Stability and sensitivity of nursing home quality indicators.

THE issues of stability and sensitivity of indicators to actually detect differences in quality of care in nursing facilities are not only of concern to researchers, but also to public policy makers, who are reporting indicators to providers and now to consumers. Our research team at the University of Missouri-Columbia recently completed a study of 92 randomly selected nursing homes with a range of quality. Quality of care measurement was based on a statewide analysis of 23 quality indicators (QIs) currently used by the federal government to evaluate quality of care in nursing homes (see Table 1). The study examined the cost, staffing, and quality of care information from the nursing home Minimum Data Set (MDS) and Medicaid cost report large data sets with processes of care data collected from on-site participant observations of each facility (1). This research brief explains what we learned in our study about stability and sensitivity of the MDS QIs.