PND9 FACTORS AFFECTING FUNCTIONAL DEPENDENCE IN ALZHEIMER PATIENTS RESIDING IN NURSING HOMES IN THE UNITED STATES - USING NATIONAL NURSING HOME SURVEY (NNHS-2004)

Persons age 65 and over constitute the largest reservoir of Mycobacterium tuberculosis infection in the United States today. During 1987, 6,150 tuberculosis cases were reported among this high-risk group. These cases represent 27% of the total US tuberculosis morbidity, although this age group constitutes only 12% of the US population. Tuberculosis case rates in the United States are higher among the elderly (20.6 per 100,000) than among all other age groups (average 9.3 per 100,000).More Americans live in nursing homes than in any other type of residential institution; on any given day approximately 5% of all elderly persons are living in a nursing home. Elderly nursing home residents are at greater risk for tuberculosis than elderly persons living in the community. In a Centers for Disease Control (CDC)-sponsored survey of 15,379 routinely-reported tuberculosis cases from 29 states, 8% of the 4,919 cases that occurred among elderly persons occurred among residents of nursing homes. The incidence of tuberculosis among nursing home residents was 39.2 per 100,000 person years, whereas the incidence of tuberculosis among elderly persons living in the community was 21.5 per 100,000. The observed rate of tuberculosis among nursing home employees was three times the rate expected in employed adults of similar age, race and sex (CDC, unpublished data).

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Mortality in Nursing Home Evacuations in the United States from 1995-2017

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19000244 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s2-s2

Author(s):

Sharon Mace ◽

Daniel Caicedo ◽

Aishwarya Sharma

Keyword(s):

United States ◽

Nursing Home ◽

Nursing Homes ◽

Natural Disasters ◽

Nursing Home Residents ◽

The United States ◽

Loss Of Life ◽

External Events ◽

Analyze Data

Introduction:There are an estimated 15,600 nursing homes with a total of 1.4 million residents in the United States. The number of residents will continue to increase due to the aging population, and the associated morbidities will make it difficult to evacuate them safely.Aim:This study is the first of its kind to provide an analysis of the number of nursing home deaths caused by external and internal events following evacuations.Methods:Information from the databases Lexis Nexis and PubMed were compiled and limited to news articles from 1995-2017. The gathered information included the reason for evacuation, injuries, deaths, and locations within the United States.Results:From 1995 to 2017, there was a total of 51 evacuations and 141 deaths in nursing homes. 27 (53%) evacuations were due to external events which resulted in a combined 121 (86%) deaths, and 24 (47%) evacuations were due to internal events which resulted in a combined 20 (14%) deaths. Hurricanes were responsible for the majority of deaths during evacuations, followed by fires and floods. The number of evacuations and deaths increased the greatest between 2005 to 2008.Discussion:External events have the greatest impact on loss of life. Internal disasters are about equal in the number of incidents, however, external events have a much greater mortality rate. Exact numbers on injuries, morbidity, and mortality are difficult to ascertain, but it appears to be related to natural disasters. In view of the increasing likelihood of natural disasters related to global warming, a drastic improvement of standard evacuation procedures of long-term nursing homes is critical to decreasing mortality of nursing home residents. There also needs to be a nationally standardized method of reporting evacuations in order to better analyze data on nursing homes.

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The Effects of Chains on the Measurement of Competition in the Nursing Home Industry

Medical Care Research and Review ◽

10.1177/1077558717701771 ◽

2017 ◽

Vol 76 (3) ◽

pp. 315-336 ◽

Cited By ~ 4

Author(s):

Richard A. Hirth ◽

Qing Zheng ◽

David C. Grabowski ◽

David G. Stevenson ◽

Orna Intrator ◽

...

Keyword(s):

United States ◽

Nursing Home ◽

Nursing Homes ◽

Market Structure ◽

Market Power ◽

The United States ◽

Local Market ◽

Common Ownership ◽

Fixed Radius

Consistently accounting for more than 50% of the nursing homes in the United States, corporate chains have played an important role in the industry for several decades. However, few studies have explicitly considered the role of chains in measuring competition in nursing home markets. In this study, we use a newly developed database tracking common ownership over a period of nearly two decades to compare chain-adjusted and unadjusted measures of competition at the county and 25 km fixed-radius levels and explore how the differences would affect the assessment of local market structure. On average, the chain-adjusted Herfindahl–Hirschman Indexes (HHIs) are about 0.02 higher than the unadjusted HHIs. Each year, about 20% to 22% of the counties would appear more concentrated when recalculating HHIs accounting for common ownership. Evidence suggests that nursing home chains tend to focus more on expanding access to new markets within a state than to increasing market power within a smaller local market.

