Joint commission accreditation and quality measures in U.S. nursing homes.

This study examines the association between accreditation and select measures of quality in U.S. nursing homes, both cross-sectionally and over time. Data analyzed in this research originated from a web-based search of The Joint Commission (TJC) accredited facilities and the Nursing Home Compare set of Quality Measures relating to physical restraint use, pain management, urinary catheter use, and pressure sores. Five-Star Nursing Home Quality Rating System information was also used to calculate overall quality measure and health inspection scores. Data were analyzed using negative binomial regression. Comparing quality in the year before accreditation with the 1st year after accreditation, all five Quality Measures and both Five-Star categories demonstrated improvement. In comparing quality after 8 years of accreditation, three of the Quality Measures examined continued to improve. There were no cases where accreditation was associated with decreased quality. These results indicate that TJC accredited nursing homes improve their quality immediately after accreditation but do not continue to improve in all areas over time.