Table 2. Characteristics of Nursing Homes Associated With Daily Variation Measuresa.
| Variable | COV | TOD | LOD | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| For RNs | For CNAs | For RNs | For CNAs | For RNs | For CNAs | |||||||
| Coefficient (95% CI) | P value | Coefficient (95% CI) | P value | Coefficient (95% CI) | P value | Coefficient (95% CI) | P value | Coefficient(95% CI) | P value | Coefficient (95% CI) | P value | |
| CMS 5-Star ranking | ||||||||||||
| Quality Measures | −0.014 (−0.021 to −0.007) | <.001 | −0.004 (−0.006 to −0.003) | <.001 | −3.79 (−4.59 to −2.99) | <.001 | −2.52 (−3.08 to −1.96) | <.001 | −2.46 (−3.03 to −1.88) | <.001 | −1.29 (−1.58 to −0.99) | <.001 |
| Survey | −0.026 (−0.033 to −0.019) | <.001 | −0.006 (−0.007 to −0.004) | <.001 | −5.10 (−5.97 to −4.23) | <.001 | −4.16 (−4.77 to −3.55) | <.001 | −3.04 (−3.65 to −2.44) | <.001 | −1.97 (−2.29 to −1.65) | <.001 |
| Case mix | −0.023 (−0.034 to 0.012) | <.001 | −0.002 (−0.005 to −0.002) | .01 | −3.67 (−4.67 to −2.68) | <.001 | −0.61 (−1.28 to 0.06) | .07 | −2.27 (−2.97 to −1.57) | <.001 | −0.37 (−0.74 to 0.00) | .05 |
| Payers | ||||||||||||
| Medicaid | [Reference] | NA | [Reference] | NA | [Reference] | NA | [Reference] | NA | [Reference] | NA | [Reference] | NA |
| Medicare | −0.027 (−0.033 to −0.020) | <.001 | 0.004 (0.001 to 0.006) | .002 | −4.90 (−5.95 − 3.84) | <.001 | 1.41 (0.84 to 1.97) | <.001 | −2.91 (−3.64 to −2.18) | <.001 | 0.62 (0.31 to 0.94) | <.001 |
| Other payers | −0.013 (−0.021 to −0.005) | .002 | 0.002 (−0.000 to 0.003) | .05 | −2.77 (−3.72 to −1.82) | <.001 | 0.71 (0.08 to 1.35) | .03 | −1.67 (−2.35 to −1.00) | <.001 | 0.22 (−0.13 to 0.57) | .22 |
| Part of a chain | −0.016 (−0.033 to 0.001) | .06 | −0.008 (−0.011 to −0.005) | <.001 | −5.48 (−7.44 to −3.53) | <.001 | −5.16 (−6.49 to −3.83) | <.001 | −3.02 (−4.36 to −1.69) | <.001 | −2.45 (−3.14 to −1.76) | <.001 |
| Ownership | ||||||||||||
| For profit | [Reference] | NA | [Reference] | NA | [Reference] | NA | [Reference] | NA | [Reference] | NA | [Reference] | NA |
| Nonprofit | −0.015 (−0.042 to 0.012) | .28 | −0.003 (−0.007 to 0.001) | .16 | −10.35 (−12.93 to −7.77) | <.001 | −5.08 (−6.72 to −3.44) | <.001 | −5.80 (−7.54 to −4.06) | <.001 | −2.62 (−3.50 to −1.74) | <.001 |
| Government | −0.043 (−0.066 to −0.020) | <.001 | −0.001 (−0.008 to 0.007) | .89 | −9.57 (−13.98 to −5.15) | <.001 | −4.51 (−7.09 to −1.93) | <.001 | −7.17 (−10.01 to −4.32) | <.001 | −2.36 (−3.72 to −1.00) | <.001 |
| Other | −0.020 (−0.042 to 0.001) | .61 | −0.003 (−0.007 to 0.001) | .17 | −5.43 (−9.00 to −1.86) | .003 | −1.89 (−4.21 to 0.43) | .11 | −2.78 (−5.24 to −0.32) | .03 | −1.02 (−2.21 to 0.17) | .09 |
| Hospital based | −0.051 (−0.097 to −0.004) | .03 | 0.002 (−0.012 to 0.016) | .80 | −2.11 (−13.34 to 9.11) | .71 | 0.980 ((−6.67 to 6.84)) | .09 | −2.78 (−9.68 to 4.12) | .43 | 1.26 (−2.86 to 5.39) | .55 |
| Resident annual mean census | −0.127 (−0.140 to −0.114) | <.001 | −0.025 (−0.027 to −0.023) | <.001 | −27.28 (−28.94 to −25.61) | <.001 | −21.73 (−23.01 to −20.45) | <.001 | −16.92 (−18.01 to −15.82) | <.001 | −10.15 (−10.82 to −9.47) | <.001 |
Abbreviations: CMS, Centers for Medicare & Medicaid Services; CNAs, certified nurse aide; COV, coefficient of variation; LOD, low outlier days; RNs, registered nurses; TOD, total outlier days.
a
Coefficients are reported as average marginal effects, and all continuous variables are standardized. All models include state fixed effects. The sample size for RNs was 23 398, with 13 295 facilities. The sample size for CNAs was 23 503, with 13 339 facilities.