Ombudsman complaints, DHSR complaints, and subsets of both types of complaints are modeled using a conditional fixed-effects Poisson model, controlling for facility characteristics and including time and facility fixed effects.
Each model of Ombudsman complaints, DHSR complaints, and subsets of both types of complaints includes as an explanatory variable one of the traditional quality measures.
As noted above, for the subsequent analyses, we removed the Ombudsman complaints that were referred to the DHSR from the Ombudsman complaint counts, reducing the number of Ombudsman complaints by 284 (3.
The DHSR received 6,245 complaints against NC nursing homes during the same period.
Table 3 reports z-values from the Poisson fixed-effects models for the association between MDS-OJs and the number of Ombudsman complaints (top half of the table) or DHSR complaints (bottom half of the table).
In contrast, there are positive and significant relationships between deficiencies at the most recent survey and the number of DHSR complaints in many categories for both total deficiencies and health deficiencies; complaint categories with significant relationships include all, substantiated, pharmacy, quality of care, residents' rights, mistreatment, and complaints with a G-level or higher deficiency.
For DHSR complaints, we generally find positive relationships between the volume of complaints and RN or LPN/LVN staffing levels, where statistically significant.
In contrast, the results for the DHSR complaint volume, found in the bottom half of Table 5, indicate positive relationships between nearly all categories of DHSR complaints (from both the current and prior quarter) and total or health deficiencies.
In contrast, the DHSR complaints show three measures of complaint volume as being predictive of low RN staffing in the next quarter: total, quality of care, and pharmacy.
Consistent with Stevenson's (2005) study of Massachusetts complaints, complaints to both the DHSR and the Ombudsman appear to be measuring different dimensions of quality than the MDS-QIs.
In contrast, consistent with national results by Stevenson (2006), there are positive and significant relationships between deficiencies found during the state certification survey and current and subsequent DHSR complaint volume in many categories.