scholarly journals PAYROLL-BASED STAFFING MEASURES FOR NURSING HOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S62-S62
Author(s):  
Christianna Williams ◽  
Qing Zheng ◽  
Alan White
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Direct Care ◽  
Staffing Level ◽  
Non Profit ◽  
Staffing Levels ◽  
Placement Decisions ◽  
And Performance ◽  
Home Placement ◽  
Nursing Home Compare

Abstract The Centers for Medicare & Medicaid Services (CMS) developed the Payroll-Based Journal (PBJ) system for nursing homes to electronically submit direct care staffing information based on payroll and other auditable data. In spring 2018, CMS started reporting PBJ-based staffing measures on Nursing Home Compare. The objective of this research is to examine nursing home staffing patterns using PBJ data. We created measures of staffing hours per resident day, using PBJ staffing information and resident census calculated from MDS assessments. We examined how PBJ staffing levels varied for different types of nursing homes and the relationship between staffing and performance on other parts of CMS’s Five-Star Quality Rating System. We also examined weekday/weekend variation in staffing levels. We tracked about 15,650 nursing homes from 2017 to 2018. The average staffing level was 3.85 hours per resident day, of which 0.66 hours were for RNs. Average staffing levels were higher for smaller, non-profit, and hospital-based facilities. They were also higher for facilities with higher health inspection and quality measure ratings. Staffing levels were about 17% lower on weekends than on weekdays, and RN staffing was 38% lower on weekends. About 20% of facilities had one or more weekend day without any RN staffing in the quarter, while only 8% of facilities had any weekday without RN staffing. The use of payroll-based staffing measures improves the accuracy of the staffing information reported on Nursing Home Compare, providing consumers with additional quality-related information that can help guide their nursing home placement decisions.

scholarly journals Does Nursing Home Compare Reflect Patient Safety In Nursing Homes?

2018 ◽  
Vol 37 (11) ◽  
pp. 1770-1778 ◽  
Author(s):  
Daniel Brauner ◽  
Rachel M. Werner ◽  
Tetyana P. Shippee ◽  
John Cursio ◽  
Hari Sharma ◽  
...  
Keyword(s):  
Patient Safety ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Compare

scholarly journals ORGANIZATIONAL CHARACTERISTICS OF HIGHLY PERSON-CENTERED UNITS IN SWEDISH NURSING HOME

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S700-S701
Author(s):  
Anders B Sköldunger ◽  
Annica Backman
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Organizational Context ◽  
Organizational Characteristics ◽  
Direct Care ◽  
Cross Sectional ◽  
Care Services ◽  
Individualized Care ◽  
Private And Public ◽  
Institutional Model

Abstract The movement from an institutional model of care towards a person-centred care as the gold standard of practice is now guiding the provision of care services in nursing homes around the world. The organizational context of care has been described as a determining factor for the extent to which staff can offer person-centred care. However, few studies have empirically investigated which factors that defines nursing home units as being person-centred. Providing information about organizational characteristics would therefor provide insight into an organizational context with capacity to enhance a person-centred care. Thus, the aim was to explore factors of nursing homes with high vs. low person-centred care with focus on organizational variables. The study was based on a cross-sectional national survey, and data on 4831 residents, 3605 staff, and facility variables were collected in 2014. Descriptive statistics and regression modelling were used to analyze the data. The preliminary results showed that characteristics of highly person-centred units were; dementia specific units and units with fewer number of beds. No significant differences were seen between private and public nursing homes in terms of degree of person-centred care. Person-centred units was characterized by managers supporting staff to provide individualized care based on the resident’s needs, as well as staff receiving supervision of a reg. nurse in the direct care. These findings can be seen as facilitators ’ for person-centred care, suggesting several contextual and organizational elements of significance for enhancing person-centred practice.

scholarly journals A Proof of Concept of a Mobile Health Application to Support Professionals in a Portuguese Nursing Home

