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Understanding the Role of Nursing Home Enforcement and Oversight in Post-Acute and Long-Stay Resident Quality of Care

Award Number: R01AG092393
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/15/2026
PERIOD OF PERFORMANCE END DATE: 01/31/2031

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Understanding the Role of Nursing Home Enforcement and Oversight in Post-Acute and Long-Stay Resident Quality of Care - PROJECT SUMMARY/ABSTRACT This mixed-methods study aims to examine the effectiveness of Civil Monetary Penalties (CMPs) in enhancing care quality within nursing homes. The study focuses on determining whether CMPs serve as effective deterrents against substandard care or if they inadvertently exacerbate existing care deficiencies by imposing financial strains on facilities. Utilizing a comprehensive dataset encompassing nursing home resident claims data from 2011 to 2024, which includes detailed facility information and enforcement actions from the ASPEN/CASPER administrative data sets, this project will analyze the impacts of CMPs on nursing home care outcomes. Aim 1 of the project will explore the relationship between CMPs and the incidence of nursing home deficiencies, considering certain resident, facility, operational, and external factors that may influence the magnitude and frequency of CMPs. Aim 2 will employ a difference-in- differences analytical approach to assess the direct impacts of CMPs on quality of care by comparing outcomes before and after penalties are imposed in facilities relative to comparison facilities with no penalties over the same period. This aim will provide a clearer picture of the causal effects of CMPs on resident care quality. Aim 3 will involve conducting in-depth qualitative interviews with state surveyors and nursing home administrators to capture insights into the variability of CMP implementation and its perceived effectiveness across different states. This aim seeks to understand the on-the-ground challenges and operational perspectives regarding CMP enforcement. We will integrate findings across Aims using a concurrent-embedded approach. The comprehensive approach of this study is expected to yield valuable empirical evidence that will inform policymakers and help refine regulatory practices to ensure that CMPs are applied effectively and fairly. By assessing whether CMPs enhance care quality without unintended negative consequences, this research supports the broader goal of improving elder care across the United States.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $676,587 )
2026	2026	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	575 LEXINGTON AVE FL 9	NEW YORK	NY	10022	NEW YORK	USA	Aging Research	000	1	2/6/2026	NEW	$676,587
														Subtotal = $676,587

Grand Total All Awards = $676,587

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Understanding the Role of Nursing Home Enforcement and Oversight in Post-Acute and Long-Stay Resident Quality of Care

Award Number: R01AG092393

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/15/2026

PERIOD OF PERFORMANCE END DATE: 01/31/2031

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