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A Stage Set for Disaster: For-Profit Nursing Homes, Federal Law, and COVID-19

10.18278/jep.1.3.8 ◽

2021 ◽

Vol 1 (3) ◽

Author(s):

David Papke

Keyword(s):

United States ◽

Twentieth Century ◽

Nursing Home ◽

Nursing Homes ◽

Home Care ◽

The United States ◽

Nursing Home Care ◽

Federal Law ◽

For Profit

This article exposes the tragic relationship between for-profit nursing homes and the spread of COVID-19 in those facilities. For-profit nursing homes came to dominate nursing-home care in the United States in the second half of the twentieth century. However, for-profit nursing homes on average provided care which was inferior to the care provided in state-run and nonprofit nursing homes. Congress attempted to address the problems in nursing homes in the final decades of the twentieth century, but massive statutes and abundant regulations served mostly to legitimize for-profit nursing homes. COVID-19 then underscored the flaws in the legally sanctioned, for-profit nursing homes, as thousands died within the problematic institution’s walls.

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Covid-19 Swept Nursing Homes in the United States

Innovation in Aging ◽

10.1093/geroni/igaa057.3439 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 939-939

Author(s):

Lei Yu

Keyword(s):

United States ◽

Nursing Home ◽

Nursing Homes ◽

Nursing Home Residents ◽

The United States ◽

Demographic Information ◽

Nursing Home Administrators ◽

Final Data ◽

The Relationship ◽

Demographic Features

Abstract Nursing Homes experienced a colossal loss impacted by the Covid-19 pandemic in the United States. This study applied Covid-19 Nursing Home Dataset (updated on 08/16/2020) released by Data.CMS.gov to explore possible factors behind the death s at nursing homes. The results indicated 2.55 residents died per week at a nursing home averagely. Besides, the absence of nursing staff, aides, clinical physicians, PPE supplies contributes to more deaths at nursing homes. Lastly, the number of positive COVID-19 cases of nursing home staff positively associate with the number of total deaths of residents（R=0.65). These findings provide more pieces of evidence for nursing home administrators and policymakers to make adjustments to help nursing home residents better cope with challenges caused by the pandemic; however, this dataset is not the final data for the pandmic is not over. Also, the dataset covers few demographic information (gender, race, ethinicty and so on) ; therefore, researchers could explore the relationship between the demographic features and COVID-19 deaths at nursing homes.

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Nursing home evacuations due to disasters in the United States over 22.5 years from 1995 to 2017

American Journal of Disaster Medicine ◽

10.5055/ajdm.2021.0393 ◽

2021 ◽

Vol 16 (2) ◽

pp. 105-121

Author(s):

Aishwarya Sharma, DO ◽

Sharon E. Mace, MD, FACEP, FAAP

Keyword(s):

United States ◽

New York ◽

Nursing Home ◽

Nursing Homes ◽

Natural Disasters ◽

Nursing Home Residents ◽

The United States ◽

Total N ◽

Nursing Home Administrators ◽

Ice Storms

A large and growing segment of the United States population resides in nursing homes. Many nursing home residents have multiple comorbidities, are unable to perform activities of daily living, and need assistance for their daily functioning. They are some of the most fragile and vulnerable members of the population. Disasters are increasing in frequency and severity. This makes it likely that disasters will strike nursing homes and affect their residents. The purpose of this study was to evaluate the characteristics of disasters in the United States that resulted in nursing home evacuations. There were 51 reported nursing home evacuations due to a disaster over 22.5 years between 1995 and 2017. Natural disasters were responsible for the majority of evacuations (58.8 percent) followed by man-made unintentional disasters (37.3 percent) and man-made intentional (arson) (3.9 percent). The single most common reason for evacuation was hurricanes (23.5 percent, N = 12) and internal fires (23.5 percent, N = 12). Water-related disasters accounted for nearly three-fourths of the natural disasters (hurricanes 40 percent, N = 12; floods, 33.3 percent, N = 10; total 73.3 percent, N = 22), then snow/ice storms (13.3 percent, N = 4). Of man-made disasters, over two-thirds (66.7 percent) were due to internal fires (internal fires, n = 12, 57.1 percent and arson n = 2, 9.5 percent; total N = 14, 66.7 percent). The highest number of evacuations occurred in Texas, Louisiana, Missouri, New York, and Pennsylvania. This knowledge should enable nursing home administrators, disaster planners, public health officials, and others to improve preparedness for disasters that lead to nursing home evacuations.

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