Case mix and surrogate indicators of quality of care over time in freestanding and hospital-based nursing homes in Colorado.

Broad case mix and surrogate indicators of quality of care were examined to assess (a) annual variations in these factors in Colorado's nursing homes over a 3-year period and (b) differences between hospital-based and freestanding nursing homes in the State. The findings pertain to 19 hospital-based and 138 freestanding nursing homes, and they are based largely on analyses of secondary data that were self-reported by nursing home staffs and collected through facility-level surveys conducted by the Colorado Professional Standards Review Organization and the Colorado Department of Health. The results suggest that case mix and quality change little from one year to the next for nursing homes. Based on the relatively crude case mix and quality indicators analyzed, there appears to be some evidence to suggest that case mix may be more complex and quality of care better in hospital-based nursing homes than in freestanding nursing homes. Further verification of the results, however, requires more refined measures of case mix and quality of care.