Abstract
Purpose
The new Minimum Data Set 3.0 was designed to improve the assessment process by requiring
nursing home (NH) staff to attempt to interview residents with scripted questions
to assess subjective states such as pain, mood, and cognitive functioning. Although
the case has been made that resident self-report is important, it is unknown whether
facilities are doing so in practice. We examined the frequency of attempts to interview
residents to elucidate the types of residents able to be interviewed about their clinical
conditions and facility characteristics related to the likelihood of attempt.
Design and Methods
Data come from Minimum Data Set 3.0 annual assessments for 757,044 residents in 15,030
NHs during 2011–2012 and the 2011 Online Survey, Certification, and Reporting database.
Hierarchical generalized linear models were conducted to test the association between
resident and facility characteristics and the attempt rate of resident interview for
3 clinical domains (cognition, mood, and pain).
Results
Over 83% of long-stay residents attempted all 3 self-report clinical items. The rates
of attempt for mood, cognition, and pain were 88%, 89%, and 92%, respectively. Results
from hierarchical generalized linear models suggest that certain resident characteristics
are related to the likelihood of participating in interviews, in particular neither
having a diagnosis of dementia nor cognitive impairment, not exhibiting signs of delirium,
nor a documented prognosis of 6 months or less to live. Residents in smaller, chain-affiliated
nursing homes with fewer Medicare residents and fewer assessments per administrative
nurse and registered nurse were more likely to attempt the resident interview items.
Implications
This article documents the high rate of NH residents' participation in interviews
about their clinical states. Furthermore, we identify types of residents for whom
additional investigation into ways to achieve higher rates of participation is required
and facility resources that are related to the likelihood of high rates of attempt.
Keywords
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Article info
Publication history
Published online: March 13, 2014
Footnotes
The authors have no conflicts of interest relating to this article. This work was supported by the National Institute on Aging (P01 AG-027296) and the Agency for Healthcare Research and Quality (T32 HS-000011).
Identification
Copyright
Published by Elsevier Inc.
