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Assessing the Accuracy of Nursing Home Falls Reporting in MDS Assessments

In the Medicare and Medicaid programs, nursing homes are required to report resident falls in patient assessments. CMS then uses this information to determine the percentage of residents experiencing falls resulting in major injury for each certified nursing home. These percentages are posted on CMS's Care Compare website to give consumers information about the relative performance of each nursing home. In this study, we will assess the accuracy of the patient assessment data used to calculate nursing home fall rates. Specifically, we will use claims data to identify hospitalizations due to falls with major injury among nursing home residents that are Medicare enrollees, including people who are dually enrolled in Medicaid. We will then use patient assessments to assess the extent to which nursing homes reported those falls. We will examine the characteristics of the people who did not have their falls reported. Finally, we will examine the characteristics of nursing homes that did not report falls among their residents.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
March 2024 Centers for Medicare and Medicaid Services Assessing the Accuracy of Nursing Home Falls Reporting in MDS Assessments Office of Evaluation and Inspections OEI-05-24-00180 2025