scholarly journals Alzheimer’s and related dementia (ADRD) episode payments and 30‐day readmission rate and timing comparing skilled nursing facility and home health discharge destinations in a statewide collaborative

2020 ◽  
Vol 16 (S10) ◽  
Author(s):  
Neil Kamdar ◽  
John Syrjamaki ◽  
Elham Mahmoudi
Keyword(s):  
Readmission Rate ◽  
Skilled Nursing Facility ◽  
Home Health ◽  
Nursing Facility ◽  
Skilled Nursing

scholarly journals Racial Disparities in Health Service Utilization Among Medicare Fee-for-Service Beneficiaries Adjusting for Multiple Chronic Conditions

2017 ◽  
Vol 30 (8) ◽  
pp. 1224-1243 ◽  
Author(s):  
Krupa Gandhi ◽  
Eunjung Lim ◽  
James Davis ◽  
John J. Chen
Keyword(s):  
Racial Disparities ◽  
Chronic Conditions ◽  
Skilled Nursing Facility ◽  
Home Health ◽  
Pacific Islanders ◽  
Multiple Chronic Conditions ◽  
Fee For Service ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Racial Disparities In Health

Objective: To examine racial disparities in health services utilization in Hawaii among Medicare fee-for-service beneficiaries aged 65 years and above. Method: All-cause utilization of inpatient, outpatient, emergency, home health agency, and skilled nursing facility admissions were investigated using 2012 Medicare data. For each type of service, multivariable logistic regression model was used to investigate racial disparities adjusting for sociodemographic factors and multiple chronic conditions. Results: Of the 84,212 beneficiaries, 27.8% were White, 27.4% were Asian, 27.3% were Pacific Islanders; 70.3% had two or more chronic conditions and 10.5% had six or more. Compared with Whites, all racial groups experienced underutilization across all types of services. As the number of chronic conditions increased, the utilization of inpatient, home health care, and skilled nursing facility dramatically increased. Discussion: Disparities persist among Asians and Pacific Islanders who encounter the problem of underutilization of various health services compared with Whites.

scholarly journals Skilled Nursing Facility Patients Discharged to Home Health Agency Services Spend More Days at Home

2020 ◽  
Vol 68 (7) ◽  
pp. 1573-1578 ◽  
Author(s):  
Adam Simning ◽  
Jessica Orth ◽  
Jinjiao Wang ◽  
Thomas V. Caprio ◽  
Yue Li ◽  
...  
Keyword(s):  
Skilled Nursing Facility ◽  
Health Agency ◽  
Home Health ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Home Health Agency ◽  
At Home

scholarly journals Implications of Racial Differences in the Shifts in the Setting of Care for Alzheimer’s Disease and Related Dementias

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 647-648
Author(s):  
Arseniy Yashkin ◽  
Galina Gorbunova ◽  
Anatoliy Yashin ◽  
Igor Akushevich
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Propensity Score ◽  
Skilled Nursing Facility ◽  
Home Health ◽  
Administrative Claims ◽  
Medicare Beneficiaries ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Race Ethnicity

Abstract The prevailing setting of care has strong associations with the progression of a disease at time of first diagnosis, subsequent treatment, resulting health outcomes as well as both long-term and short-term costs. The care of Alzheimer’s Disease (AD) and Related Dementias (ADRD) has been experiencing a shift from skilled nursing facility to home health care. However, changes in practice do not disseminate equally across the race/ethnicity spectrum of the U.S. and disadvantaged race/ethnicity-related groups often encounter differing conditions from those experienced by the majority. In this study, we calculated the race/ethnicity-related direct healthcare costs of individuals with AD and ADRD, stratified by care-provider structure (physician, inpatient, outpatient, skilled nursing facility, home health, hospice), and modeled the trends and the relative contributions of each setting over the 1991-2017 period using administrative claims from a 5% sample of Medicare beneficiaries. Inflation and the gradual switch of Medicare compensation to the HCC model between 2004 and 2007 were accounted for. We then applied an inverse probability weighting algorithm to propensity-score-match the AD/ADRD race/ethnicity-specific groups to Medicare beneficiaries to make them comparable in demographics and co-morbidity status but without AD/ADRD. Finally, we performed a comparison of the Medicare costs and associated survival within (AD/ADRD vs. No AD/ADRD) and between (Black vs. White vs. Hispanic) race/ethnicity-related groups. Comparisons were done for: i)1-year before; ii) 1-year after iii) years 2-11; iv)years 12-21 and v) years 22+ after an AD/ADRD diagnosis. We found significant race/ethnicity-related differences in costs and survival both before and after propensity score matching.