Sensors ◽  
2019 ◽  
Vol 19 (18) ◽  
pp. 3951
Author(s):  
Márcia Esteves ◽  
Marisa Esteves ◽  
António Abelha ◽  
José Machado
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Mobile Health ◽  
Health Professionals ◽  
Point Of Care ◽  
Healthcare Delivery ◽  
Proof Of Concept ◽  
Mobile Health Application ◽  
And Performance

Over the past few years, the rapidly aging population has been posing several challenges to healthcare systems worldwide. Consequently, in Portugal, nursing homes have been getting a higher demand, and health professionals working in these facilities are overloaded with work. Moreover, the lack of health information and communication technology (HICT) and the use of unsophisticated methods, such as paper, in nursing homes to clinically manage residents lead to more errors and are time-consuming. Thus, this article proposes a proof of concept of a mobile health (mHealth) application developed for the health professionals working in a Portuguese nursing home to support them at the point-of-care, namely to manage and have access to information and to help them schedule, perform, and digitally record their tasks. Additionally, clinical and performance business intelligence (BI) indicators to assist the decision-making process are also defined. Thereby, this solution aims to introduce technological improvements into the facility to improve healthcare delivery and, by taking advantage of the benefits provided by these improvements, lessen some of the workload experienced by health professionals, reduce time-waste and errors, and, ultimately, enhance elders’ quality of life and improve the quality of the services provided.

scholarly journals Early- versus Late-Onset Alzheimer Disease: Long-Term Functional Outcomes, Nursing Home Placement, and Risk Factors for Rate of Progression

2017 ◽  
Vol 7 (1) ◽  
pp. 172-187 ◽  
Author(s):  
Carina Wattmo ◽  
Åsa K. Wallin
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Nursing Homes ◽  
Alzheimer Disease ◽  
Late Onset ◽  
Age At Onset ◽  
Clinical Importance ◽  
Nursing Home Placement ◽  
Antidepressant Use ◽  
Home Placement

Background/Aims: Whether age at onset influences functional deterioration in Alzheimer disease (AD) is unclear. We, therefore, investigated risk factors for progression in activities of daily living (ADL) and nursing home placement (NHP) in cholinesterase inhibitor (ChEI)-treated patients with early-onset AD (EOAD) versus late-onset AD (LOAD). Methods: This 3-year, prospective, observational, multicenter study included 1,017 participants with mild-to-moderate AD; 143 had EOAD (onset <65 years) and 874 LOAD (onset ≥65 years). Possible sociodemographic and clinical factors that could affect functional outcome and NHP were analyzed using mixed-effects models and logistic regression, respectively. Results: Younger individuals exhibited longer illness duration before AD diagnosis, whereas 6-month functional response to ChEI therapy, 3-year changes in ADL capacities, time from diagnosis to NHP, and survival time in nursing homes were similar between the groups. In LOAD, a higher ChEI dose, no antidepressant use, and lower education level were protective factors for slower instrumental ADL (IADL) decline. In EOAD, antihypertensives/cardiac therapy implied faster IADL progression but lower risk of NHP. Conclusion: This study highlights the clinical importance of an earlier diagnosis and treatment initiation and the need for functional evaluations in EOAD. Despite the age differences between EOAD and LOAD, a similar need for nursing homes was observed.

scholarly journals Is There Evidence of Cream Skimming Among Nursing Homes Following the Publication of the Nursing Home Compare Report Card?

2009 ◽  
Vol 49 (6) ◽  
pp. 793-802 ◽  
Author(s):  
Dana B. Mukamel ◽  
Heather Ladd ◽  
David L. Weimer ◽  
William D. Spector ◽  
Jacqueline S. Zinn
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Report Card ◽  
Cream Skimming ◽  
Nursing Home Compare

Factors Influencing Nursing Home Placement Decisions

1994 ◽  
Vol 3 (3) ◽  
pp. 269-281 ◽  
Author(s):  
Rebecca A. Johnson ◽  
Valerie B. Schwiebert ◽  
Patricia Alvarado Rosenmann
Keyword(s):  
Nursing Home ◽  
Nursing Home Placement ◽  
Placement Decisions ◽  
Factors Influencing ◽  
Home Placement

Two Decades of Nursing Home Compare: What Have We Learned?

