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Geographic Variation in Missing Race and Ethnicity Data in Minimum Data Set 3.0

Jennifer Tjia1, Francesca L Troiani1, Anna Wyndham2

  • 1Department of Population and Quantitative Health Sciences, Division of Epidemiology, Worcester, MA.

Medical Care
|May 8, 2026
PubMed
Abstract

Insights

Geographic variation exists in missing race and ethnicity data within US nursing homes. Discrepancies between Minimum Data Set (MDS) and Medicare data sources highlight data quality challenges.

Area of Science:

  • Gerontology
  • Health Services Research
  • Data Science

Background:

  • Administrative data on race and ethnicity in US nursing homes exhibit geographic variability.
  • The extent of missing race and ethnicity data in nursing home administrative records is not well-characterized.

Purpose of the Study:

  • To analyze geographic variations in missing race and ethnicity data within the Minimum Data Set (MDS) 3.0.
  • To compare discrepancies in race and ethnicity data between MDS 3.0 and Medicare claims.

Main Methods:

  • A cross-sectional study analyzed Medicare beneficiaries with MDS 3.0 records from 2014-2018.
  • Missingness of race and ethnicity data in MDS was assessed by state.
  • Misclassification rates of race and ethnicity variables from Medicare enrollment database (EDB) and Research Triangle Institute (RTI) were compared against MDS data.

Main Results:

  • Significant geographic variation in missing MDS race and ethnicity data was observed, ranging from 1.2% to 14.7%.
  • Misclassification rates varied substantially between MDS and Medicare data sources (EDB and RTI) for Hispanic, Asian American/Pacific Islander, and Black populations.
  • RTI variables demonstrated superior sensitivity and specificity compared to EDB when contrasted with MDS data.

Conclusions:

  • Geographic disparities in missing race and ethnicity data are evident in US nursing homes' MDS.
  • Discrepancies between MDS and Medicare data sources (EDB, RTI) also vary geographically.
  • Careful consideration of these data quality issues is crucial when utilizing MDS race and ethnicity information.
Keywords:
Medicareadministrative datanursing homesrace

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