scholarly journals CONSISTENT ASSIGNMENT: AN UPDATE ON THE QUALITY IMPACT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S802-S802
Author(s):  
Nicholas Castle ◽  
John A Harris
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Family Satisfaction ◽  
Nursing Home Administrators ◽  
Logistic Regression Models ◽  
Staffing Levels ◽  
Nursing Home Quality ◽  
Resource File ◽  
Low Levels ◽  
Nurse Aides

Abstract The association of consistent assignment of Nurse Aides (NAs) with nursing home quality indicators is examined. Consistent assignment is defined as the same caregivers consistently caring for the same residents almost (80% of their shifts) every time they are on duty. Data used came from a survey of nursing home administrators, Nursing Home Compare, the Certification and Survey Provider Enhanced Reporting (CASPER) data, and the Area Resource File. All of the data was from 2015, and included 3,550 facilities. Several multivariate logistic regression models (using GEE) were used, including staffing variables (turnover, agency use, staffing levels), facility factors (size, ownership, occupancy rate), and market characteristics (competition, Medicaid rates). An average of 77% of nursing homes reported using at least some level of consistent assignment; although some were at low levels. In the multivariate analyses, accepted levels of consistent assignment were used. Turnover and family satisfaction quality were significantly (p<.01) better in facilities with the highest levels of consistent NA assignment. 7 of the 9 Quality Measures and 3 of the 5 Five-Star measures examined were significantly (p<.01) better in facilities with the highest levels of consistent NA assignment. Consistent assignment has developed as a preferred practice in nursing homes based on little empirical evidence. The findings presented here provide substantial justification for the use of this staffing practice for NAs.

scholarly journals THE INFLUENCE OF STAFF RETENTION ON NURSING HOME QUALITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S701-S701 ◽  
Author(s):  
Nicholas Castle ◽  
Kathryn Hyer ◽  
John A Harris
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Staff Retention ◽  
Nursing Home Administrators ◽  
Logistic Regression Models ◽  
Nursing Home Quality ◽  
One Year

Abstract The association of retention of Nurse Aides (NAs) with nursing home quality of care is examined. Retention is defined as staff continuously employed in the same facility for a defined period of time. Deficiency citations were used as quality indicators. Data used came from a survey of nursing home administrators, the Certification and Survey Provider Enhanced Reporting (CASPER) data, and the Area Resource File. All of the data was from 2015, and included 3,550 facilities. Analyses included negative binomial regression and multivariate logistic regression models (using GEE). The analytic modeling included staffing variables (turnover, agency use, staffing levels), facility factors (size, ownership, occupancy rate), and market characteristics (competition, Medicaid rates). The average number of deficiency citations was significantly lower (p<.01) in facilities with the higher levels of NAs consistently employed for one year or more. The same was found for facilities with the higher levels of NAs consistently employed for two years or more. While the average number of deficiency citations, the quality of care grouping of deficiency citations, and J, K, L deficiency citations were all significantly lower (p<.01) in facilities with the higher levels of NAs consistently employed for three years or more. Staff retention has been promoted as potentially influential based on little empirical evidence. The findings provide some justification for the importance of NA retention.

scholarly journals When Is a Nursing Home Complaint Really a Complaint? Making Sense Out of Increased Complaints in U.S. Nursing Homes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 852-853
Author(s):  
Xiao Qiu ◽  
Jane Straker ◽  
Katherine Abbott
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Urban Areas ◽  
Family Satisfaction ◽  
Term Care ◽  
Making Sense ◽  
Nurse Aide ◽  
Nursing Home Quality ◽  
Director Of Nursing ◽  
Occupancy Rates

Abstract Official complaints are one tool for addressing nursing home quality concerns in a timely manner. Similar to trends nationwide, the Ohio Department of Health (ODH) has noticed a trend in increasing nursing home complaints and has partnered with the Scripps Gerontology Center to learn more about facilities that receive complaints. Greater understanding may lead to proactive approaches to addressing and preventing issues. This study relies on two years of statewide Ohio nursing home complaint data. Between 2018 and 2019, the average complaint rate per 100 residents went from 6.59 to 7.06, with more than 70% of complaints unsubstantiated. Complaint information from 629 Ohio nursing homes in 2018 was linked with Centers for Medicare and Medicaid Services Nursing Home Compare data, the Ohio Biennial Survey of Long-Term Care Facilities, and Ohio Nursing Home Resident and Family Satisfaction Surveys. Using ordered logistic regression analyses, we investigated nursing home providers' characteristics using different levels of complaints and substantiated complaints. Findings suggest that providers with higher complaint rates are located in urban areas, had administrator and/or director of nursing (DON) turnover in the previous 3 years, experienced decreased occupancy rates, had reduced nurse aide retention, and received lower family satisfaction scores. Additionally, providers with administrator and/or DON turnover, and low family satisfaction scores are more likely to have substantiated complaints. Because increasing numbers of complaints are accompanied by relatively low substantiation rates, policy interventions targeted to specific types of providers may improve the cost-effectiveness of complaint resolution, as well as the quality of care.

