Medicaid Threats on the Horizon

2020 ◽  
Vol 35 (3) ◽  
pp. 145-145
Author(s):  
Paul Baldwin
Keyword(s):  
United States ◽  
Long Term Care ◽  
Acute Care Hospital ◽  
The United States ◽  
Care Hospital ◽  
Short Term ◽  
Term Care ◽  
Episodes Of Care ◽  
Primary Payer

Those of you who have been around for a while understand that Medicaid is the primary payer for long-term care in the United States. While Medicare pays for the short-term episodes of care associated with rehabilitation following a three-day stay in an acute-care hospital, it?s Medicaid that foots the bill for live-in residents who are unable to afford it themselves.

scholarly journals The Effectiveness of Contact Precautions on Methicillin-Resistant Staphylococcus aureus in Long-term Care Across the United States

2019 ◽  
Vol 71 (7) ◽  
pp. 1676-1683 ◽  
Author(s):  
Daniel J Morgan ◽  
Min Zhan ◽  
Michihiko Goto ◽  
Carrie Franciscus ◽  
Bruce Alexander ◽  
...  
Keyword(s):  
United States ◽  
Staphylococcus Aureus ◽  
Long Term Care ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
The United States ◽  
Standard Precautions ◽  
Term Care ◽  
Contact Precautions ◽  
Care Facilities

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of health care–associated infections in long-term care facilities (LTCFs). The Centers for Disease Control and Prevention recommends contact precautions for the prevention of MRSA within acute care facilities, which are being used within the United States Department of Veterans Affairs (VA) for LTCFs in a modified fashion. The impact of contact precautions in long-term care is unknown. Methods To evaluate whether contact precautions decreased MRSA acquisition in LTCFs, compared to standard precautions, we performed a retrospective effectiveness study (pre-post, with concurrent controls) using data from the VA health-care system from 1 January 2011 until 31 December 2015, 2 years before and after a 2013 policy recommending a more aggressive form of contact precautions. Results Across 75 414 patient admissions from 74 long-term care facilities in the United States, the overall unadjusted rate of MRSA acquisition was 2.6/1000 patient days. Patients were no more likely to acquire MRSA if they were cared for using standard precautions versus contact precautions in a multivariable, discrete time survival analysis, controlling for patient demographics, risk factors, and year of admission (odds ratio, 0.97; 95% confidence interval, .85–1.12; P = .71). Conclusions MRSA acquisition and infections were not impacted by the use of active surveillance and contact precautions in LTCFs in the VA.

Kelly, James R., Jr.

2021 ◽  
Author(s):  
Sadye L. M. Logan
Keyword(s):  
United States ◽  
Long Term Care ◽  
The United States ◽  
Veterans Administration ◽  
Term Care ◽  
Extended Care

James R. Kelly, Jr. (1934–2002) undertook pioneering work in the development and administration of the Veterans Administration (VA) Extended Care programs that has basically shaped the modalities of long-term care now available to veterans across the United States.

scholarly journals Prevalence of advanced directives in the geriatric population with in long-term care facilities in the United States

2021 ◽  
Vol 12 (2) ◽  
pp. 173-178
Author(s):  
Ateequr Rahman ◽  
Druti Shukla ◽  
Lejla Cukovic ◽  
Kirstin Krzyzewski ◽  
Noopur Walia ◽  
...  
Keyword(s):  
United States ◽  
Long Term Care ◽  
The United States ◽  
Living Wills ◽  
Term Care ◽  
Advanced Directive ◽  
Advanced Directives ◽  
Significant Difference ◽  
Care Facilities

Advanced directives, such as Living Wills and Do Not Resuscitate (DNR) orders, provide the ability to identify, respect, and implement an individual's wishes for medical care during serious illness or end-of-life care. The aim of this study was to evaluate the prevalence of advanced directives amongst the residents of long-term care facilities in the United States. A total of 527 cases were extracted from 2018 National Study of Long-Term Care Providers, which was collected by the National Center for Health Statistics through the surveys of residential care communities and adult day services centers. Advanced directive rates were higher in patients 90 years of age and above as compared to other age groups. Nursing home residents were more likely to have advanced directives than other long term care facilities. There was no significant difference among males and females in the rate of advanced directives. Nursing home and Hospice residents had more advanced directives compared to other facilities. The Black population had the highest rate of advanced directive preparedness. Overall, the finding of this study revealed that there was a significant difference in the preparedness of DNR orders and Living Wills by patient demographics and the type of long-term care facility. Offering advanced directive services at public health/social services facilities can enhance the rate of advanced directive preparedness. Advanced directives ease the stress and anxiety of patients, family, and friends during difficult times.

Improving the Fate of Nursing Homes During the COVID-19 Pandemic: The Need for Policy

2021 ◽  
pp. e1-e3
Author(s):  
R. Tamara Konetzka
Keyword(s):  
Public Health ◽  
United States ◽  
New York ◽  
Nursing Homes ◽  
Long Term Care ◽  
New York Times ◽  
The United States ◽  
Term Care ◽  
Care Facilities

Approximately 40% of all COVID-19 deaths in the United States have been linked to long-term care facilities.1 Early in the pandemic, as the scope of the problem became apparent, the nursing home sector generated significant media attention and public alarm. A New York Times article in mid-April referred to nursing homes as “death pits”2 because of the seemingly uncontrollable spread of the virus through these facilities. This devastation continued during subsequent surges,3 but there is a role for policy to change this trajectory. (Am J Public Health. Published online ahead of print January 28, 2021: e1–e3. https://doi.org/10.2105/AJPH.2020.306107 )

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