TY - JOUR. T1 - Quality and Costs in the Nursing-Home Market. AU - Ullmann, Steven G.. PY - 1983/3/17. Y1 - 1983/3/17. N2 - To the Editor: In one of a series of articles appearing in the Journal concerning the nursing-home industry, Vladeck (Sept. 30 issue)1 indicates that there is an implicit assumption that a positive relation exists between the quality of resident care and facility costs. As Vladeck points out, however, there is no empirical evidence supporting this assumption. Nursing-home quality may be more a function of staff and administrative attitudes - characteristics that may be independent of facility costs. I recently conducted an extensive study of New York nursing homes and obtained interesting results concerning the relation between the quality of facilities.. AB - To the Editor: In one of a series of articles appearing in the Journal concerning the nursing-home industry, Vladeck (Sept. 30 issue)1 indicates that there is an implicit assumption that a positive relation exists ...
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Researchers said nursing homes must help residents maintain clean teeth and dentures because germs found in dental plaque can make their way into the lungs and cause deadly pneumonia in elderly residents, according to a new study report.
Examining a 5% random sample of Medicare beneficiaries in 2006, we found that approximately 25% of NH residents with FTs required an ED visit or hospitalization, with 44% of hospitalizations and 24% of ED visits being potentially preventable for an ACS condition. Moreover, nearly 30% of NH residents with FTs were considered "comatose" or without "discernible consciousness", representing 20060 NH residents with FTs in the US. We further found that 42% of NH residents with FTs were dependent in all ADLs, representing 31,700 NH residents who are unable to eat, bathe, toilet, transfer, or dress.. Previous studies suggest that there are little or no benefits to FTs in cognitively impaired patients, particularly among those with advanced dementia. Evidence suggests that FTs in cognitively impaired patients do not prevent aspiration pneumonia, improve function, prevent or improve pressure ulcers, reduce the risk of infection, meaningfully improve nutritional status, decrease weight loss, improve wound ...
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Objective. This study examines the experiences of the caregiver involved in the placement process of an older family member into a nursing home facility. Background. The caregiving journey is both complex and challenging. Family caregivers provide many time and labor intensive tasks that have been associated with increased stress and burden. Caregivers are often unable to maintain care at home and have to consider nursing home placement. The caregivers role within the nursing home placement process and their continued responsibility post-placement has not been well explored. Methods. This qualitative descriptive study utilized the Family Management Style Framework to understand how caregivers define, manage, 33 and perceive the consequences of the nursing home placement process. 10 primary family caregivers were interviewed shortly after placement and then again 3-months post-placement. The results of the study were organized to understand the contextual influences of each individual case and to
Again The Dispatchs bias against the nursing-home profession rears its ugly head (Wheelchair windfall, editorial, Thursday).
WASHINGTON, Aug. 9, 2017 /PRNewswire/ -- Nursing Home Complaint Center Now Urges the Family Members of Nursing Home Patients Nationwide With Recently...
Data for the 1977 National Nursing Home Survey were collected in a nationwide sample of nursing homes, personal care homes (with or without nursing), and domicilary care homes. Information on staff, residents, and discharges was collected via a combination of personal interviews and self-enumerated forms. Four files are contained within this data collection. Part 1, Facility-Expense File, contains information on type of facility, certification, bed size, services and therapy routinely provided to residents or non-residents, regular and temporary admissions, vacant staff positions, facility income, and expenditures. Parts 2 and 3, Current and Discharged Resident Files, supply data on residents regarding admissions, impairments, conditions, behavioral problems, visits to a physician, services, therapy or treatments received, use of aids or need of assistance, level of care received, total charges for care, and sources and amount of payments. Part 4, Staff File, contains information on employees ...
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Restrictions on what Medicaid and Medicare will cover for nursing home patients can often lead to unnecessary hospitalizations - an estimated $8 billion in
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National Nursing Home Week, established by the American Health Care Association, honors those who promote quality of care at nursing home facilities, including residents, family members, volunteers, community, and staff. A Nursing Home Survey conducted by CDC indicated that approximately 18,000 nursing homes in the United States provide care for 1.6 million residents; 1.4 million (90%) of these residents are aged ,65 years (1,2). By 2030, approximately 70 million U.S. residents will be aged ,65 years, and the number of persons residing in nursing homes will increase to 3 million persons (3). Infections, particularly respiratory and urinary tract infections, are a major cause of morbidity, mortality, and excess health-care costs among nursing home residents (4,5). To address the burden of infections among nursing homes residents, CDC launched a national educational campaign targeting clinicians who provide care to persons in long-term--care facilities. The campaign promotes 12 evidence-based ...
