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Medical Care Research and Review
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What's this?

Characteristics of Community Nursing Homes Serving Per Diem Veterans, 1999 to 2002

Christopher E. Johnson

Texas A&M University System Health Science Center

Robert Weech-Maldonado

University of Florida

Huanguang Jia

U.S. Department of Veterans A fairs Rehabilitation Outcomes Research Center of Excellence

Dean Reker

U.S. Department of Veterans A fairs Medical Center Research Service University of Kansas Medical Center

Robert Buchanan

Mississippi State University

Alexandre Laberge

University of Florida

This study compared the characteristics of community nursing homes where veterans received their care with those of facilities that did not treat veterans from 1999 to 2002 using the Centers for Medicare and Medicaid Services (CMS) Online Survey Certification and Reporting system data merged with the CMS Minimum Data Set. A structure, process, and outcome model was used to examine whether the presence of per diem veterans had any impact on multidimensional quality measures. Facilities with any veterans were less likely to meet recommended nurse staffing standards; more likely to have patients with tube feeding, new catheterizations, and mobility restraints; and more likely to have actual harm citations and new pressure sores, plus quality-of-care, quality-of-life, and total deficiencies, than facilities without veterans. The implications of this study are that the U.S. Department of Veterans Affairs may need to examine its contracting policies with community facilities to understand both quality and selection effects that may be occurring.

Key Words: veterans • nursing homes • quality

This version was published on December 1, 2007

Medical Care Research and Review, Vol. 64, No. 6, 673-690 (2007)
DOI: 10.1177/1077558707304740
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