Memory care reduces nursing home admissions among assisted‐living residents with dementia

2022 ◽  
Author(s):  
Portia Y. Cornell ◽  
Wenhan Zhang ◽  
Lindsey Smith ◽  
Momotazur Rahman ◽  
David C. Grabowski ◽  
...  
2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 528-528
Author(s):  
Portia Cornell ◽  
Tetyana Shippee

Abstract Assisted living is generally understood to offer a greater degree of privacy and independence than a nursing home; most residents pay privately, with some receiving support from state subsidies and Medicaid; regulation and oversight are the purview of state agencies. Within these broad parameters, however, one assisted living community may look quite different from another across the country, or down the street, in its resident population and the regulations that govern its operating license. The purpose of this symposium is to explore that variation. The papers leverage an in-depth review of changes in assisted-living regulation from 2007 to 2019 and a methodology to identify Medicare beneficiaries in assisted living using ZIP codes. To set the stage, the first paper examines variation across assisted living licenses to identify six regulatory types and compare their populations’ characteristics and health-care use. The second paper analyzes trends over time in the clinical acuity of assisted living residents associated with changes in nursing home populations. The third paper investigates racial disparities in assisted living associated with memory-care designations and proportions of Medicaid recipients. The fourth investigates how regulation of hospice providers in assisted living affect end-of-life care and place of death. The final paper describes requirements related to care for the residents with mental illness in seven states. The symposium concludes with an expert in long-term care disparities and quality discussing the implications for policymakers, providers, and the population needing long-term care in assisted living.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Katherine Abbott ◽  
Kristine Williams

Abstract Advancing our knowledge related to honoring nursing home resident preferences is a cornerstone of person-centered care (PCC). While there are multiple approaches to providing PCC, we focus on resident preferences as assessed via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In this symposium, we explore the perspectives of a variety of stakeholders including nursing home residents, staff, and the impact of preference-based care on provider level regulatory outcomes. First, we present a comparative study of preference importance among n=317 African America and White nursing home residents that found more similarities than differences between the two groups. Second, a content analysis of the responses from n=196 interviews with nursing home residents details the barriers and facilitators connected to their levels of satisfaction with their preferences being fulfilled. Third, perspectives from n=27 direct care workers explore the concept of pervasive risk avoidance to the delivery of PCC. Fourth, systems-level practices, such as shift assignments and provider schedules are identified as barriers to successfully fulfilling resident preferences from the perspectives of n=19 staff within assisted living. Our final presentation utilizes a fixed-effects panel regression analysis with n=551 Ohio nursing home providers to explore the impact of PELI use on regulatory outcomes such as substantiated complaints and deficiency scores reported in the CMS Nursing Home Compare data. Discussant Dr. Kristi Williams will integrate findings, highlighting implications for policy, practice, and future directions. Research in Quality of Care Interest Group Sponsored Symposium.


2009 ◽  
Vol 50 (2) ◽  
pp. 192-203 ◽  
Author(s):  
S. G. Kelsey ◽  
S. B. Laditka ◽  
J. N. Laditka
Keyword(s):  

Author(s):  
Pauline Karikari-Martin ◽  
Lirong Zhao ◽  
Lynn Miescier

Background In 2016, Medicare finalized the Service Intensity Add-on (SIA) payment policy to increase the intensity of hospice registered nurse (RN) or social worker (SW) visits in the last 7 days of life. The research objective was to compare the intensity of hospice RN or SW visits in the last 7 days of life among older decedents who received a hospice visit, while residing in a traditional home, an assisted living facility, or long-term nursing home. Methods A retrospective analysis using 2016-2018 Medicare data of decedents 65 years or older (n= 2 067 863) related to the Medicare SIA payment policy. Intensity was defined as the number and duration of hospice RN or SW visits in the last 7 days of life using Medicare claims code G0299 and G0155. Results Regression results suggest that decedents who received a SIA related visit while residing in an assisted living facility, had on average a slightly longer duration of hospice RN visits in the last 7 days of life, compared to decedents residing in a traditional home, after controlling for demographics and other factors (P<.0001). The duration of hospice RN visits remained unchanged among decedents who received a SIA visit in 2017 or 2018, when compared to 2016 (P <.0001). Overall the average number of hospice SW visits did not differ by place of residence among decedents who received a SIA visit. Conclusions Among decedents who received a SIA related visit, the duration of hospice RN visits were slightly different by place of residence.


2008 ◽  
Author(s):  
Marilyn J. Rantz ◽  
Myra A. Aud ◽  
Mary Zwygart-Stauffacher ◽  
David R. Mehr ◽  
Gregory F. Petroski ◽  
...  

2019 ◽  
Vol 45 (4) ◽  
pp. 21-29 ◽  
Author(s):  
Phyllis M. Gaspar ◽  
Cindy A. Scherb ◽  
Felix Rivera-Mariani

2020 ◽  
Vol 60 (5) ◽  
pp. 878-884 ◽  
Author(s):  
Mitchell Roberts ◽  
Lindsay J Peterson ◽  
Kathryn Hyer

Abstract Background and Objectives Assisted living (AL) is a growing sector of the U.S. long-term care market, with its development driven largely by private market choices. However, consumers need information to choose the right AL community (ALC). This paper examined information available on U.S. state websites concerning ALC quality, costs, and services. Research Design and Methods Based on prior research and their analysis of a sample of state websites, researchers identified 39 key informational elements and grouped them into four categories, (a) ALC characteristics, (b) payment and services, (c) quality, and (d) website usability. Researchers then examined the presence of the 39 elements on 51 websites (U.S. states and the District of Columbia), meeting regularly to discuss findings and resolve differences. Results A majority of states provided basic information about individual ALCs (e.g., number of beds, ownership). Only 35% listed payment(s) accepted (e.g., Medicaid), and 31% indicated the availability of memory care. Nearly 70% posted inspection results, while only 43% provided information about complaints. Many met basic usability guidelines (e.g., type size), but locating content on many sites required multiple steps, and none met 5th-grade-or-below readability standards. Discussion and Implications A majority of websites provided important information, such as inspection results. However, many were lacking key elements concerning payment accepted and services. Finding what was available was burdensome. More work is needed to help states provide information that enables consumers to find ALCs that meet their needs. The lack of such information puts older adults at risk of inappropriate placements.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S545-S546
Author(s):  
Portia Y Cornell ◽  
Momotazur Rahman ◽  
Wenhan Zhang ◽  
Kali Thomas

Abstract The objective of this study is to estimate the effect of receiving care in a dementia-care licensed (DCL) assisted living community, versus a standard AL, on outcomes of residents with ADRD. In four states that issue a license for specialized dementia care (AL, CO, MS, and NY), we identify a cohort of 5,720 Medicare fee-for-services beneficiaries with ADRD who moved to an AL in 2014. To control for unobserved factors that contribute to a patient’s selection of AL type, we use the difference in the log-distances from an individual’s home address to the nearest DCL and standard AL as an instrumental variable. We will report the effect of residence in a DCL AL on mortality, inpatient hospital days, emergency department utilization, and hospice use, showing how the use the distance instrument offers differing estimates from unadjusted or multiple-regression methods.


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