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1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non- accredited facilities All non-hospital affiliated nursing homes (675 accredited, 14,153 not accredited) Three for-profit chains with >15 accredited facilities (total of 156 accredited, 406 not accredited)

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Page 1: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

1

The LTCQ-Joint Commission Accreditation Study Public access data

Surveys Complaint investigations

Accreditation status Compared accredited with non-accredited

facilities All non-hospital affiliated nursing homes (675

accredited, 14,153 not accredited) Three for-profit chains with >15 accredited facilities

(total of 156 accredited, 406 not accredited)

Page 2: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

Health Deficiencies

9.1

6.2 6.2 6.1

7.5

3.0

6.4

5.5

0

1

2

3

4

5

6

7

8

9

10

Chain A Chain B Chain C All Facilities

Group of Facilities

Avera

ge N

um

ber

of

Defi

cien

cies

Non-Accredited Accredited

Page 3: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

Quality of Care Deficiencies

3.1

21.8

2

2.6

0.91.2

1.9

0

0.5

1

1.5

2

2.5

3

3.5

Chain A Chain B Chain C All Facilities

Group of Facilities

Avera

ge N

um

ber

of

Defi

cie

ncie

sNon-Accredited Accredited

Page 4: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

Substantiated Allegations

3.3

2.8

3.2

2.1

3

1.11.3

1.9

0

0.5

1

1.5

2

2.5

3

3.5

Chain A Chain B Chain C All Facilities

Group of Facilities

Avera

ge N

um

ber

of

Alleg

ati

on

s

Non-Accredited Accredited

Page 5: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

Complaint Survey Deficiencies

9.5

8.1 7.8

6.6

8.1

2.7 3

6.2

0

1

2

3

4

5

6

7

8

9

10

Chain A Chain B Chain C All Facilities

Group of Facilities

Avera

ge N

um

ber

of

Defi

cie

ncie

sNon-Accredited Accredited

Page 6: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

Facility-Acquired Pressure Ulcers

3.73.4

3.9

3.5

3

2.2

2.6

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

Chain A Chain B Chain C All Facilities

Group of Facilities

Avera

ge P

erc

en

tag

e o

f R

esid

en

tsNon-Accredited Accredited

Page 7: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

Occupancy

83.9 83.9

88.9

82.5

89.7

85.6

90.189.0

78

80

82

84

86

88

90

92

Chain A Chain B Chain C All Facilities

Group of Facilities

Avera

ge P

erc

en

tag

e O

ccu

pan

cy

Non-Accredited Accredited

Page 8: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

Private Pay Proportion

21.1

26.2

18.1

24.225.0

27.9

20.4

23.1

0

5

10

15

20

25

30

Chain A Chain B Chain C All Facilities

Group of Facilities

Avera

ge P

erc

en

tag

e o

f R

esid

en

ts

Non-Accredited Accredited

Page 9: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

Medicare Proportion

21.122.9

14.5

11.4

25.027.1

20.4

16.8

0

5

10

15

20

25

30

Chain A Chain B Chain C All Facilities

Group of Facilities

Avera

ge P

erc

en

tag

e o

f R

esid

en

tsNon-Accredited Accredited

Page 10: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

10

Correlates of Accreditation Fewer survey deficiencies Fewer QOC deficiencies Fewer substantiated allegations Fewer complaint survey deficiencies Lower rate of facility-acquired pressure ulcers Higher occupancy Higher Medicare proportion Higher private pay proportion

Page 11: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

11

Geography Isn’t The Reason - But Results May Vary Differences remain if survey results,

investigation results, occupancy and payer mix are all adjusted for the States in which the facilities are located.

All differences are statistically significant. Membership in chains implies common policies,

procedures, staffing rules, etc., making the findings for chains particularly relevant.

The size - and practical significance -- of differences varied by outcome and by chain.

Page 12: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

12

Accreditation: Part of a Larger Risk Management Plan Accreditation is associated with better

outcomes, lower risk, and more revenue Accreditation, as a third party review, helps

prove good faith to insurers - and potentially to jurors

Accreditation doesn’t imply a causal relationship, though it supports it

Facilities need a complete program of quality improvement and risk management to realize the benefits of accreditation

Page 13: 1 The LTCQ-Joint Commission Accreditation Study Public access data Surveys Complaint investigations Accreditation status Compared accredited with non-accredited

13

About LTCQ

Operations began in 1995

Founders were from Harvard University, Brown University, and Boston's Hebrew Rehabilitation Center for Aged

Part of the original Minimum Data Set (MDS) development team. The MDS is the national standard for resident assessment and federal reimbursement for long term care

Provide Web-based information services utilizing a data driven approach for:

Accurate Medicare and Medicaid Reimbursement Risk Management Improved Clinical Outcomes Regulatory Compliance