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Article History

Received: 26 May 2023

Accepted: 12 December 2025

First Online: 24 March 2026

Declarations

: The authors have no relevant financial or non-financial interests to disclose. The authors have no competing interests to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article.

: A data user agreement was signed between Purdue University and the Indiana Family and Social Services Administration (FSSA) over the CMS grant entitled “Cost-Effective Quality Care for Indiana’s Long-Term Care (LTC) Medicaid Patients”, October 2018 - September 2020. MDS data collection and reporting is mandated by CMS on all CMS certified nursing homes. FSSA allowed Purdue to set up a data repository on a Purdue HIPAA-compliant data server. Purdue IRB determined that the study does not meet the usual requirement for human subject research.

: N/A

: All authors agree to submit this manuscript for publication.

: The authors declare no conflicts of interest.