Implementation of a CMS nursing facility initiative
Differences by racial minority resident population
Bercaw, L. E., Gasdaska, A., Segelman, M., Voltmer, H., Jones, J. M., Feng, Z., Khatutsky, G., & Ingber, M. J. (2023). Implementation of a CMS nursing facility initiative: Differences by racial minority resident population. Journal of Applied Gerontology, 42(5), 800-810. Article 7334648221141411. Advance online publication. https://doi.org/10.1177/07334648221141411
Objectives: The CMS Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents: Payment Reform (NFI 2) provided billing opportunities to incentivize participating facilities to keep long-stay residents onsite for acute care, rather than hospitalizing them. We examined cross-facility differences in NFI 2 implementation by racial composition of facility resident populations. Methods: We analyzed Medicare claims in conjunction with in-person and telephone interviews among facility staff to assess NFI 2 engagement in relation to racial minority resident population. Results: Participating facilities with larger racial minority resident populations faced additional barriers to NFI 2 implementation. These facilities submitted fewer NFI 2 claims, reported more challenges engaging resident families, and experienced greater facility staff and leadership instability, compared to facilities with predominantly white resident populations. Discussion: Addressing structural differences within facilities with larger populations of racial minority residents may encourage future development of targeted programs to support diverse nursing facilities.