scholarly journals Antibody Responses to Third-Dose mRNA Vaccines in Nursing Home and Assisted Living Residents

2022 ◽  
Author(s):  
Ali Zhang ◽  
Jessica A. Breznik ◽  
Rumi Clare ◽  
Ishac Nazy ◽  
Matthew S. Miller ◽  
...  
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Antibody Responses

scholarly journals Antibody Responses to 3rd Dose mRNA Vaccines in Nursing Home and Assisted Living Residents

2021 ◽  
Author(s):  
Ali Zhang ◽  
Jessica A Breznik ◽  
Rumi Clare ◽  
Ishac Nazy ◽  
Matthew S Miller ◽  
...  
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Nursing Home Residents ◽  
Humoral Response ◽  
Antibody Responses ◽  
Wild Type ◽  
Neutralization Capacity ◽  
Vaccine Recommendations ◽  
Variant Virus ◽  
Dose Vaccine

A comparison of SARS-CoV-2 wild-type and the beta variant virus neutralization capacity between 2 and 3 mRNA vaccine series in nursing home residents, and between nursing home and assisted living residents strongly supports 3rd dose vaccine recommendations, and equivalent polices for nursing homes and assisted living settings. Findings suggest that residents mount a robust humoral response to a 3rd mRNA vaccination, and have greater neuralization capacity compared to a 2 dose series.

scholarly journals From Micro to Macro: Exploring Preference-Based Person Centered Care from Multiple Perspectives

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Katherine Abbott ◽  
Kristine Williams
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Fixed Effects ◽  
Nursing Home Residents ◽  
Direct Care ◽  
Multiple Perspectives ◽  
Person Centered Care ◽  
Fixed Effects Panel Regression ◽  
Centered Care ◽  
The Impact

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.

A Secondary Analysis of the Intensity of Hospice Visits Among Medicare Decedents in the Last Seven Days of Life by Place of Residence

2021 ◽  
pp. 104990912110648
Author(s):  
Pauline Karikari-Martin ◽  
Lirong Zhao ◽  
Lynn Miescier
Keyword(s):  
Nursing Home ◽  
Retrospective Analysis ◽  
Social Worker ◽  
Assisted Living ◽  
Secondary Analysis ◽  
Place Of Residence ◽  
Assisted Living Facility ◽  
Payment Policy ◽  
Medicare Data

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.

Observable Indicators of Nursing Home Care Quality Instrument−Assisted Living Version

2008 ◽  
Author(s):  
Marilyn J. Rantz ◽  
Myra A. Aud ◽  
Mary Zwygart-Stauffacher ◽  
David R. Mehr ◽  
Gregory F. Petroski ◽  
...  
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Assisted Living ◽  
Care Quality ◽  
Nursing Home Care ◽  
Quality Instrument

Hospice Attitudes among Assisted Living and Nursing Home Administrators, and the Long-Term Care Hospice Attitudes Scale

2006 ◽  
Vol 9 (6) ◽  
pp. 1388-1400 ◽  
Author(s):  
Debra Jean Dobbs ◽  
Laura Hanson ◽  
Sheryl Zimmerman ◽  
Christianna S. Williams ◽  
Jean Munn
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Long Term Care ◽  
Term Care ◽  
Nursing Home Administrators

Nursing home prices and market structure: the effect of assisted living industry expansion

2013 ◽  
Vol 9 (1) ◽  
pp. 95-112 ◽  
Author(s):  
John R. Bowblis
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Market Structure ◽  
Assisted Living ◽  
Nursing Home Care ◽  
Assisted Living Facilities ◽  
Home Market ◽  
Home Prices ◽  
The Relationship

AbstractSince the 1990s, there has been substantial expansion of facility-based alternatives to nursing home care, such as assisted living facilities. This paper analyzes the relationship between expansion of the assisted living industry, nursing home market structure and nursing home private pay prices using a two-year panel of nursing homes in the State of Ohio. Fixed effect regressions suggest that the expansion of assisted living facilities are associated with increased nursing home concentration, but find no effect on private pay nursing home prices. This would be consistent with assisted livings reducing demand for nursing homes by delaying entry into a nursing home, though assisted livings are not direct competitors of nursing homes.

