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)

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

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.

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

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