scholarly journals Article Commentary: The Need for Higher Minimum Staffing Standards in U.S. Nursing Homes

2016 ◽  
Vol 9 ◽  
pp. HSI.S38994 ◽  
Author(s):  
Charlene Harrington ◽  
John F. Schnelle ◽  
Margaret McGregor ◽  
Sandra F. Simmons
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Financial Incentives ◽  
Positive Relationship ◽  
Nurse Staffing ◽  
Federal Regulations ◽  
Political Strategies ◽  
Political Opposition ◽  
Staffing Levels ◽  
Nursing Home Quality

Many U.S. nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing. This commentary focuses on two issues. First, there is a need for higher minimum nurse staffing standards for U.S. nursing homes based on multiple research studies showing a positive relationship between nursing home quality and staffing and the benefits of implementing higher minimum staffing standards. Studies have identified the minimum staffing levels necessary to provide care consistent with the federal regulations, but many U.S. facilities have dangerously low staffing. Second, the barriers to staffing reform are discussed. These include economic concerns about costs and a focus on financial incentives. The enforcement of existing staffing standards has been weak, and strong nursing home industry political opposition has limited efforts to establish higher standards. Researchers should study the ways to improve staffing standards and new payment, regulatory, and political strategies to improve nursing home staffing and quality.

scholarly journals Decomposing Racial and Ethnic Disparities in Nursing Home Quality of Life

2020 ◽  
pp. 073346482094665
Author(s):  
John R. Bowblis ◽  
Weiwen Ng ◽  
Odichinma Akosionu ◽  
Tetyana P. Shippee
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Structural Characteristics ◽  
Ethnic Disparities ◽  
People Of Color ◽  
Racial And Ethnic Disparities ◽  
Staffing Levels ◽  
Nursing Home Quality ◽  
Racial Ethnic

This study examines the racial/ethnic disparity among nursing home (NH) residents using a self-reported, validated measure of quality of life (QoL) among long-stay residents in Minnesota. Blinder–Oaxaca decomposition techniques determine which resident and facility factors are the potential sources of the racial/ethnic disparities in QoL. Black, Indigenous, and other People of Color (BIPOC) report lower QoL than White residents. Facility structural characteristics and being a NH with a high proportion of residents who are BIPOC are the factors that have the largest explanatory share of the disparity. Modifiable characteristics like staffing levels explain a small share of the disparity. To improve the QoL of BIPOC NH residents, efforts need to focus on addressing systemic disparities for NHs with a high proportion of residents who are BIPOC.

scholarly journals EVALUATING THE EVIDENCE BASE OF A STAFFING GUIDELINE FOR DUTCH NURSING HOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S381-S381
Author(s):  
Ramona Backhaus ◽  
Hilde Verbeek ◽  
Bram De Boer ◽  
Erik Van Rossum ◽  
Jos Schols ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Home ◽  
Nursing Homes ◽  
Scientific Literature ◽  
Evidence Base ◽  
Care Provision ◽  
Ministry Of Health ◽  
Nursing Home Quality ◽  
Quality Framework ◽  
Board Level

Abstract Related to the Dutch nursing home quality framework implemented in 2017, a staffing guideline was developed, aimed at assisting nursing homes to adequately staff their wards. For the Dutch Ministry of Health, we investigated the evidence base of this guideline. We critically reviewed scientific literature (n=65) and interviewed (inter)national experts (n=8) and potential guideline users (n=5). We found that departing a quality improvement dialogue directly from teams, clients and their families is positive. However, weaknesses were identified as well. Several risks exist for employees to adequately assess resident needs. Furthermore, buy-in is needed from board level to develop a vision on which competencies and amount of staff are needed to fulfill these needs. Examples of guideline improvement recommendations were assisting teams in how to assess resident needs, critically reflect on care provision and considering a role for (top)management. Overall, it was concluded that the value of the guideline was limited.

Nursing homes’ preparedness plans and capabilities

2012 ◽  
Vol 7 (2) ◽  
pp. 127-135 ◽  
Author(s):  
Hilary Eiring, MPH ◽  
Sarah C. Blake, MA, PhD Candidate ◽  
David H. Howard, PhD
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Disaster Preparedness ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Probit Regression ◽  
Nursing Home Administrators ◽  
Local Officials ◽  
Almost All ◽  
Question Survey

