Nursing home deficiency citations for medication use

Deficiency citations for medication use in nursing homes, including those for psychoactive drug use, are examined. The variables of interest include eight structural and market factors. Data primarily came from the 1997 through 2003 Online Survey, Certification and Recording data and the 2004 Area Resource File. Multivariate logistic regression analyses were used with generalized estimating equations and multinomial logistic regression models with Huber-White robust estimation. Smaller nursing homes and high Medicaid reimbursement rates were consistently significantly associated with fewer deficiency citations in general and fewer repeat deficiency citations. For the other structural and market factors, varying results were identified depending on whether the deficiency citation was specifically for psychoactive drugs, medication errors, or medication administration. Relatively few facilities received psychoactive-specific deficiency citations, whereas numerous facilities were identified with medication error deficiency citations and medication administration deficiency citations. In addition, a relatively large number of facilities received these same citations repeatedly.