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CMS recently announced significant changes to Nursing Home Compare and the Five-Star Quality Rating System. The agency also says that it is considering abandoning the star ratings for hospitals completely. The Nursing Home Compare website and Five-Star Quality Rating System are aimed at helping consumers, families, and caregivers compare nursing homes. CMS says the recent changes are meant to make the tools more accurate.
Medical Homes Survey reveals diverse settings, but single goal: Increase quality of care. When primary-care physicians needed to go somewhere new to revitalize their field, they found that there was no place quite like the patient-centered medical home: A practice model that emphasizes care coordination, increased access and enhanced doctor-patient communication-all with an emphasis on…
Staff need the confidence, communication skills and knowledge to initiate and handle relationships with GPs. Nurses in care homes should be offered joint training with their counterparts employed in the NHS, and the opportunity to obtain practice hours in order to validate specific training. GPs and health care professionals can play a valuable role in training and updating staff, and homes can also contribute to the training of doctors and nursing staff. Relatives in one study [22] thought that more information and support could be provided by health specialists already working with the home, including the community pharmacist and GP. GPs, nurses and relatives report a low level of confidence, knowledge and skills among care home staff, associated with a lack of access to training. This can affect their interactions with GPs, and GPs or relatives perceptions of care home staff, as well as being a barrier to partnership working. This can be exacerbated by high turnover among staff. [1] It has ...
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Median survival in NH was 2.2 years (95% confidence interval [CI]: 1.9-2.4). Yearly mortality rate throughout the three-year observation period was 31.8%. Mortality was associated with higher age and comorbidity at BL, and more severe dementia, higher ADL-dependency, less severe psychotic symptoms, and a lower BMI throughout the study period. Of the organizational variables, living on a ward with more residents resulted in a higher risk of mortality.. Conclusion. In conclusion, the NH mortality rate remained stable throughout the three-year study period with about one third of the residents deceasing each year. Individual resident characteristics appeared to be more important than organizational variables for predicting mortality risk. The finding of an association between ward size and mortality risk deserves further investigation in future studies.. OPEN ACCESS ...
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article{565ac9e0-21b0-4b21-897a-28b3fd4f413b, abstract = {In this study, cancer patients characteristics associated with death in nursing homes were explored. The study sample included 395 cancer patients who had participated in a trial of palliative care, 260 ( 66%) patients died in hospital, 80 (20%) at home and 55 (14%) in nursing homes. Health-related quality of life was prospectively recorded using the EORTC QLQ-C30 questionnaire. Death in nursing home was associated with greater age, not living with spouse and poor performance status. Patients dying in nursing homes reported severe functioning impairments and more fatigue and appetite loss compared with those dying elsewhere. The association between death in nursing homes and poor physical, role, cognitive and social functioning remained significant when sociodemographic and medical differences were taken into account. Further research on frail elderly cancer patients is warranted to improve their care, to evaluate the appropriateness of ...
Health and Human Services had considered easing up on homes with a history of good care. By Laura Meckler ASSOCIATED PRESS WASHINGTON - White House officials said yesterday that they had
A cleaning supervisor at Queens nursing home was shot dead on the job yesterday, and police say they suspect a disgruntled employee. Elizabeth Parker, 58,...
Mayor de Blasio said on March 28 that he had only recently learned about a controversial deal to turn a Lower East Side nursing home into luxury condos, and...
May 2, 2016 - Six new quality measures have been added to the Nursing Home Compare website and three are the first to be based on Medicare-claims data from hospitals, rather than data self-reported by nursing homes. With these updates, it now reports information on 24 quality measures for 15,655 nursing home providers.
The data shows that primary care trusts (PCTs) do not accord sufficient priority to care home residents when planning and ensuring the delivery of local healthcare services. This has resulted in considerable variation in the extent to which their healthcare needs are being met. The BGS report has been published at the same time as the CQC report to complement its findings.. There are 376,250 older people living in 10,331 care homes in England[1] and the majority are frail with multiple needs and require help with self-care. Over 40% suffer from dementia.[2] The BGS report Failing the Frail: A Chaotic Approach to Commissioning Healthcare Services for Care Homes based on its analysis of the CQC data focuses on the provision of NHS healthcare support to care homes and confirms many of the findings of the BGSs inquiry Quest for Quality published last year. This described the unmet need, unacceptable variation and often poor quality of care provided by the NHS to older people resident in care ...
Aims and objectives. The aim of this paper was to explore carers and nurses appraisals concerning if and when nursing home placement for frail older people awaiting placement was needed and to illuminate ethical issues involved in decisions regarding nursing home placement.. Background. Requesting nursing home placement can be a complicated decision for carers, causing feelings of failure, anxiety and guilt. After the necessity of nursing home care is determined, the names of the older people are put on waiting lists. While waiting, home health care provides support services. Even with this care, many of the older people and their carers face difficult life situations.. Design. This is a descriptive and comparative cross-sectional study using qualitative methods.. Methods. The convenience sample (n = 36) comprised 11 carers of older people on a nursing home placement waiting list in Norway and 11 nurses caring for these older people. Every one willingly participated in interviews that were ...
