Comparing Public Quality Ratings for Accredited and Nonaccredited Nursing Homes

Abstract Objectives Compare quality ratings of accredited and nonaccredited nursing homes using the publicly available Centers for Medicare and Medicaid Services (CMS) Nursing Home Compare data set. Methods This cross-sectional study compared the performance of 711 Joint Commission–accredited (TJC-accredited) nursing homes (81 of which also had Post-Acute Care Certification) to 14,926 non–Joint Commission–accredited (non–TJC-accredited) facilities using the Nursing Home Compare data set (as downloaded on April 2015). Measures included the overall Five-Star Quality Rating and its 4 components (health inspection, quality measures, staffing, and RN staffing), the 18 Nursing Home Compare quality measures (5 short-stay measures, 13 long-stay measures), as well as inspection deficiencies, fines, and payment denials. t tests were used to assess differences in rates for TJC-accredited nursing homes versus non–TJC-accredited nursing homes for quality measures, ratings, and fine amounts. Analysis of variance models were used to determine differences in rates using Joint Commission accreditation status, nursing home size based on number of beds, and ownership type. An additional model with an interaction term using Joint Commission accreditation status and Joint Commission Post-Acute Care Certification status was used to determine differences in rates for Post-Acute Care Certified nursing homes. Binary variables (eg, deficiency type, fines, and payment denials) were evaluated using a logistic regression model with the same covariates. Results After controlling for the influences of facility size and ownership type, TJC-accredited nursing homes had significantly higher star ratings than non–TJC-accredited nursing homes on each of the star rating component subscales ( P