The objective of this study was to determine whether the Minimum Data Set (MDS) 3.0 discharge record accurately identifies hospitalizations and deaths of nursing home residents.
We merged date of death from Medicare enrollment data and hospital inpatient claims with MDS discharge records to check whether the same information can be verified from both the sources. We examined the association of 30-day rehospitalization rates from nursing homes calculated only from MDS and only from claims. We also examined how correspondence between these 2 data sources varies across nursing homes.
All fee-for-service (FFS) Medicare beneficiaries admitted for Medicare-paid (with prospective payment system) skilled nursing facility (SNF) care in 2011.
Some 94% of hospitalization events in Medicare claims can be identified using MDS discharge records and 87% of hospitalization events detected in MDS data can be verified by Medicare hospital claims. Death can be identified almost perfectly from MDS discharge records. More than 99% of the variation in nursing home–level 30-day rehospitalization rate calculated using claims data can be explained by the same rates calculated using MDS. Nursing home structural characteristics explain only 5% of the variation in nursing home–level sensitivity and 3% of the variation in nursing home–level specificity.
The new MDS 3.0 discharge record matches Medicare enrollment and hospitalization claims events with a high degree of accuracy, meaning that hospitalization rates calculated based on MDS offer a good proxy for the “gold standard” Medicare data.
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- The impact of hospital-based skilled nursing facility closures on rehospitalizations.Health Serv Res. 2013; 48: 499518
- Rehospitalizations among patients in the Medicare fee-for-service program.N Engl J Med. 2009; 360: 1418-1428
- The revolving door of rehospitalization from skilled nursing facilities.Health Aff (Millwood). 2010; 29: 57-64
- Effect of nursing home ownership on the quality of post-acute care: An instrumental variables approach.J Health Econ. 2013; 32: 12-21
- Effect of nursing home ownership on hospitalization of long-stay residents: An instrumental variables approach.Int J Health Care Finance Econ. 2014; 14: 1-18
- Effect of hospital-SNF referral linkages on rehospitalization.Health Serv Res. 2013; 48: 1898-1919
- Serious mental illness and nursing home quality of care.Health Serv Res. 2013; 48: 1279-1298
- Hospitalization of nursing home residents: The effects of states' Medicaid payment and bed-hold policies.Health Serv Res. 2007; 42: 1651-1671
- The costs and potential savings associated with nursing home hospitalizations.Health Aff (Millwood). 2007; 26: 1753-1761
- Nursing home characteristics and potentially preventable hospitalizations of long-stay residents.J Am Geriatr Soc. 2004; 52: 1730-1736
- Appropriateness of the decision to transfer nursing facility residents to the hospital.J Am Geriatr Soc. 2000; 48: 154-163
- Hospital readmissions and the Affordable Care Act.JAMA. 2011; 306: 1794-1795
- Revisiting hospital readmissions.JAMA. 2013; 309: 398-400
- A Data Book: Health Care Spending and the Medicare Program.Medicare Payment Advisory Commission, Washington, DC2009
- Medicare Advantage 2012 Data Spotlight: Enrollment Market Update.Kaiser Family Fund, Washington, DC2013
- Designing the national resident assessment instrument for nursing homes.Gerontologist. 1990; 30: 293-307
- A comprehensive clinical assessment tool to inform policy and practice: Applications of the minimum data set.Med Care. 2004; 42: III50-III59
- Development and testing of nursing home quality indicators.Health Care Financ Rev. 1995; 16: 107-127
- Impact of public reporting on unreported quality of care.Health Serv Res. 2009; 44: 379-398
- Achieving improvement through nursing home quality measurement.Health Care Financ Rev. 2002; 23: 5
- The nursing home Minimum Data Set assessment instrument: Manifest functions and unintended consequences—past, present, and future.Gerontologist. 2009; 49: 727-735
- Temporal and geographic variation in the validity and internal consistency of the Nursing Home Resident Assessment Minimum Data Set 2.0.BMC Health Serv Res. 2011; 11: 78
- Sharp rise in Medicare enrollees being held in hospitals for observation raises concerns about causes and consequences.Health Aff (Millwood). 2012; 31: 1251-1259
Published online: August 29, 2014
The authors declare no conflicts of interest.
© 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.