scholarly journals Antibody Responses in Elderly Residential Care Persons following COVID-19 mRNA Vaccination

2021 ◽  
Author(s):  
David A Nace ◽  
Kevin E Kip ◽  
Octavia M Peck Palmer ◽  
Michael R Shurin ◽  
Katie Mulvey ◽  
...  
Keyword(s):  
Antibody Response ◽  
Assisted Living ◽  
Independent Living ◽  
Long Term Care ◽  
Linear Regression Analysis ◽  
Antibody Responses ◽  
Personal Care ◽  
Term Care ◽  
Antibody Levels

Objective COVID-19 disproportionately impacts older adults residing at long-term care facilities. Data regarding antibody response to COVID-19 vaccines in this population is limited. Our objective was to quantify the presence and magnitude of antibody response in older, vaccinated residents at assisted living, personal care, and independent living facilities. Design A cross-sectional quality improvement study was conducted March 15-April 1, 2021 in the Pittsburgh region. Setting and Population Participants were volunteers at assisted living, personal care, and independent living facilities, who received mRNA COVID-19 vaccine. Conditions that obviate immune responses were exclusionary criteria. Methods Sera were collected to measure IgG anti-SARS-CoV-2 antibody level with reflex to total anti-SARS-CoV-2 immunoglobulin levels. Descriptive statistics, Pearson correlation coefficients, and multiple linear regression analysis were performed to evaluate relationships between factors potentially associated with antibody levels. Results All participants (N=70) had received two rounds of vaccination for COVID-19 and were found to have antibodies to SARS-CoV-2. There was wide variation in relative levels of antibodies as determined by extinction coefficients. Antibody levels trended lower in male sex, advanced age, steroid medications, and longer length of time from vaccination. Conclusions and Implications Higher functioning long-term care residents mounted detectable antibody responses when vaccinated with COVID-19 mRNA-based vaccines. This study provides preliminary information on level of population risk of assisted living, personal care, and independent living residents which can inform reopening strategies. Data suggests some degree of immunity is present during the immediate period following vaccination. However, protective effects of such vaccination programs remain to be determined in larger studies. Clinical protection is afforded not just by pre-formed antibody levels, but by ongoing adaptive immunity, which is known to be decreased in older individuals. Thus, the implications of these levels of antibodies in preventing COVID-19 disease must be determined by clinical follow-up.

scholarly journals Black–White Disparities in Moves to Assisted Living and Nursing Homes Among Older Medicare Beneficiaries

2019 ◽  
Vol 75 (9) ◽  
pp. 1972-1982 ◽  
Author(s):  
Meghan Jenkins Morales ◽  
Stephanie A Robert
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Assisted Living ◽  
Multinomial Logistic Regression ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Housing Tenure ◽  
Medicare Beneficiaries ◽  
Nationally Representative

Abstract Objectives Investigate black-white disparities in older adults’ moves to assisted living and nursing homes and draw from the Andersen Healthcare Utilization Model to test explanations for any disparities. Methods Data are from a nationally representative sample of older community-dwelling Medicare beneficiaries from the 2015 (N = 5,212) National Health and Aging Trends Study (NHATS). We use stepwise multinomial logistic regression to examine black-white disparities in moves out of community housing to assisted living or a nursing home over 2 years, before and after adjusting for predisposing (age, gender), enabling (income, housing tenure, Medicaid, living arrangement) and need (activities of daily living [ADL] limitation, physical capacity, self-rated health, and dementia) factors. Results Black older adults are less likely to move to assisted living and are more likely to move to a nursing home compared to white older adults. Black-white disparities in moves to nursing homes are explained by black-white differences in enabling and need factors, whereas black-white disparities in moves to assisted living remain even after adjusting for enabling and need factors. Discussion Unmeasured factors related to systemic racism (e.g., residential racial segregation, racial discrimination) and/or black-white differences in care preferences might further explain black-white disparities in moves to assisted living and warrant further investigation.

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