2020 ◽  
pp. 107755872093165
Author(s):  
R. Tamara Konetzka ◽  
Kevin Yan ◽  
Rachel M. Werner
Keyword(s):  
Systematic Review ◽  
Quality Improvement ◽  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Risk Adjustment ◽  
Public Reporting ◽  
Review Of The Literature ◽  
Nursing Home Compare

Approximately two decades ago, federally mandated public reporting began for U.S. nursing homes through a system now known as Nursing Home Compare. The goals were to provide information to enable consumers to choose higher quality nursing homes and to incent providers to improve the quality of care delivered. We conduct a systematic review of the literature on responses to Nursing Home Compare and its effectiveness in meeting these goals. We find evidence of modest but meaningful response by both consumers and providers. However, we also find evidence that some improvement in scores does not reflect true quality improvement, that disparities by race and income have increased, that risk-adjustment of the measures is likely inadequate, and that several key domains of quality are not represented. Our results support moderate success of Nursing Home Compare in achieving intended goals but also reveal the need for continued refinement.

Resilience and Challenges among Staff of Gulf Coast Nursing Homes Sheltering Frail Evacuees following Hurricane Katrina, 2005: Implications for Planning and Training

2009 ◽  
Vol 24 (1) ◽  
pp. 54-62 ◽  
Author(s):  
Sarah B. Laditka ◽  
James N. Laditka ◽  
Carol B. Cornman ◽  
Courtney B. Davis ◽  
Jane V.E. Richter
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Hurricane Katrina ◽  
Well Being ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Staff Members ◽  
And Training ◽  
Physical Care

AbstractPurpose:The purpose of this study was to: (1) explore experiences and responses of staff in caring for sheltered, frail, Hurricane Katrina evacuees; and (2) identify how planning and training can be enhanced for staff who may care for frail older populations during and after disasters.Methods:Individual, in-person, semi-structured interviews were conducted with 38 staff members in four nursing homes in Mississippi, sheltering 109 evacuees in November 2005, nine weeks after Hurricane Katrina.Twenty-four were direct care staff, including certified nursing assistants, licensed nurses, dietary aides, and social workers; 14 were support staff, including maintenance and business managers. The number interviewed in each nursing home averaged 9.5 (range 6–15). Using a discussion guide and focusing on their experiences caring for nursing home evacuees, staff were asked to describe: (1) experiences; (2) problems; (3) what helped; and (4) what was learned. Data were processed using grounded theory and thematic analysis. Responses of direct care staff differed in emphasis from those of support staff in several areas; responses from these groups were analyzed separately and together. Three of the researchers identified recurring themes; two organized themes conceptually.Results:Staff emphasized providing emotional reassurance to evacuees as well as physical care. Many described caring for evacuees as “a blessing,” saying the experience helped them bond with residents, evacuees, and other staff. However, caring for evacuees was difficult because staff members were extremely anxious and in poor physical condition after an arduous evacuation. Challenges included communicating with evacuees' families, preventing dehydration, lack of personal hygiene supplies, staff exhaustion, and emotional needs of residents, evacuees, and staff. Teamwork, community help, and having a well-organized disaster plan, extra supplies, and dependable staff helped personnel cope with the situation.Conclusions:Staff of nursing homes that sheltered Katrina evacuees demonstrated resilience in the disaster's aftermath. Many placed the well-being of residents as their first priority. Results underscore the importance of planning, teamwork, and adequate supplies and staffing. Training for long-term care staff should emphasize providing emotional support as well as physical care for residents and evacuees during and following disasters. Nurses, social workers, and other staff members responsible for promoting emotional well-being for nursing home residents should be prepared to respond to disasters.

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