The final analytic sample for this study was comprised of 209 freestanding and hospital-based facilities located in six states: California, Illinois, Missouri, Ohio, Pennsylvania and Tennessee. States were selected for regional representation and size in terms of numbers of facilities. Facility selection was stratified based upon volume of post-hospital discharge, sub-acute care provided, as indicated by whether the facility is hospital based or not. Within these two strata, we sought to select facilities based upon their QI scores in the year prior to the study (2000) in order to compare historically poor and well performing facilities. A total of 338 non-hospital based facilities and 124 hospital-based facilities were approached about participating in the study.
We attempted to select 30 residents per facility. In non-hospital based facilities, the sample was comprised of 10 residents with a recently completed admission MDS assessment; 10 residents with a recently completed quarterly MDS assessment; and 10 residents with a recently completed annual MDS assessment. "Recently completed" assessments were defined as those that were completed one-month prior to the nurse researcher arriving at the site. If a sample could not be captured with recently completed assessments, the nurse assessors looked back as far as 90 days to fulfill the sample. In hospital-based facilities, the sample was the 30 most recently assessed patients.