Underreporting in Nursing Home Quality Measures



Research conducted by Integra Med Analytics, a sister company of Integra FEC, finds that Medicare-certified nursing homes often underreport incidences of preventable hospitalizations. Below is a summary of the findings from their research:

  • Publicly available Skilled Nursing Facility (“SNF”) quality measures from The Centers for Medicare & Medicaid Services ("CMS") are susceptible to self-reporting bias which hampers their accuracy.

  • Comparison of self-reported SNF data with subsequent hospital claims data for the same SNF patients indicates that the self-reported data is often under-reported and unrelated to hospital data.

  • Pressure ulcers are under-reported by the SNF self-reported measure when compared with the hospital-based measure.

  • Self-reported measures for pressure ulcers, UTIs and falls are uncorrelated with hospital-based measures.

Additional details can be found in the research report published online at nursinghomereporting.com. That website also provides a searchable database where you can access additional metrics to find and evaluate Medicare-certified nursing facilities.

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