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Written consent was not obtained from participants given that the study solely used existing electronic clinical records (i.e., secondary use of health information). These same assessment records (i.e., MDS 2.0, MDS 3.0, and interRAI LTCF) are in common use in North America, Europe, and the Pacific Rim for public reporting, quality measurement, case mix and reimbursement, as well as research. As such, these data have been extensively studied for their psychometric properties (some of which we cite). Specific to our study, we have met all of the requirements for the secondary use of health information outlined in our provincial legislation (Province of Ontario Personal Health Information Protection Act, 2004, S.O. 2004, c. 3, Sched. A). Under the provisions set out in the legislation as well as research ethics, our study received full clearance from the Hamilton Integrated Research Ethics Board (project 0739D), which is the research ethics board for McMaster University, St. Joseph\u2019s Healthcare Hamilton and Hamilton Health Sciences.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"This work and any views expressed within it are solely those of the authors. The funders and collaborating organizations had no role in the study design, analysis, interpretation, or writing of the manuscript. No other relationships or activities that could appear to have influenced the submitted work.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Publisher\u2019s Note"}}],"article-number":"39"}}