# Disparities in the Quality of Nursing Home Care

> **NIH NIH R01** · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · 2024 · $613,270

## Abstract

ABSTRACT
The quality of nursing home care is an essential issue for the health and well-being of the elderly. For decades,
there have been widespread concerns about the quality of nursing home care in the US, as well as disparities
in the quality of care received across different groups. Exacerbating these issues are worries about the ability
of patients (or their caregivers) to assess nursing home quality, an issue that is particularly acute for patients
with Alzheimer’s disease or a related dementia (ADRD).
We propose to document the extent of disparities in the quality of Medicare-covered nursing home care
received, to investigate the forces behind those disparities, and to evaluate the impact of potential policy
interventions. We will focus on disparities across racial groups (specifically Black non-Hispanic patients
compared to White non-Hispanic patients), ethnic groups (Hispanic patients compared to non-Hispanic
patients), socio-economic status (patients dually-enrolled in Medicaid at admission or not), and health groups
(patients with and without ADRD on admission).
To accomplish this, we will build on our existing work estimating average value-added for each nursing home.
We created a measurement framework for estimating this value-added that can be applied to any health
measure (or combination of health measures) in the rich data on patient physical health, mental health, daily
functioning, dementia, and cognitive capacity available in the Centers for Medicare and Medicaid Services’
Minimum Data Set; these assessments cover all patients in Medicare and Medicaid certified nursing homes.
We propose to expand our framework to allow value added to differ across different groups of patients within
each nursing home, and then to use it to document the extent of disparities in nursing home quality
experienced by group. Then we will examine the disparities in value-added to determine what can be attributed
to differential treatment of patients within the same nursing home as opposed to different allocation of patients
across nursing homes. We will analyze the likely impact of alternative public policies on these disparities and
the health outcomes of nursing home residents. We aim to shed light on both the sources of disparities and the
potential of different types of policies on reducing disparities.

## Key facts

- **NIH application ID:** 10894329
- **Project number:** 5R01AG082871-02
- **Recipient organization:** MASSACHUSETTS INSTITUTE OF TECHNOLOGY
- **Principal Investigator:** Amy N. Finkelstein
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $613,270
- **Award type:** 5
- **Project period:** 2023-08-01 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10894329

## Citation

> US National Institutes of Health, RePORTER application 10894329, Disparities in the Quality of Nursing Home Care (5R01AG082871-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10894329. Licensed CC0.

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