236859 Informal Dispute Resolution Process for Nursing Homes' Appeals of Deficiency Citations

Monday, October 31, 2011: 10:30 AM

Dana B. Mukamel, PhD , Department of Medicine, Health Policy Research Institute, University of California, Irvine, Irvine, CA
David L. Weimer, PhD , LaFollette School of Public Affairs, University of Wisconsin - Madison, Madison, WI
Yue Li, PhD , Department of Community and Preventive Medicine, University of Rochester Medical Center, Rochester, NY
Lauren Bailey, MS , Health Policy Research Institute, University of California, Irvine, Irvine
William D. Spector, PhD , Agency for Healthcare Research & Quality, Rockville, MD
Charlene Harrington, PhD , Social and Behavioral Sciences, University of California San Francisco, San Francisco, CA
Nursing-homes are inspected annually by states and those not meeting minimum quality standards are cited for deficiencies. They can appeal these citations through the Informal Dispute Resolution (IDR) process, a precursor to a more costly, formal appeal. There are no studies examining the use of IDRs by nursing-homes. This study was designed to determine what influences nursing-homes' decisions to submit an IDR. OSCAR data on102,962 deficiency citations for 15,918 nursing homes nationally in 2005-2008 were merged with information about their IDR submissions, facility, markets and state characteristics. We estimated random effect a logistic model predicting whether a deficiency citation is appealed or not. The average nursing-home submitted 0.9 IDRs. Nursing-homes were more likely to appeal citations resulting from the annual survey than from resident complaints (OR=1.16), and more likely to appeal severe deficiencies (G level or above OR=1.58; abuse and neglect (OR=1.11). They were more likely to appeal if they were in a more competitive market (OR=1.08) or a market of higher socio-economic characteristics, suggesting more demand for higher quality (OR=1.05 for $10,000 increase in median income and OR=1.02 for 1% increase in high school graduates). Non-profit (OR=0.83) and Government (OR=0.69) nursing homes were less likely to appeal than for-profit.

Learning Areas:
Public health or related public policy

Learning Objectives:
Discuss the informal dispute resolution process for nursing homes.

Keywords: Nursing Homes, Quality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working for over 20 years in the field of aging and public health related to the topic of my presentation and I was the lead researcher on this study, responsible for data acquisition and analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.