Variation Across U.S. Assisted Living Facilities: Admissions, Resident Care Needs, and Staffing

2016 ◽  
Vol 49 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Kihye Han ◽  
Alison M. Trinkoff ◽  
Carla L. Storr ◽  
Nancy Lerner ◽  
Bo Kyum Yang
Keyword(s):  
Assisted Living ◽  
Assisted Living Facilities ◽  
Care Needs ◽  
Resident Care

scholarly journals Student-Led Fall Prevention Care Management Reduced Fall Risks at Assisted Living Facilities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 238-238
Author(s):  
Hiroko Kiyoshi-Teo ◽  
Claire McKinley-Yoder ◽  
Erin Lemon ◽  
Olivia Ochoa
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Fall Prevention ◽  
Fall Risk ◽  
Care Management ◽  
Assisted Living Facilities ◽  
Care Needs ◽  
Term Care ◽  
Fall Risks ◽  
The Impact

Abstract Older adults in residential care settings are four times more likely than those not living in care facilities to experience falls. Yet, fall prevention efforts at long-term care settings are under-resourced, under-regulated, and under-studied. To address this gap, we developed and studied the impact of a specialty clinical, Fall Prevention Care Management (FPCM), for nursing students to decrease older adults’ fall risks. We enrolled assisted living residents that facility liaison identified as being high fall risk (fall rates or fall risk were not tracked at the study sites) and MOCA ≥15, in 2 assisted living facilities in Northwest USA. Participants received weekly, 1-hour, individual, semi-structured, Motivational Interviewing-based care management visits by same students over 6 visits. Changes in fall risks were measured by the CDC STEADI assessment (unsteadiness & worry), Falls Self-Efficacy Scale International-Short (FESI-S), and Falls Behavioral Scale (FAB). Twenty-five residents completed the study. Students addressed the following (multiple responses possible): emotional needs (n=23), improved motivation to prevent falls (n=21), and individualized education/coaching (i.e., exercise, mobility aids) (n=10-17). FESI-S score improved from 16.0 to 14.4 (p=.001; decreased fear. FAB score improved from 2.94 to 3.10 (p=.05; more frequent fall prevention behaviors). Frequency of those who felt steady while standing or walking increased (24% to 40%, p=.07) and those who did not worry about falling increased (20% to 36%, p=.08). FPCM clinical offered valuable opportunity to address unmet care needs of older adults to reduce fall risks.

scholarly journals Trends in Deficiency Citations in Florida Assisted Living Facilities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 86-86
Author(s):  
Hari Sharma
Keyword(s):  
Assisted Living ◽  
Care Service ◽  
Poor Quality ◽  
Assisted Living Facilities ◽  
For Profit ◽  
Not For Profit ◽  
Resident Care ◽  
Service Patterns ◽  
Profit Status ◽  
Over Time

Abstract Despite numerous anecdotal reports of poor quality and residential safety concerns in Assisted Living Facilities (ALFs), there is limited federal oversight of ALFs. Usually, state surveyors conduct inspections of ALFs for compliance with regulations and issue deficiency citations and/or fine non-compliant facilities. Florida is one of the few states that publicly releases inspections data. The aim of this study is to fill the gap in our understanding of ALF quality by examining the trends in deficiency citations in Florida. We obtain data on 1,047 ALFs with 25 or more beds operating in Florida between 2012-2018. We use descriptive methods to examine the trends in citations over time and further stratify by profit status. We also evaluate whether facilities get cited for the same deficiencies repeatedly. Every year, approximately, one third of the facilities were free of any deficiency citations. From 2012 to 2018, fewer facilities were cited for resident care and medication but more facilities were cited for training and staffing. Approximately 45.8% of not-for-profit and 35.1% of for-profit facilities were free of deficiency citations in 2018. A majority of facilities cited for a given deficiency were cited at least once again for that deficiency within the study period. Florida ALFs appear to be improving only in some deficiencies but getting worse in some other deficiencies. Furthermore, repeat citations are common suggesting that facilities fail to improve their care/service patterns to avoid repeat citations. More stringent regulations and stricter enforcements may deter facilities from repeat citations.

Exploring the Experiences of Mr. J. W. Green

2018 ◽  
Author(s):  
David Wendell Moller
Keyword(s):  
Decision Making ◽  
Social Services ◽  
Assisted Living ◽  
Medical Decision Making ◽  
Life Experience ◽  
Medical Decision ◽  
Physician Communication ◽  
Assisted Living Facilities ◽  
Optimal Care ◽  
Low Health Literacy

Inattentive care and lack of compassion exacerbated the Whites’ suffering, leading to unconscionable indignity for both in the nursing home. Ken and Virble White were a part of the ongoing fabric of our society, that portion which includes the working poor. We know that individuals like them are subject to worse health outcomes. They possess inadequate resources to make the health system work in their favor or even on balance with the rest of the population. Their medical decision-making takes place in a context of inadequate patient–physician communication, low health literacy, lack of access to social services, and other factors that undermine optimal care. These factors are present in different ways throughout the life experience of disempowered patients every day in clinics, hospitals, and assisted-living facilities throughout the nation.

scholarly journals Challenges, Barriers, Strategies Implementing an Oral Hygiene Program in Assisted Living Facilities Post COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 935-935
Author(s):  
Kim Attanasi ◽  
Victoria Raveis
Keyword(s):  
Oral Health ◽  
Assisted Living ◽  
Oral Hygiene ◽  
Health Program ◽  
Dental Hygiene ◽  
Oral Disease ◽  
Final Decision ◽  
Assisted Living Facilities ◽  
New York University ◽  
Term Care

Abstract [Objective] Almost 8% of the U.S. population, 65 and older, reside in long term care facilities with limited delivery of essential dental care to prevent and manage oral health disease. By 2050, this population is expected to increase by 1.6 billion. Multiple bi-directional connections exist between oral disease and overall health. [Methods] Faculty from the Dental Hygiene Department, New York University College of Dentistry conducted an extensive outreach effort and randomly selected assisted living facilities. Facilities were offered the opportunity to receive at no-cost, a dental hygiene-led, educational, preventive oral health program delivered virtually to their residents as a community service. Incentives discussed. [Results] Twenty-one facilities were contacted, 17 (94.4%) had no oral healthcare program; one had an oral health component. In 13 (72%), the concierge functioned as gatekeeper, unwilling to transfer calls or deliver messages. In five (28%), calls were directed to the activity coordinator. Feasibility concerns and uncertainty about oral health service necessity and resident safety were voiced. Two facilities mentioned familiarity with dental hygiene professionals. Strategic changes in outreach resulted in successfully engaging with facility administrators. Strategies included identifying directors with familiarity or experience with dental hygiene profession, establishing a portfolio and utilizing technology that facilitate incorporating COVID-19 protocols. [Conclusions] Efforts to initiate a dental hygiene-led virtual oral health program encountered gatekeeper challenges. Although facility activity coordinators acknowledged benefits for their population, they were not final decision-makers. It was necessary to implement strategies that facilitated discussing the virtual oral hygiene program directly with the facility’s executive leadership.

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