Volume 51 | Number S1 | February 2016

Abstract List

Christopher C. Afendulis, Daryl J. Caudry S.M., A. James O'Malley Ph.D., Peter Kemper, David C. Grabowski Ph.D.,


To evaluate the impact of the Green House () model on nursing home resident‐level quality of care measures.

Data Sources/Study Setting

Resident‐level minimum data set () assessments merged with Medicare inpatient claims for the period 2005 through 2010.

Study Design

Using a difference‐in‐differences framework, we compared changes in care quality and outcomes in 15 nursing homes that adopted the model relative to changes over the same time period in 223 matched nursing homes that had not adopted the model.

Principal Findings

For individuals residing in homes, adoption of the model lowered readmissions and several measures of poor quality, including bedfast residents, catheter use, and pressure ulcers, but these results were not present across the entire organization, suggesting possible offsetting effects for residents of non‐ “legacy” units within the organization.


adoption led to improvement in rehospitalizations and certain nursing home quality measures for individuals residing in a home. The absence of evidence of a decline in other clinical quality measures in nursing homes should reassure anyone concerned that might have sacrificed clinical quality for improved quality of life.