Many seniors are challenging the idea that growing older means leaving home to live in a nursing home or other care facility. Instead, they are increasingly choosing to renovate their own home and enjoy their golden years in the environment where they feel most comfortable. Choosing to age in place does not mean forgoing support. Many aging seniors receive home health services as well as assistance with both home maintenance and daily tasks. Even with support, remaining in ones home can give a person a valuable sense of independence and empowerment. Of course, appropriate planning is necessary to ensure that a senior can age in place safely and comfortably. Before beginning any home renovations, keep in mind any specific medical issues and health issues that require accommodation. Arranging a home consultation with an occupational therapist might be a valuable use of time, as they can make a home visit and offer suggestions for that particular space. While a consultation with a specialist can ...
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The prevalence of Medicaid nursing home use in the last year ranged from 23 percent for those aged 74 and younger to 60 percent for those aged 85 and older.
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I am very particular with the referral partners I work with. Referring my clients to a house inspector who will educate, understand, and go the extra mile for my clients is so important. Brad Hanson from Hanson Inspections has proven himself to be one of the best home inspectors I have had to privilege to work with over the years. Here is Brad letting giving us a few tips on why a new home should be inspected.. There are some very important reasons why new home buyers should always get a home inspection done before purchasing. Buying a new home is an exciting experience, with great opportunities to pick your finishes, choose your colours, and to decide what floor coverings you want. But with all the excitement of choosing your decor and finding your new daily route to work, dont forget to have your new home inspected. While its best to have your first home inspection when the home is in the early phases of construction, when more of the home is visible, its still a good idea once it is all ...
http://www.yourlawyer.com/practice_areas/nursing_home_negligence">Nursing home abuse and nursing home negligence is a growing problem in the US, but now there is a new tool available to help families avoid the worst nursing homes. The Bush administration finally published the names of 131 of the nation’s worst nursing homes. The administration initially tried to protect the deficient nursing homes, claiming some of the facilities were already showing signs of improvement. But that decision drew the ire of congress, elderly advocates and others who said consumers needed the list to protect loved ones from nursing home abuse and negligence. the list was ultimately released by the Centers for Medicare and Medicaid Services (CMS) and represents those troubled facilities that are cited as being a "special focus facility," a designation used to identify facilities needing increased oversight. For these nursing homes, states conduct inspections at six-month intervals rather than ...
A new study says that the scoring system government agencies use to rate nursing home quality does not provide an adequate evaluation.
The nations nursing homes are perilously close to laying off workers, cutting services - possibly even closing - because of a perfect storm wallop from the recession and deep federal and state government spending cuts, industry experts say. A Medicare rate adjustment that cuts an estimated $16 billion in nursing home funding over the next 10 years was enacted at weeks end by the federal Centers for Medicare and Medicaid Services - on top of state-level cuts or flat-funding that already had the industry reeling. [...] Congress is debating billions more in Medicare funding cuts as part of health care reform. [...] this year, 24 states have cut funds for nursing home care and other health services needed by low-income people who are elderly or disabled, according to the Center on Budget and Policy Priorities, a nonprofit research firm based in Washington, D.C.
Research in Gerontological Nursing | Obesity rates are high among all age groups, including older adults. Obesity negatively affects health and functional ability, increasing the risk for nursing home (NH) admission. The current study examines trends over 11 years in moderate to severe obesity rates among NH residents. A generalized least squares regression model for panel data was used to test the effect of time (years) on the
Reports examining racial and ethnic disparities in the quality of nursing home care typically focus on the collective experience of thousands of residents living in many nursing homes.. Jennifer Gaudet Hefele, an assistant professor of gerontology at the University of Massachusetts Boston, believes information about racial and ethnic disparities can and should be publicly reported for individual nursing homes as well.. Hefele, who is a fellow in the LeadingAge LTSS Center @UMass Boston, recently joined 6 co-authors in publishing the results of the first study to examine differences in quality by race and ethnicity within nursing homes, based on a large set of publicly reported national measures.. Their results showed:. ...
Longitudinal changes in the characteristics of the nursing home population as represented in the most recent National Nursing Home Surveys (NNHS) were analyzed (1977 and 1985). This period is characterized by major changes in the delivery and financi
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The average stay of patients in a nursing home for acute rehabilitation is 23 days; only 9 percent of nursing home patients fall into this category. According to Medicare, approximately 43 percent of people over the age of 65 are likely to spend time in a nursing home; of these, 24 percent will be there less than one year. According to the California Association of Health Facilities, 78 percent of the nursing home population stays there for three months or less. ...
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