Timely Data-Driven Solutions for Nursing Homes

The COVID-19 pandemic has had a devastating impact on the nursing home sector, resulting in hundreds of thousands of deaths of residents and staff and exacerbating longstanding quality and workforce issues. These unprecedented tragedies underscore the need for innovative, timely, and proactive data-driven solutions to support public health surveillance and inform policy, implementation, monitoring, and oversight.

Soon after the pandemic swept through the nursing homes, Westat began conducting data management activities required for the public reporting of nursing home COVID-19 data for the Centers for Medicare & Medicaid Services (CMS). This involved developing data programming specifications and processes for the weekly public reporting of data submitted by 15,000-plus nursing homes on COVID-19 incidence and mortality, the availability of personal protective equipment, and the testing and vaccinations of residents and staff. These data quickly became the authoritative source of nursing home COVID data with many government officials, major news outlets, and researchers citing them widely.

Westat has also implemented, monitored, and/or assessed adherence to new COVID-19 requirements. In addition to preparing data reports on infection control surveys, Westat helped implement the COVID data submission requirements, conducting dispute resolutions of civil money penalties. Also, Westat implemented revisions to the on-site survey process to incorporate COVID vaccination requirements of health care personnel. More recently we conducted analysis of nursing shortage areas and used text analytics to inform efforts to attract individuals to nursing home careers.

As technical lead for these projects, Westat’s Laurie Coots Daras, PhD, a Vice President for Behavioral Health and Health Policy, was recently asked how the pandemic impacted Westat’s approach to data analytics and what innovative analytic methods proved most effective in managing quality improvement and oversight activities in nursing homes. Here are her answers.

Q. What did Westat learn during the pandemic about our approach to data analytics to support our clients?

A. The pandemic accelerated our work to design data processing programs that can rapidly and accurately turn data into actionable information. Our team had to be nimble to quickly adapt our data solutions to accommodate a dynamic situation with frequently evolving requirements and information while ensuring the integrity of our work.

Q. How do you ensure the accuracy and reliability of data collected from diverse nursing homes, considering the challenges posed by the pandemic?

A. Much of our analytics for long-term and post-acute care relies on providers’ self-reported data. So, we have developed rigorous data processing programs and quality assurance procedures to ensure the validity and accuracy of the data. We have also designed validation studies to assess the agreement between data submitted to federal programs against other sources like medical charts, which requires us to develop scientifically sound approaches to sampling and scoring.

Q. What innovative analytic methods or techniques have been particularly effective in supporting quality improvement or oversight activities in nursing homes?

A. Leveraging large national datasets and merging them with other data sources can be quite powerful. We frequently merge disparate datasets for analysis and reporting. Recently we used a geographic information system to analyze nurse workforce issues. We’ve used text analytics and natural language processing to identify themes among vast amounts of qualitative data. We also produce data visualizations and dashboards to foster user-centered solutions.

Q. What lessons from our work can we apply to future public health emergencies?

A. Delivering validated, actionable, timely data that users can easily interpret is imperative. This means working swiftly to understand the analytic needs and determine which approach can best convey actionable information. Any future crisis will demand an experienced team of programmers, data scientists, and policy analysts like ours who can quickly manage these critical data activities and collaborate with our government clients.