scholarly journals THE QUALITY OF DENTAL CARE IN NURSING HOMES: VARIATION BY FACILITY AND MARKET CHARACTERISTICS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S606-S607
Author(s):  
Zhiqiu Ye ◽  
Bei Wu
Keyword(s):  
Oral Health ◽  
Nursing Homes ◽  
Dental Care ◽  
Estimating Equation ◽  
Care Quality ◽  
Policy And Practice ◽  
For Profit ◽  
Low Performance ◽  
Competing Priorities

Abstract Nursing home (NH) residents are disproportionately affected by poor oral health. But little we known about the root causes. We analyzed the 2000-2016 national inspection survey data for all certified-NHs (n=248,975 facility-years). Dental care performance was measured by two designated deficiency citations. Generalized estimating equation models were used to predict if the NH facility and market characteristics were associated with low performance. The rates of deficiency citation tripled from 1.2% in 2000 to 3.4% in 2016 (p<0.001) with substantial variation across states. NHs with more minority residents and poorer resources (higher share of Medicaid and lack of registered nurse), and NHs with high competing priorities (larger, for profit, chain-affiliated and urban locations) were more likely to receive deficiency citations. Residents in these facilities are at greater risks of poor oral health. This presentation will provide discussion on relevant policy and practice to improve dental care quality in nursing homes.

scholarly journals RACIAL-ETHNIC DISPARITY IN DENTAL CARE IN NURSING HOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S245-S245
Author(s):  
Zhiqiu Ye ◽  
Bei Wu
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Nursing Homes ◽  
Dental Care ◽  
Ethnic Disparity ◽  
System Level ◽  
Term Care ◽  
For Profit ◽  
Racial Ethnic ◽  
Care Performance

Abstract Minority older adults are at higher risks of poor oral health. Little is known about the extent of and the contributing factors to racial/ethnic disparity in dental care quality in the long-term care settings. Previous studies suggest that organizational and system-level factors are key determinants of oral health among minority older adults. We examined the racial/ethnic disparity in dental care delivery in nursing homes (NHs) by facility and market characteristics. We analyzed the 2000-2016 national Inspection Survey data for all certified-NHs (n=248,975 facility-years). Two designated deficiency citations were used to measure dental care performance. Generalized estimating equations were used to compare the rates of deficiency citations among NHs in different quartiles of the share of minority residents, adjusting for facility characteristics, market characteristics, year and state fixed effects. Overall, compared to NHs in the lowest quartile of the share of minority residents (average % minority residents =0.24%), NHs in the highest quartile of the share of minority residents (average % minority residents = 46.5%) and those in the second highest share (average % minority residents=13.9%) had 46.8% and 31.2% higher odds of receiving dental care citations(p<0.001 for both), respectively. The increased citation rates persisted over time (p=0.40) and were greater among for-profit NHs (p=0.02). Our study suggests that minority older adults in NHs are disproportionately affected by poorer dental care performance. There is a great need to improve quality of dental care in NHs, particularly for those that are for-profit and those that disproportionately serve minority residents.

scholarly journals Analyzing Nursing Home Complaints: From Substantiated Allegation to Deficiency Citations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 82-83
Author(s):  
Kallol Kumar Bhattacharyya ◽  
Lindsay Peterson ◽  
John Bowblis ◽  
Kathryn Hyer
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Staff Training ◽  
Policy And Practice ◽  
Abuse And Neglect ◽  
The Relationship ◽  
Investigation Process

Abstract Complaints provide important information to consumers about nursing homes (NHs). Complaints that are substantiated often lead to an investigation and potentially a deficiency citation. The purpose of this study is to understand the relationship between substantiated complaints and deficiency citations. Because a complaint may contain multiple allegations, and the data do not identify which allegation(s) lead to a complaint’s substantiation, we identified all substantiated single allegation complaints for NHs in 2017. Our data were drawn from federally collected NH complaint and inspection records. Among the 369 substantiated single-allegation complaints, we found most were categorized as quality of care (31.7%), resident abuse (17.3%), or resident neglect (14.1%). Of the deficiency citations resulting from complaints in our sample, 27.9% were categorized as quality of care and 19.5% were in the category of resident behavior and facility practices, which includes abuse and neglect. While two-thirds (N=239) of the substantiated complaints generated from 1 to 19 deficiency citations, nearly one third had no citations. Surprisingly, 28% of substantiated abuse and neglect allegations resulted in no deficiency citations. More surprisingly, a fifth of complaints that were categorized as “immediate jeopardy” at intake did not result in any deficiency citations. We also found a number of asymmetries in the allegation categories suggesting different processes by Centers for Medicare and Medicaid Services (CMS) region. These results suggest that the compliant investigation process warrants further investigation. Other policy and practice implications, including the need for better and more uniform investigation processes and staff training, will be discussed.

scholarly journals How implementation of a national strategy for nursing homes is experienced by the healthcare personnel: A qualitative study with content analysis of interviews.

