Indicators of adverse somatic outcome in three Veterans Affairs nursing homes

Frequencies of undernutrition, bedsores, and deterioration in activities of daily living were compared in three Veterans Affairs nursing homes serving both chronic psychiatric patients and medical or neurological patients. The three facilities varied in the proportions of patients with adverse outcomes, with one home having noticeably higher rates for both subgroups of patients. In each home, the two subgroups were equally likely to show evidence of adverse outcome, suggesting that differences in the frequency of adverse outcomes among the facilities were accounted for by extrinsic factors related to quality of care rather than intrinsic factors related to patient characteristics.