Table 4.
Results from Regressions Showing Effect of P4P Implementation on Nursing Home Quality
| Resident-Level Outcomes | Facility-Level Outcomes | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Catheter Inserted | Physically Restrained | Pain | Falls | Pressure Sores | Weight Loss | Total Number of Deficiencies | Immediate Jeopardy Deficiencies | Total Staff HPRD | RN + LPN HPRD | |
| One year following P4P implementation | ||||||||||
| P4P | 0.0016* (0.0008) | −0.0050*** (0.0012) | −0.0050*** (0.0017) | 0.0019 (0.0014) | −0.0032** (0.0016) | 0.0026* (0.0015) | 0.1178*** (0.0094) | 0.6794*** (0.1119) | −0.0148 (0.0161) | −0.0029 (0.0085) |
| Constant | 0.153*** (0.0022) | 0.0274** (0.0112) | 0.175*** (0.0036) | 0.0575*** (0.0013) | 0.146*** (0.0027) | 0.0684*** (0.0017) | 1.3948*** (0.0350) | −0.1698 (0.2589) | 3.170*** (0.163) | 1.359*** (0.107) |
| Observations | 34,809,913 | 35,691,015 | 35,545,537 | 30,037,910 | 20,704,519 | 34,205,962 | 447,016 | 73,665 | 437,288 | 437,288 |
| Number of nursing homes | 14,511 | 15,257 | 14,925 | 14,462 | 15,122 | 14,687 | 16,265 | 2,452 | 16,661 | 16,661 |
| Two years following P4P implementation | ||||||||||
| P4P | 0.0026*** (0.0010) | −0.0078*** (0.0013) | −0.0061*** (0.0018) | 0.0024* (0.0013) | −0.0033** (0.0016) | 0.0026* (0.0014) | 0.131*** (0.0080) | 0.9592*** (0.0874) | −0.0066 (0.0150) | −0.0059 (0.0079) |
| Constant | 0.153*** (0.0021) | 0.0277** (0.0111) | 0.175*** (0.0036) | 0.0574*** (0.0013) | 0.146*** (0.0027) | 0.0444*** (0.0132) | 1.378*** (0.0347) | −0.2021*** (0.2570) | 3.166*** (0.161) | 1.352*** (0.105) |
| Observations | 34,975,704 | 35,982,151 | 35,771,523 | 30,174,254 | 20,880,951 | 34,364,577 | 456,916 | 74,708 | 447,809 | 447,809 |
| Number of nursing homes | 14,514 | 15,265 | 14,929 | 14,465 | 15,132 | 14,691 | 16,351 | 2,510 | 16,721 | 16,721 |
| Resident covariates | X | X | X | X | X | X | ||||
| Facility covariates | X | X | X | X | X | X | X | X | X | X |
| Facility fixed effects | X | X | X | X | X | X | X | X | X | X |
| Time fixed effects | X | X | X | X | X | X | X | X | X | |
Note. The coefficient on the P4P variable indicates the within-facility difference in outcomes for P4P states compared with non-P4P states after P4P was implemented compared to before. All regressions used a linear model except when the outcome was number of deficiencies for which a negative binomial model was used. Robust standard errors are in parentheses.
***
p < .01,
**
p < .05,
*
p < .1.
HPRD, hours per resident day; LPN, licensed practical nurse; P4P, Medicaid nursing home pay for performance; RN, registered nurse.