2020 ◽  
Author(s):  
Beate Andre ◽  
RN. Kjersti Grønning ◽  
Frode F. Jacobsen ◽  
Gørill Haugan
Keyword(s):  
Content Analysis ◽  
Nursing Home ◽  
Nursing Homes ◽  
Qualitative Content Analysis ◽  
Implementation Process ◽  
Care Quality ◽  
Healthcare Personnel ◽  
Health Promoting ◽  
Positive Experiences

Abstract Background: Nursing homes are under strong pressure to provide good care to the residents. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Home’ strategy to increase a health-promoting perception that focuses on the older persons` resources. Implementations represent introducing changes to the healthcare personnel; however, changing one’s working approaches, routines and working culture may be demanding. On this background, we explored how the ‘Joy-of-Life-Nursing-Home’ strategy is perceived by the employees in retrospective, over a period after the implementation and which challenges the employees experience with this implementation.Method: We used a qualitative approach and interviewed 14 healthcare personnel working in nursing homes in one Norwegian municipality, which had implemented the ‘Joy-of-Life-Nursing-Home’ strategy. The analysis was conducted following Kvale’s approach to qualitative content analysis.Results: The main categories were: (a) the characteristics of care activities before implementations of ‘Joy-of-Life-Nursing-Home’, (b) how ‘Joy-of-Life-Nursing-Home’ influenced the care activities, and (c) challenges with the implementation of ‘Joy-of-Life-Nursing-Home’. Some of the informants spoke well about the implementation concerning the care quality stating “to see the joy in the eyes of the resident then I feel we have succeeded”. For informants who experienced resistance toward the implementation, they felt it was too much to document, it was too complicated, and the requirements were too many. Conclusions: Quality of care seems to have increased after the implementation, as perceived by the informants. Nevertheless, the fact that the informants seemed to be divided into two different groups related to their main perspective of the implementation is concerning. One group has positive experiences with the implementations process and the benefits of it, while the other group focuses on lack of benefits and problems with the implementation process. In order to understand what facilitates and hinders the implementation, research on contextual factors like work environment and leadership is recommended.

2013 AAHA Dental Care Guidelines for Dogs and Cats*

2013 ◽  
Vol 49 (2) ◽  
pp. 75-82 ◽  
Author(s):  
Steven E. Holmstrom ◽  
Jan Bellows ◽  
Stephen Juriga ◽  
Kate Knutson ◽  
Brook A. Niemiec ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Oral Health ◽  
Dental Care ◽  
Systemic Diseases ◽  
Veterinary Profession ◽  
Care Guidelines ◽  
Communication Evaluation ◽  
Client Communication

Veterinary dentistry is constantly progressing. The purpose of this document is to provide guidelines for the practice of companion animal dentistry for the veterinary profession. Dental care is necessary to provide optimum health and optimize quality of life. Untreated diseases of the oral cavity are painful and can contribute to local and systemic diseases. This article includes guidelines for preventive oral health care, client communication, evaluation, dental cleaning, and treatment. In addition, materials and equipment necessary to perform a medically appropriate procedure are described.

Does Investor-Ownership of Nursing Homes Compromise the Quality of Care?

2002 ◽  
Vol 32 (2) ◽  
pp. 315-325 ◽  
Author(s):  
Charlene Harrington ◽  
Steffie Woolhandler ◽  
Joseph Mullan ◽  
Helen Carrillo ◽  
David U. Himmelstein
Keyword(s):  
Quality Of Care ◽  
Nursing Homes ◽  
Skilled Nursing Facility ◽  
Nurse Staffing ◽  
Care Quality ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Staffing Ratios ◽  
The Impact

Quality problems have long plagued the nursing home industry. While two-thirds of U.S. nursing homes are investor-owned, few studies have examined the impact of investor-ownership on the quality of care. The authors analyzed 1998 data from inspections of 13,693 nursing facilities representing virtually all U.S. nursing homes. They grouped deficiency citations issued by inspectors into three categories (“quality of care,” “quality of life,” and “other”) and compared deficiency rates in investor-owned, nonprofit, and public nursing homes. A multivariate model was used to control for case mix, percentage of residents covered by Medicaid, whether the facility was hospital-based, whether it was a skilled nursing facility for Medicare only, chain ownership, and location by state. The study also assessed nurse staffing. The authors found that investor-owned nursing homes provide worse care and less nursing care than nonprofit or public homes. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5 percent higher than nonprofit and 43.0 percent higher than public facilities, and also had more of each category of deficiency. In the multivariate analysis, investor-ownership predicted 0.679 additional deficiencies per home; chain-ownership predicted an additional 0.633 deficiencies per home. Nurse staffing ratios were markedly lower at investor-owned homes.

