Table 3.
Multivariate Results Examining Deficiency Citations for Resident Safety in Nursing Homes and Internal, Organizational and External Factors
| Environmental Safety Issues1 | Care Safety Issues2 | All K-Tags3 | |||||||
|---|---|---|---|---|---|---|---|---|---|
|
|
|||||||||
| AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | ||||
| Internal Factors of Interest: | |||||||||
| FTE NAs/100 beds | 1.01 | (1.00 –1.02) | * | 1.01 | (0.99 –1.02) | 1.00 | (0.98 –1.01) | ||
| FTE LPNs/100 beds | 0.98 | (0.96 –1.01) | 1.02 | (1.00 –1.05) | * | 1.01 | (0.99 –1.04) | ||
| FTE RNs/100 beds | 0.97 | (0.95 –1.00) | ** | 0.95 | (0.92 –0.97) | *** | 0.97 | (0.96 –1.00) | ** |
| Other Internal Factors: | |||||||||
| Resident case-mix (ADL score) | 0.97 | (0.95 –0.99) | ** | 1.01 | (0.99 –1.03) | 1.01 | (0.99 –1.03) | ||
| Restraint use | 1.02 | (1.01 –1.04) | ** | 1.00 | (0.98 –1.02) | 1.03 | (1.02 –1.05) | ** | |
| Psychiatric condition | 1.04 | (1.02 –1.05) | *** | 1.00 | (0.98 –1.02) | 0.99 | (0.97 –1.01) | ||
| Mental retardation | 1.00 | (0.98 –1.01) | 1.00 | (0.98 –1.02) | 0.98 | (0.96 –1.00) | * | ||
| Dementia | 1.04 | (1.03 –1.06) | *** | 0.99 | (0.97 –1.01) | 0.99 | (0.98 –1.01) | ||
| Organizational Factor of Interest: | |||||||||
| Quality of care citations | 1.22 | (1.22 –1.23) | *** | 1.15 | (1.15 –1.16) | *** | 1.02 | (1.02 –1.02) | *** |
| Any J, K or L citation | 1.00 | (0.93 –1.07) | 0.93 | (0.88 –0.98) | *** | 1.01 | (0.98 –1.05) | ||
| Medicaid resident occupancya | 1.03 | (1.01 –1.05) | *** | 1.02 | (1.01 –1.10) | * | 1.04 | (1.00 –1.10) | * |
| Other Organizational Factors: | |||||||||
| Bed size | 1.02 | (1.00 –1.04) | * | 1.03 | (1.01 –1.05) | ** | 1.13 | (1.09 –1.17) | ** |
| For-profit ownership | 0.96 | (0.93 –1.00) | * | 1.03 | (0.99 –1.08) | 1.03 | (0.98 –1.08) | ||
| Chain membership | 1.00 | (0.97 –1.04) | 1.06 | (1.02 –1.11) | * | 0.96 | (0.92 –1.00) | * | |
| Occupancy rate | 0.97 | (0.95 –0.98) | ** | 1.04 | (1.02 –1.06) | ** | 1.00 | (0.97 –1.02) | |
| External Factor of Interest: | |||||||||
| Medicaid reimbursement rateb | 0.95 | (0.87 –0.98) | ** | 0.96 | (0.95 –0.98) | ** | 0.97 | (0.95 –1.00) | * |
| Medicaid reimbursement rate X | |||||||||
| Medicaid resident occupancyc | 1.08 | (1.02 –1.10) | ** | 1.10 | (1.03 –1.12) | ** | 1.06 | (1.02 –1.09) | ** |
| Other External Factors: | |||||||||
| Competition (Herfindahl index) | 0.99 | (0.97 –1.01) | 0.97 | (0.94 –0.99) | *** | 0.96 | (0.93 –0.99) | ** | |
| Number of elderly in county | 1.01 | (0.99 –1.03) | 0.99 | (0.96 –1.01) | 1.04 | (1.01 –1.07) | *** | ||
| Per capita income | 1.01 | (0.99 –1.03) | 0.99 | (0.97 –1.01) | 1.09 | (1.06 –1.13) | *** | ||
| Intercept | 0.10 | (0.06 –0.16) | *** | 0.09 | (0.05 –0.16) | *** | 0.00 | (0.00 –0.01) | *** |
N = 14,934 nursing homes and 119,472 observations
Statistically significant at p=0.05 level or better;
Statistically significant at p=0.01 level or better;
Statistically significant at p=0.001 level or better Results reported using generalized estimating equations (GEE).
Adjusted Odds Ratio for Medicaid reimbursement rate incorporates the interaction with Medicaid resident occupancy and are evaluated at the mean value for Medicaid resident occupancy.
Adjusted Odds Ratio for Medicaid resident occupancy incorporates the interaction with Medicaid reimbursement rate and are evaluated at the mean value for Medicaid reimbursement rate.
Adjusted Odds Ratios were manually calculated by using the mean levels of the variables (Medicaid reimbursement rate and Medicaid resident occupancy [i.e., a and b] and the variance/covariance matrix [Ai & Norton, 2003].
State dummies and year dummies also included (not shown).
FTE = full-time equivalent, LTC = long-term care, ADL = activities of daily living, RNs = Registered Nurses, LPNs = Licensed Practical Nurses, NAs = Nurse aides; AOR = Adjusted Odds Ratio; CI = Confidence Interval.
= See Appendix 1;
= See Appendix 1;
= All Life Safety Code (LSC) K-tags