Objectives: To assess nursing homes’ capabilities to evacuate or shelter-in-place during a disaster and to determine their actual preparedness-related capacity.Design: A 27-question survey assessing disaster preparedness plans and capabilities in nursing homes. Respondents and nonresponders were compared based on characteristics from the Nursing Home Compare Web site using t tests for continuous variables and χ2 test for categorical variables. Probit regression was used to estimate the relationships between nursing home characteristics and dichotomous measures of preparedness.Setting: Web and paper surveys of nursing home administrators.Participants: Nursing home administrators in California, Florida, and Georgia.Main outcome measures: Number of disaster drills, days supply of emergency food and water, evacuation transportation and destination.Results: All facilities reported conducting at least one disaster drill per year. Only 55 percent of facilities used a template to develop their disaster plans and 74 percent of facilities reported that they discuss their disaster plans with local or state emergency management officials. Most facilities (81 percent) have generators. All but 19 (7 percent) of nursing homes are able to shelterin- place for 2 days or longer. Ambulance services are the most common form of transportation (76 percent). Most facilities (73 percent) plan to evacuate residents to nursing homes affiliated with their corporate group.Discussion: Almost all respondents conducted disaster drills, discussed preparedness with local officials, and were able to shelter-in-place for at least 2 days. However, many facilities rely on resources that may not be available during a large disaster.

Factors Influencing Models of End-of-Life Care in Nursing Homes: Results of a Survey of Nursing Home Administrators

2004 ◽  
Vol 7 (5) ◽  
pp. 668-675 ◽  
Author(s):  
Kristen N. Rice ◽  
Eric A. Coleman ◽  
Ron Fish ◽  
Cari Levy ◽  
Jean S. Kutner
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Nursing Home Administrators ◽  
Factors Influencing

scholarly journals Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

2003 ◽  
Vol 3 (1) ◽  
Author(s):  
Stephanie Kissam ◽  
David Gifford ◽  
Peggy Parks ◽  
Gail Patry ◽  
Laura Palmer ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Home ◽  
Nursing Homes ◽  
Lessons Learned ◽  
Nursing Home Quality

scholarly journals Nursing Home Factors and Their Impact on COVID-19 Cases: A Study of Wisconsin State

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 884-884
Author(s):  
Mohammed Abahussain ◽  
Priya Nambisan ◽  
Colleen Galambos ◽  
Bo Zhang ◽  
Elizabeth Bukowy
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Missing Values ◽  
Organizational Factors ◽  
Data Sets ◽  
Occupancy Rate ◽  
Free Standing ◽  
Staff Shortage ◽  
For Profit ◽  
Nurse Aides

Abstract COVID-19 has been devastating for Nursing Homes (NHs). The concentration of older adults with underlying chronic conditions inevitably made the setting highly vulnerable leading to high rates of mortality for residents. However, some nursing homes fared better than others. This study examines several quality measures and organizational factors to understand whether these factors are associated with COVID-19 cases in Wisconsin. We combined three datasets from Centers for Medicare & Medicaid Services (CMS) – the Star Rating dataset, Provider Information dataset and COVID-19 Nursing Home dataset. Data used is from the period of Jan 1 – Oct 25, 2020 for the state of Wisconsin. The analysis includes 331 free-standing NHs with no missing values from the data sets. The variables used were self-reported information on nursing home ratings, staff shortage, staff reported hours, occupancy rate, number of beds and ownership. Of the 331 NHs examined, shortages were reported of 25.4%, 31.1%, 3.2% and 15.6% of licensed nurse staff (25.4%), nurse aides (31.1%), clinical staff, (3.2%) and other staff (15.6%) Additionally, there was a significant (p<.05) positive correlation between number of beds and COVID-19 cases, and there was no statistically significant association between occupancy rate and COVID-19 cases. NHs with better star ratings were also found to have less COVID-19 cases. Interestingly, private NHs had significantly higher COVID-19 cases than for-profit and government owned NHs, a finding that is congruent with other studies in this area. Recommendations for practice will be discussed.

Amazing numbers and bottom rankings: the reporting of nursing home resident user surveys in the press

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Elisabeth Carlstedt ◽  
Håkan Jönson
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Media Representations ◽  
Nursing Home Care ◽  
User Survey ◽  
Content Type ◽  
User Perceptions ◽  
Nursing Home Quality ◽  
Survey Results ◽  
Media Reports

PurposeMedia reporting is one of many circumstances that nursing homes have to relate to, because of the reputational risks. The aim of this article is to investigate media representations of Swedish nursing homes in relation to reports on an annual national user survey.Design/methodology/approachThe empirical data consist of 381 Swedish newspaper articles about the survey results. The questions guiding the analysis were: what messages on nursing homes are communicated, and how are claims organized in order to appear factual?FindingsThe data show that press reports focus on comparisons of care units' survey results, eldercare representatives' explanations of the results, and what improvements will be made in order to do better in the next year's survey. With their use of truth-making rhetoric, press articles construct survey results as credible and valid, thus mirroring user perceptions and ultimately nursing home quality. The selection of nursing home representatives' comments equally reinforces the validity of claims.Originality/valueGiven nursing homes' problems with demonstrating success, the authors argue that media reports on the user survey is a way for eldercare organizations to achieve results in an otherwise resultless field, and while media reports might be seen as prompting change in nursing home care, what is ultimately achieved is the legitimation of a costly survey with low response rate.

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