Nursing Home Profit Margins and Citations for Infection Prevention and Control.
Hari Sharma, Lili Xu
PMID 33930318WHAT IT FOUND
Nursing homes with lower profit margins were significantly more likely to receive infection control citations, including repeated citations over three years.
Facilities in the lowest profit quintile had 87.6% higher odds of being cited in all three years compared to the highest profit quintile.
Key findings
01Facilities in the lowest profit margin quintile had 87.6% higher odds of receiving infection control deficiency citations in all three years compared to those in the highest quintile.
02Facilities with negative profit margins had 44.6% higher odds of being cited for infection control in all three years compared to facilities with positive margins.
03Higher registered nurse staffing hours per resident day were associated with lower odds of deficiency citations, independent of profit margins.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study cannot prove that low profits cause poor infection control; other unmeasured factors may explain both. Profit margin data from CMS Cost Reports may contain errors. The analysis did not account for the severity of the citations. The study focused on profit margins and did not examine liquidity or cash flow, which may also affect resource availability.
The easy way to misread this
Do not conclude that increasing profit margins alone will automatically improve infection control compliance. The study shows an association between financial resources and citations, but it does not demonstrate that simply having more money fixes the underlying operational issues without targeted resource allocation to staffing and training.