Implementation of a CMS Nursing Facility Initiative: Differences by Racial Minority Resident Population

• Published in: Journal of applied gerontology 2023-05, Vol.42 (5), p.800-810
• Main Authors: Bercaw, Lawren E., Gasdaska, Angela, Segelman, Micah, Voltmer, Helena, Jones, Jessica M., Feng, Zhanlian, Khatutsky, Galina, Ingber, Melvin J.
• Format: Article
• Language: English
• Subjects: Aged; Centers for Medicare and Medicaid Services, U.S; Ethnic and Racial Minorities; Hospitalization; Humans; Leadership; Medicare; Minority groups; Nurses; Nursing Homes; Population growth; Racial differences; United States
• ISSN: 0733-4648; 1552-4523
• DOI: 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.