TABLE 1.
Sample characteristics of the New York State fee‐for‐service Medicare beneficiaries stratified by skilled nursing facility quality
| 1‐star SNF (N = 1651) | 2‐ to 3‐star SNF (N = 7272) | 4‐ to 5‐star SNF (N = 16 372) | P‐value (χ 2 or ANOVA) | |
|---|---|---|---|---|
| Mean ± SD or prevalence | ||||
| Patient factors | ||||
| Age | 80.66 ± 8.66 | 81.57 ± 8.48 | 81.81 ± 8.45 | <.0001 |
| Female | 64.99% | 65.24% | 66.61% | .0723 |
| Non‐white | 9.51% | 11.45% | 18.03% | <.0001 |
| Married | 33.43% | 34.63% | 34.71% | .4331 |
| Medicaid dual eligible | 24.17% | 24.45% | 25.29% | .2823 |
| Alzheimer's disease/dementia | 16.78% | 19.02% | 19.58% | .0192 |
| Days in SNF | 26.24 ± 18.46 | 27.53 ± 18.99 | 27.93 ± 18.91 | .0016 |
| Days spent in hospital prior to SNF stay | 7.32 ± 6.09 | 7.08 ± 6.55 | 6.84 ± 5.92 | .0007 |
| Perfect 30‐d home time | 78.13% | 82.60% | 84.58% | <.0001 |
| Perfect 90‐d home time | 66.20% | 68.99% | 71.72% | <.0001 |
| Average 30‐d home time | 26.69 ± 8.07 | 27.91 ± 6.10 | 28.10 ± 5.86 | <.0001 |
| Average 90‐d home time | 78.41 ± 24.42 | 81.45 ± 20.16 | 81.95 ± 19.65 | <.0001 |
| Number of diagnoses | 4.20 ± 3.57 | 5.81 ± 3.30 | 6.21 ± 3.77 | <.0001 |
| Medical DRG prior to SNF stay | 59.72% | 59.38% | 56.61% | <.0001 |
| Died within 30 d | 3.69% | 2.35% | 2.34% | .0026 |
| Died within 90 d | 7.51% | 6.48% | 5.76% | .0044 |
| No outpatient ED visit in 30 d | 89.64% | 88.41% | 90.56% | <.0001 |
| No outpatient ED visit in 90 d | 77.83% | 77.63% | 80.81% | <.0001 |
| No hospital stay in 30 d | 81.28% | 85.67% | 87.07% | <.0001 |
| No hospital stay in 90 d | 70.62% | 73.67% | 75.48% | <.0001 |
| No SNF stay in 30 d | 90.98% | 94.11% | 94.64% | <.0001 |
| No SNF stay in 90 d | 85.16% | 88.08% | 88.57% | <.0001 |
| Admitting diagnosis | ||||
| Neoplasms | 2.12% | 1.66% | 1.60% | <.0001 |
| Endocrine, metabolic, immunity disorders | 3.03% | 4.51% | 2.68% | |
| Nervous system and sense organs | 2.24% | 1.88% | 1.50% | |
| Circulatory system diseases | 15.26% | 13.22% | 12.69% | |
| Respiratory system diseases | 7.15% | 5.53% | 5.51% | |
| Digestive system diseases | 4.12% | 3.19% | 2.66% | |
| Genitourinary system diseases | 4.18% | 3.58% | 2.91% | |
| Skin and subcutaneous tissue diseases | 2.54% | 1.82% | 1.52% | |
| Musculoskeletal system diseases | 19.50% | 15.03% | 12.62% | |
| Injury and poisoning | 9.45% | 10.51% | 8.36% | |
| Other | 30.41% | 39.08% | 47.95% | |
| Brief Interview for Mental Status score | 13.02 ± 3.26 | 13.08 ± 3.20 | 13.03 ± 3.27 | .5030 |
| Functional Status Scale | 12.89 ± 6.34 | 14.11 ± 5.77 | 15.44 ± 5.31 | <.0001 |
| SNF factors | ||||
| For profit | 68.50% | 51.66% | 44.41% | <.0001 |
| Occupancy | 0.97 ± 0.81 | 0.93 ± 0.24 | 0.91 ± 0.10 | <.0001 |
| Total licensed nursing hours per resident day | 1.45 ± 0.19 | 1.56 ± 0.39 | 1.78 ± 0.82 | <.0001 |
| Nurse aid nursing hours per resident day | 2.26 ± 0.30 | 2.39 ± 0.39 | 2.47 ± 0.47 | <.0001 |
| Hospital‐based | 3.82% | 9.09% | 13.36% | <.0001 |
| County factors | ||||
| Metro | 87.34% | 86.47% | 97.53% | <.0001 |
| Primary care physicians rate per 100 000 | 92.46 ± 35.09 | 81.07 ± 29.85 | 97.34 ± 36.26 | <.0001 |
| Hospital beds rate per 100 000 | 370.97 ± 170.08 | 357.37 ± 161.03 | 321.66 ± 138.86 | <.0001 |
| SNF beds rate per 100 000 | 716.82 ± 214.72 | 634.05 ± 173.05 | 583.09 ± 119.80 | <.0001 |
| Home health agencies rate per 100 000 | 1.25 ± 0.66 | 0.92 ± 0.62 | 0.87 ± 0.47 | <.0001 |
Based on authors’ analysis of the Master Beneficiary Summary File, Medicare Provider Analysis and Review File, Long‐Term Care Minimum Data Set 3.0, revenue center file, Centers for Medicare and Medicaid Services’ FY 2014 Final Rule Tables and Nursing Home Compare file, and the Area Health Resources File, 2014. Some factors are missing observations.