Home Health Care for Adults: A Tutorial for SLPs

2013 ◽  
Vol 18 (1) ◽  
pp. 7-13
Author(s):  
Megan L. Malone ◽  
Jennifer Loehr
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Home Health Care ◽  
Outpatient Treatment ◽  
Skilled Nursing Facility ◽  
Home Health ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Speech Language Pathologist

Today, the settings in which a speech-language pathologist (SLP) can practice are as varied as the patients served. From the skilled nursing facility to outpatient treatment to acute care, SLPs provide services in more settings than ever before. One setting that is growing in need is the home health setting. The home health setting provides many benefits to an SLP and to the patients receiving services.

scholarly journals Home Health Care After Skilled Nursing Facility Discharge Following Heart Failure Hospitalization

2019 ◽  
Vol 68 (1) ◽  
pp. 96-102 ◽  
Author(s):  
Himali Weerahandi ◽  
Haikun Bao ◽  
Jeph Herrin ◽  
Kumar Dharmarajan ◽  
Joseph S. Ross ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Home Health Care ◽  
Skilled Nursing Facility ◽  
Home Health ◽  
Heart Failure Hospitalization ◽  
Nursing Facility ◽  
Skilled Nursing

Pharmacist-led program to improve transitions from acute care to skilled nursing facility care

2020 ◽  
Vol 77 (12) ◽  
pp. 979-984
Author(s):  
Maria Achilleos ◽  
Jordan McEwen ◽  
Megan Hoesly ◽  
Mark DeAngelo ◽  
Tim Jennings
Keyword(s):  
Acute Care ◽  
Readmission Rate ◽  
Medication Management ◽  
Skilled Nursing Facility ◽  
Medication Administration ◽  
Pilot Program ◽  
Order Entry ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Transferred Patients

Abstract Purpose A pharmacist-led process to improve medication management in transitions from acute care to skilled nursing facility (SNF) care is described. Summary The process of transitioning patients from an acute care facility to a SNF involves multiple steps, with the potential for delays in medication administration. As part of a health system’s effort to evaluate barriers to timely first-dose administration after hospital-to-SNF transfers, a multidisciplinary team was tasked with defining the frequency of missed doses of high-risk medications and identifying reasons for medication administration delays. A retrospective review was conducted to evaluate medication orders for patients discharged from a community hospital and admitted to a SNF from January through June 2017 (the baseline period). This review found that 60% of first doses of high-risk medications were given after the scheduled administration time. One major barrier identified was a delay in entering medication orders in the SNF electronic medical record after SNF admission. It was also observed that 30-day readmission rates for transferred patients exceeded established readmission rate targets. To address identified process barriers, a pharmacist-led pilot program was developed. The program focused on process improvements at the same 2 hospitals and SNF sites during the period of March through May 2018. The pharmacist reviewed, reconciled, and entered medication orders prior to patient arrivals to the SNF. After pharmacist implementation, order entry delays were eliminated, and the mean delay from medication due time to administration was decreased by 68% relative to baseline data. The discharge summaries of 51% of transferred patients were found to contain medication errors, most of which were clarified and resolved prior to SNF admission. It was observed that the 30-day all-cause readmission rate after SNF transfers during the pilot program was 10.4% lower than during the same timeframe of the previous year. Conclusion By implementing a pharmacist-led process for medication management in transitions from acute care to SNF care, major barriers such as delayed medication administration and medication order entry were reduced. In addition, discharge medication errors were addressed and resolved prior to patients’ admission to the SNF.

scholarly journals Trends in the Use of Skilled Nursing Facility and Home Health Care Under the Hospital Readmissions Reduction Program

Medical Care ◽  
2019 ◽  
Vol 57 (10) ◽  
pp. 757-765
Author(s):  
Ioana Popescu ◽  
Neeraj Sood ◽  
Sushant Joshi ◽  
Peter Huckfeldt ◽  
José Escarce ◽  
...  
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Hospital Readmissions ◽  
Skilled Nursing Facility ◽  
Home Health ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Reduction Program
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