Quality of Post-Acute Care in Skilled Nursing Facilities That Disproportionately Serve Hispanics With Dementia.

The study is cross-sectional and uses facility-level data, so it cannot show that a high Hispanic concentration caused poorer care. The authors could not determine whether Hispanic residents chose these facilities, were steered there, or lived in areas with lower-quality facilities. The final sample count is inconsistent between sections: methods report 177,396 beneficiaries and results report 117,396 beneficiaries. Facility quality indicators are calculated for all residents admitted to the skilled nursing facilities, not only for residents with dementia or Hispanic residents. Medicare Advantage concentration was associated with different directions across facility groups, and some differences were not significant. Unmeasured referral processes, family choice, and local facility availability could explain the observed differences.

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Do not conclude that more Hispanic residents caused lower quality care. The study is observational and facility-level, and the authors could not determine whether patients chose these facilities, were steered there, or lived where lower-quality facilities were available.