistic model results examining the influence of competition and occupancy on quality measure scores.
| Quality measures | n | Competition*1 | Occupancy*2 | Competition × occupancy interaction*3 |
|---|---|---|---|---|
| AOR (95% CI) | AOR (95% CI) | AOR (95% CI) | ||
| 1. Percentage of residents whose need for help with daily activities has increased | 8446 | 1.18 (1.03 to 1.27*) | 0.85 (0.64 to 0.96**) | 0.92 (0.76 to 1.05) |
| 2. Percentage of residents with moderate to severe pain | 6105 | 1.10 (0.98 to 1.32) | 0.97 (0.61 to 1.04) | 0.99 (0.67 to 1.10) |
| 3. Percentage of low‐risk residents who have pressure sores | 9999 | 1.14 (1.01 to 1.26*) | 0.86 (0.70 to 0.97*) | 0.88 (0.71 to 0.97*) |
| 4. Percentage of residents who are physically restrained | 11 885 | 0.81 (0.76 to 1.03) | 1.11 (0.90 to 1.32) | 0.91 (0.86 to 1.12) |
| 5. Percentage of residents who are more depressed or anxious | 11 901 | 0.95 (0.80 to 1.02) | 0.96 (0.80 to 1.12) | 0.97 (0.82 to 1.15) |
| 6. Percentage of low‐risk residents who have lost control over their bowels or bladder | 12 005 | 0.92 (0.81 to 1.08) | 0.98 (0.81 to 1.22) | 0.93 (0.78 to 1.19) |
| 7. Percentage of residents who have/had a catheter inserted and left in their bladder | 12 019 | 1.07 (0.89 to 1.10) | 0.89 (0.77 to 1.00*) | 0.90 (0.79 to 0.98*) |
| 8. Percentage of residents who spend most of their time in bed or in a chair | 11 942 | 0.93 (0.81 to 1.05) | 0.90 (0.72 to 1.15) | 0.95 (0.77 to 1.12) |
| 9. Percentage of residents whose ability to move about in and around their room has become worse | 10 068 | 0.96 (0.86 to 1.11) | 0.93 (0.88 to 0.99*) | 0.95 (0.82 to 0.99*) |
| 10. Percentage of residents with a urinary tract infection | 11 451 | 0.95 (0.86 to 1.05) | 1.03 (0.93 to 1.12) | 0.93 (0.86 to 1.10) |
| 11. Percentage of residents who have lost too much weight | 12 024 | 0.87 (0.79 to 1.08) | 0.91 (0.88 to 1.13) | 0.97 (0.89 to 1.10) |
| 12. Percentage of short‐stay residents with delirium | 8596 | 1.25 (1.04 to 1.29*) | 0.85 (0.69 to 0.99*) | 0.88 (0.70 to 0.97*) |
| 13. Percentage of short‐stay residents with moderate to severe pain | 8513 | 1.21 (1.07 to 1.33*) | 0.73 (0.61 to 0.95*) | 0.75 (0.68 to 0.98*) |
| 14. Percentage of short‐stay residents with pressure sores | 7731 | 1.15 (1.03 to 1.27*) | 0.84 (0.78 to 0.97*) | 0.99 (0.70 to 1.17) |
| Overall quality measures' difference | 12 974 | 1.12 (1.03 to 1.16*) | 0.89 (0.76 to 0.98*) | 0.93 (0.79 to 0.97*) |
AOR, adjusted odds ratio.
The total number of facilities is 14 554. However, for each of the 14 quality measures, we include only those facilities with scores available for both years for calculating the difference. In all cases, variables included in the estimating equations include aggregate resident factors (ie, dementia, activities of daily living) and facility factors (ie, ownership, chain membership, bed size, staffing levels).
*AOR results reported for the highest quartile compared with the lowest quartile; (1) The analyses are coded such that AOR >1 indicates that greater competition is associated with improved QM scores. (2) The analyses are coded such that AOR >1 indicate that high occupancy is associated with improved QM scores. (3) The analyses are coded such that AOR >1 indicates that lower competition and high occupancy are associated with improved QM scores.