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Lies and Statistics

Published on January 15th, 2020

How can you trust numbers when they are self-reported and directly affect the rating of the nursing home?  A new study proves that nursing homes do not report quality measures such as falls. University of Chicago researchers found 150,828 major-injury falls that occurred at nursing homes were reported in hospital claims. Just 57.5% of those were reported on the MDS item (J1900C) used by Nursing Home Compare.   Falls data used by the Nursing Home Compare website “may be highly inaccurate,” says researchers whose new study shows that nursing homes fail to report major-injury falls.

The study assessed the accuracy of nursing home self-reporting of major injury falls on the MDS. Researchers used data from Medicare claims between 2011 and 2015 for the investigation. The data was then compared to MDS 3.0 assessments submitted by providers during those same years.

About 62.9% of major-injury falls were reported for long-stay residents on the MDS item, while 47.2% were reported for short-stay residents. Findings also showed that major-injury falls in white residents were reported at a higher rate than non-white residents — 64.5% compared to 37.4%.

“Our study indicates an urgent need to assess the value and limits of patient safety measurement that is based on the MDS. Given the amount of research that has been based on the MDS, it may be important to revisit some of our understanding of nursing home quality of care,” the authors wrote.

Full findings were published in Health Services Research.

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