Hurricane Irma’s Impact on Assisted Living Residents’ Rates of Hospitalization, Nursing Home Placement, and Mortality

Abstract Little is known about the impact of hurricanes on the large and increasingly vulnerable population residing in assisted living communities (ALs). The objective of this paper was to leverage a novel methodology to identify Medicare beneficiaries residing in Florida ALs and determine their outcomes associated with Hurricane Irma in 2017. With Medicare enrollment records, claims, and the nursing home Minimum Data Set, we identified a cohort of AL residents in 2015 (n=45,505) and 2017 (n=42,306) and compared their rates of 30-day hospitalization, nursing home placement, and mortality in the two years. AL residents in 2017 had a 10% increase in their 30-day hospitalization rates (3.96 in 2015, 4.34 in 2017), 16% increase in their 30-day nursing home placement rates (1.61 in 2015, 1.87 in 2017), and 22% increase in their 30-day mortality (0.54 in 2015, 0.66 in 2017). Findings suggest Florida AL residents experienced adverse outcomes following Hurricane Irma.

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Building the Evidence for Hospital Mobility

Innovation in Aging ◽

10.1093/geroni/igaa057.3205 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 867-867

Keyword(s):

Nursing Home ◽

Health System ◽

Functional Decline ◽

Bed Rest ◽

Illness Severity ◽

Adverse Outcomes ◽

Nursing Home Placement ◽

System Level ◽

Home Placement

Abstract Low mobility in the hospital, defined as mobility limited to bed rest or bed to chair transfers, is associated with high rates of functional decline, nursing home placement, and death even after adjusting for illness severity and comorbidity. This lecture will describe the gradual of building of evidence for both the adverse outcomes and potential solutions at both an individual and a health system level to address the challenge of low mobility.

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The Impact of Ethnic Involvement and Migration Patterns on Long-Term Care Plans Among Retired Sunbelt Migrants: Plans for Nursing Home Placement

The Journals of Gerontology Series B ◽

10.1093/geronb/58.6.s369 ◽

2003 ◽

Vol 58 (6) ◽

pp. S369-S376 ◽

Cited By ~ 9

Author(s):

E. P. Stoller ◽

A. T. Perzynski

Keyword(s):

Nursing Home ◽

Long Term Care ◽

Nursing Home Placement ◽

Term Care ◽

Migration Patterns ◽

Care Plans ◽

And Migration ◽

Home Placement ◽

The Impact

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The Impact of Respite Use on Nursing Home Placement

The Gerontologist ◽

10.1093/geront/35.1.67 ◽

1995 ◽

Vol 35 (1) ◽

pp. 67-74 ◽

Cited By ~ 60

Author(s):

K. Kosloski ◽

R. J. V. Montgomery

Keyword(s):

Nursing Home ◽

Nursing Home Placement ◽

Home Placement ◽

The Impact

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Predictors of Nursing Home Placement from Assisted Living Settings in Canada

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980813000469 ◽

2013 ◽

Vol 32 (4) ◽

pp. 333-348 ◽

Cited By ~ 20

Author(s):

Colleen J. Maxwell ◽

Andrea Soo ◽

David B. Hogan ◽

Walter P. Wodchis ◽

Erin Gilbart ◽

...

Keyword(s):

Nursing Home ◽

Assisted Living ◽

Nursing Home Placement ◽

Facteurs Prédictifs ◽

Longue Duree ◽

Longue Durée ◽

Home Placement ◽

Pour Cent

RÉSUMÉCette étude visait à évaluer l’incidence de placement dans un établissement de soins de longue durée (SLD) et d’identifier les facteurs prédictifs de placement résidentiel et d’installation parmi résidents âgés dans établissements aidant à la vie autonome en Alberta, au Canada. 1,086 résidents de 59 installations en Alberta ont été inclus. Infirmières de recherche ont effectué des évaluations de résidents interRAI-AL et ont interrogé les aidants familiaux et les administrateurs. Les prédicteurs de placement ont été identifiés avec des modèles de risques proportionnels de Cox multivariés. L’incidence cumulative SLD de l’admission était de 18,3 pour cent en 12 mois. Le risque de placement a augmenté significativement pour les résidents âgés et ceux avec des relations sociales médiocres, peu d’implication dans les activités, la dépreciation cognitive et/ou fonctionnelle, l’instabilité de la santé,une histoire des chutes et des hospitalisations récentes/visites à l’urgence, et l’incontinence urinaire sévère. Une diminution du risque de placement a été montré pour les résidents de grandes établissements avec une infirmière autorisée et/ou une infirmière auxiliaire autorisée disponible 24 heures par jour et un médecin de premier recours affilié. Nos résultats font ressortir les domaines cliniques et politiques ou des interventions ciblées peuvent retarder les admissions SLD.

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Stopping Donepezil may be linked to nursing home placement for people with Alzheimer’s disease, but a “cause and effect” not conclusive

10.3310/signal-000160 ◽

2015 ◽

Author(s):

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Nursing Home ◽

Nursing Home Placement ◽

Cause And Effect ◽

Home Placement

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

Innovation in Aging ◽

10.1093/geroni/igaa057.3062 ◽

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.

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