The Residential History File: Studying Nursing Home Residents' Long‐Term Care Histories^*

Abstract

Objective To construct a data tool, the Residential History File (RHF), that summarizes information from Medicare claims and nursing home (NH) Minimum Data Set (MDS) assessments to track people through health care locations including non-Medicare paid Nursing Home (NH) stays. Data Sources Online Survey Certification and Reporting (OSCAR) data for 202 free-standing NHs, Medicare Denominator, claims (Parts A and B) and MDS assessments for 60,984 people who were present in one of these NHs in 2006. Methods The algorithm creating the RHF is outlined and the RHF for the study data is used to describe place of death. The identification of residents in nursing homes is compared to the reports in OSCAR and part B claims. Principal Findings The RHF correctly identified 84.8% of part B claims with place-of-service in NH, and identified 18.3 less residents on average than reported in the OSCAR on the day of the survey. The RHF indicated that 17.5% non-Medicare NH decedents were transferred to the hospital to die versus 45.6% SNF decedents. Conclusions The population-based design of the RHF makes it possible to conduct policy relevant research to examine the variation in the rate and type of health care transitions across the United States.

Site of Death, Place of Care, and Health Care Transitions Among US Medicare Beneficiaries, 2000-2015

“…13 The Residential History File tracks beneficiaries by place and time using the dates of service on Medicare claims and Minimum Data Set assessments, and the date of death from the Medicare enrollment file. Based on the Residential History File, a health care transition was defined as a change in the place of care.…”

The Impact of Medicaid Payer Status on Hospitalizations in Nursing Homes

“…27 The MDS is a federally mandated assessment tool for all residents in Medicare and/or Medicaid certified NHs. The MDS contains detailed information on individual socio-demographic characteristics as well as health conditions.…”

The Origin and Disposition of Medicare Observation Stays

“…This file allows the tracking of individuals as they transition through various settings in the acute and post-acute care systems. (18)…”

“…We did this using the Residential History File (RHF), which concatenates Medicare claim dates of service and MDS assessment dates to determine where patients are each day. (18)…”