Civil Money Penalty Enforcement Actions for Quality Deficiencies in Nursing Homes

2019 ◽  
Vol 60 (5) ◽  
pp. 868-877
Author(s):  
Xiaochuan Wang ◽  
Denise Gammonley ◽  
Felicia Bender
Keyword(s):  
Quality Of Life ◽  
Nursing Homes ◽  
Fixed Effects ◽  
State Level ◽  
Regulatory Oversight ◽  
Cross Sectional ◽  
For Profit ◽  
Profit Status ◽  
Fixed Effects Regression

Abstract Background and Objectives Civil money penalties (CMP) are fines collected by CMS. A portion of these CMPs are redistributed to states for purposes including improving resident care and quality of life through reinvestment in quality improvement projects. This study examined state variation in civil money penalty enforcement actions for quality of life (QOL) and quality of care (QOC) deficiencies in nursing homes. Research Design and Methods 2015–2016 cross-sectional CASPER nursing home survey data obtained from the CMS QCOR database were used to explore the pattern of enforcement actions for QOL and QOC deficiencies across states. Fixed effects regression models examined relationships between state-level characteristics, quality deficiencies, and enforcement actions imposed by states. Results State enforcement actions resulting in a CMP were more likely for QOC deficiencies (M = 0.143, SD = 0.097) than for QOL deficiencies (M = 0.070, SD = 0.056) and states exhibited variability in imposing enforcement actions. The presence of severe QOC deficiencies resulting in actual resident harm contributed to CMP enforcement actions for both QOL and QOC deficiencies. States with primarily for-profit status providers had more enforcement actions. Discussion and Implications The variability noted in state enforcement for quality deficiencies actions parallels inconsistencies in state regulatory oversight of nursing homes.

Evaluation of Oral Therapeuthical and Surgical Treatment Needs among Retirement Age Population in Different Countries

2011 ◽  
Vol 11 (1) ◽  
pp. 139-143
Author(s):  
Ingrida Krasta ◽  
Aldis Vidzis ◽  
Anda Brinkmane ◽  
Ingrida Cema
Keyword(s):  
Surgical Treatment ◽  
Oral Health ◽  
Nursing Homes ◽  
Health Indicators ◽  
Developed Countries ◽  
Retirement Age ◽  
Age Group ◽  
Treatment Needs ◽  
Oral Health Indicators

Evaluation of Oral Therapeuthical and Surgical Treatment Needs among Retirement Age Population in Different Countries Oral health in connection with quality of life is affected by such functional factors as dental decay and its complications, untreated tooth roots, oral mucosal diseases and inflammations, precancerous diseases, cancers, pain in temporomandibular joints, xerostomia and partially or fully edentulous jaws. It has been noted in literature that among retirement age population the number of remaining teeth has increased and the number of untreated decayed teeth in developed countries for the last 20 years has decreased. Despite this fact the need to improve measures of oral health remains actual in this age group due to increasing prevalence of diagnosed oral diseases and number of extracted teeth and roots. Oral health indicators among retirement age population living in nursing homes in such countries as Canada, USA, UK, Finland, Denmark, Germany, Turkey, Brazil, Australia and Lithuania differ from the same age group indicators among self-dependent old people able to take care of themself. Oral health indicators of nursing homes residents in many countries are significantly worse than oral health indicators of the corresponding age group population. The proposed evaluation data of oral hygiene, periodontal status, DMF-T index, quality of existing and needs of new prosthodontics as well as oral mucosal disorders among retirement age population provides an important insight into therapeutic and surgical treatment provision in different countries.

For-profit and not-for-profit nursing homes in Israel: Do they differ with respect to quality of care?

2009 ◽  
Vol 48 (2) ◽  
pp. 167-172 ◽  
Author(s):  
A. Mark Clarfield ◽  
Gary Ginsberg ◽  
Iris Rasooly ◽  
Sara Levi ◽  
Jacob Gindin ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Nursing Homes ◽  
For Profit ◽  
Not For Profit
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