FAQs

1. Where does the data come from?

The variables in HHFoCUS were developed from several sources. Descriptions of each follow. Each variable label in the Data Dictionary includes the source of the data.

The Outcome and Assessment Information Set (OASIS) is a standardized assessment tool completed by trained clinicians to measure outcomes for Medicare beneficiaries who are receiving home health services. More information about OASIS data sets and user manuals can be found at https://www.cms.gov/medicare/quality/home-health.
The Residential History File (RHF) is a data resource developed at the Brown University Center for Gerontology and Healthcare Research. It is built using Medicare enrollment data, Medicare claims, and Minimum Data Set (MDS) data. It can be used to track individuals as they move through the long-term care system, including between different care settings and different care types. The goal of the RHF is to create a per-person chronological history of health service utilization and location of care throughout a calendar year.
Medicare Beneficiary Summary File (MBSF) is an annual dataset maintained by the Centers for Medicare & Medicaid Services (CMS) that describes Medicare beneficiary enrollment and demographic characteristics. More information about the MBSF, including a data dictionary, can be found at https://www.cms.gov/data-research/files-for-order/limited-data-set-lds-files/master-beneficiary-summary-file-mbsf-lds.

2. How did you define a unique home health stay?

We defined unique home health stays using OASIS, beginning with a new start of care assessment and ending with a discharge assessment. A research brief describing HHFoCUS and the methodology used to create the dataset can be found at https://doi.org/10.1370/afm.250090.

3. How are the data aggregated, and what populations are included?

The data include information on both Traditional Medicare and Medicare Advantage beneficiaries, aggregated annually at the home health agency, county, and state level for years 2016 to 2019. We identified home health agencies by their CMS Certification Number (CCN). We assigned beneficiaries who received services within a home health agency their county and state of residence as recorded in the Master Beneficiary Summary File.

4. What does LNE mean in the dataset?

LNE means “low number of events”. Because much of the data are aggregated from CMS data, which are covered under the strict terms of a data use agreement, the most prevalent reason that an agency will be missing information on an item is to adhere to CMS’s cell suppression policy. This policy stipulates that no cell of 10 or less may be displayed. Also, no use of percentages or other mathematical formulas may be used if they result in the display of a cell 10 or less. Therefore, in these data, if either the numerator or the denominator was less than or equal to 10 after aggregating, the result was set to LNE. Because this is done after aggregating, agencies whose values were set to missing in the agency-level file can still contribute to the measure at the county and state levels.

5. Will more years of data be available?

Yes! Additional years of HHFoCUS data are currently in development. Join our mailing list by signing up on the “Download the Data” page to receive updates on changes to the available data.

If you have additional questions related to the data, please reach out to us at FoCUS@Brown.edu.