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Study Finds Underreporting of Quality Measures Leading to Data Inaccuracies on Nursing Home Care Compare Website

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A new study published in JAMA Network Open found the Nursing Home Care Compare Website not only contains inaccurate information, but those inaccuracies appear to be at least partially driven by race.

The Nursing Home Care Compare website was established in early 1990s by the U.S. Centers for Medicare and Medicaid Services (CMS) to publicly report patient safety indicators for every nursing facility in the nation. But the report found the site appears to drastically underreport the number and severity of major injury falls and bedsores suffered by Medicare residents in specific nursing homes. The Website relies on self-reported data from nursing homes to track falls and bedsores, but analysis of the Medicare claims data found that nursing homes are not reporting all of these incidents. About 40% of major injury fall hospitalizations and 32% of severe bedsore hospitalizations found in Medicare claims data did not show up on the CMS website.

Researchers also found that the underreporting varied based on the racial composition of the nursing homes. Nursing homes with more white residents had higher reporting rates for major injury falls and lower reporting rates for pressure ulcers, and vice versa was true for nursing homes with more Black residents.

For this study, the researchers compared data from the CMS site directly against claims that hospitals filed with Medicare to reimburse treatment for either falls or bedsores.

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