Table 3.
Unadjusted study outcomes death within 30 days according to skilled nursing facility performance measures and facility characteristics.
| Discharges | Death within 30 days (%) | Readmission within 30 days (%) | Readmission or death within 30 days (%) | |
|---|---|---|---|---|
| Percentage of post-acute care residents with delirium | ||||
| At or below the 25th percentile | 428,349 | 20,500 (4.8)a | 92,262 (21.5) | 102,210 (23.9) |
| Between the 25th and 75th percentiles | 817,217 | 38,355 (4.7) | 173,444 (21.2) | 192,267 (23.5) |
| Above the 75th percentiles | 285,258 | 13,617 (4.8) | 56,003 (19.6) | 63,275 (22.2) |
| Percentage of post-acute care residents with moderate-to- severe pain | ||||
| At or below the 25th percentile | 328,252 | 16,542 (5.0) | 74,021 (22.6) | 81,990 (25.0) |
| Between the 25th and 75th percentiles | 768,564 | 37,843 (4.9) | 164,592 (21.4) | 183,453 (23.9) |
| Above the 75th percentiles | 434,008 | 18,087 (4.2) | 83,096 (19.2) | 92,309 (21.3) |
| Percentage of post-acute care residents with new or worsening pressure ulcers | ||||
| At or below the 25th percentile | 288,664 | 13,331 (4.6)b | 56,143 (19.5) | 63,166 (21.9) |
| Between the 25th and 75th percentiles | 784,731 | 37,455 (4.8) | 164,775 (21.0) | 183,470 (23.4) |
| Above the 75th percentiles | 457,429 | 21,686 (4.7) | 100,791 (22.0) | 111,116 (24.3) |
| Staffing rating | ||||
| One star | 253,231 | 13,687 (5.4) | 58,004 (22.9) | 64,677 (25.5) |
| Two stars | 278,207 | 13,906 (5.0) | 61,938 (22.3) | 68,713 (24.7) |
| Three stars | 329,884 | 16,283 (4.9) | 70,938 (21.5) | 78,920 (23.9) |
| Four stars | 535,473 | 23,919 (4.5) | 106,722 (19.9) | 118,911 (22.2) |
| Five stars | 134,029 | 4,677 (3.5) | 24,107 (18.0) | 26,531 (19.8) |
| Inspection rating | ||||
| One star | 275,471 | 14,045 (5.1) | 61,838 (22.5) | 68,642 (24.9) |
| Two stars | 353,400 | 17,666 (5.0) | 76,415 (21.6) | 85,175 (24.1) |
| Three stars | 367,110 | 17,296 (4.7) | 76,496 (20.8) | 85,103 (23.2) |
| Four stars | 370,214 | 16,643 (4.5) | 75,130 (20.3) | 83,500 (22.6) |
| Five stars | 164,629 | 6,822 (4.1) | 31,830 (19.3) | 35,332 (21.5) |
| Total beds | ||||
| 50 or fewer | 125,749 | 4,379 (3.5) | 22,110 (17.6) | 24,451 (19.4) |
| 51–100 | 360,133 | 16,982 (4.7) | 71,472 (19.9) | 80,370 (22.3) |
| 101–150 | 577,442 | 28,364 (4.9) | 122,754 (21.3) | 136,736 (23.7) |
| 151 or more | 467,500 | 22,747 (4.9) | 105,373 (22.5) | 116,195 (24.9) |
| Percentage of all residents covered by Medicare | ||||
| At or below the 25th percentile | 150,276 | 8,040 (5.4) | 30,609 (20.4) | 35,035 (23.3) |
| Between the 25th and 75th percentiles | 672,206 | 34,472 (5.1) | 144,244 (21.5) | 161,937 (24.1) |
| Above the 75th percentiles | 708,342 | 29,960 (4.2) | 146,856 (20.7) | 160,780 (22.7) |
| Percentage of all residents covered by Medicaid | ||||
| At or below the 25th percentile | 575,956 | 22,870 (4.0) | 112,610 (19.6) | 123,694 (21.5) |
| Between the 25th and 75th percentiles | 736,854 | 37,672 (5.1) | 157,349 (21.4) | 176,432 (23.9) |
| Above the 75th percentiles | 218,014 | 11,930 (5.5) | 51,750 (23.7) | 57,626 (26.4) |
| Percent occupancy | ||||
| At or below the 25th percentile | 291,504 | 13,505 (4.6) | 60,419 (20.7) | 67,159 (23.0) |
| Between the 25th and 75th percentiles | 808,962 | 38,971 (4.8) | 172,042 (21.3) | 191,248 (23.6) |
| Above the 75th percentiles | 430,358 | 19,996 (4.7) | 89,248 (20.7) | 99,345 (23.1) |
| Part of a chain | ||||
| Yes | 853,722 | 41,614 (4.9) | 180,089 (21.1)c | 200,935 (23.5) |
| No | 677,102 | 30,858 (4.6) | 141,620 (20.9) | 156,817 (23.2) |
| Hospital based | ||||
| Yes | 114,781 | 4,062 (3.5) | 20,526 (17.9) | 22,708 (19.8) |
| No | 1,416,043 | 68,410 (4.8) | 301,183 (21.3) | 335,044 (23.7) |
| Ownership | ||||
| Not-for-profit | 414,348 | 17,493 (4.2) | 79,136 (19.1) | 88,325 (21.3) |
| For profit | 1,049,227 | 51,515 (4.9) | 229,424 (21.9) | 254,449 (24.3) |
| Government | 49,532 | 2,472 (5.0) | 9,345 (18.9) | 10,705 (21.6) |
Notes: Percentile cutoffs determined based on the distribution of values across 14,251 SNFs in the study sample. Chi-square P<0.001 for difference across categories except where noted as follows:
a
P= 0.038;
b
P= 0.004,
c
P=0.007.
For staffing and inspection ratings, five stars indicate the highest category of performance.