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Accuracy of Pressure Ulcer Events in US Nursing Home Ratings

Bibliographic Data

ID9102337
AuthorsZihan Chen (0009-0006-8636-1959, University of Chicago, corresponding author), Lauren J Gleason (0000-0001-5267-1840, Section of Geriatrics and Palliative Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, IL), Prachi Sanghavi (0000-0002-0738-3193, University of Chicago, corresponding author)
Year2022
Volume60
Issue10
Pages775-783
Publication date2022-10-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001763
PMID35944135
OpenAlexW4293370486
LanguageEN
Citations received1
References cited20

BACKGROUND: The US government relies on nursing home-reported data to create quality of care measures and star ratings for Nursing Home Compare (NHC). These data are not systematically validated, and some evidence indicates NHC's patient safety measures may not be reliable. OBJECTIVE: The objective of this study was to assess the accuracy of NHC's pressure ulcer measures, which are chief indicators of nursing home patient safety. RESEARCH DESIGN: For Medicare fee-for-service beneficiaries who were nursing home residents between 2011 and 2017, we identified hospital admissions for pressure ulcers and linked these to the nursing home-reported data at the patient level. We then calculated the percentages of pressure ulcers that were appropriately reported by stage, long-stay versus short-stay status, and race. After developing an alternative claims-based measure of pressure ulcer events, we estimated the correlation between this indicator and NHC-reported ratings. SUBJECTS: Medicare nursing home residents with hospitalizations for pressure ulcers. MEASURES: Pressure ulcer reporting rates; nursing home-level claims-based measure of pressure ulcer events. RESULTS: Reporting rates were low for both short-stay (70.2% of 173,043 stage 2-4 pressure ulcer hospitalizations) and long-stay (59.7% of 137,315 stage 2-4 pressure ulcer hospitalizations) residents. Black residents experienced more severe pressure ulcers than White residents, however, this translated into having slightly higher reporting rates because higher staged pressure ulcers were more likely to be reported. Correlations between our claims-based measure and NHC ratings were poor. CONCLUSIONS: Pressure ulcers were substantially underreported in data used by NHC to measure patient safety. Alternative approaches are needed to improve surveillance of health care quality in nursing homes

Nursing care · Nursing homes · Diabetic Foot Ulcer Assessment and Management · Emergency Medicine · Geriatric Care and Nursing Homes · Medicine · Nursing · Pressure Ulcer Prevention and Management

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Unique citing works1
Citations per year1
Citation span2025 - 2025 (1)
Citation velocityrecent
Highly citedNo
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