A Rising Tide Lifts “Related” Boats—Post-Acute Care Quality Improvement is Associated with Improvement in Long-Term Care Quality in Nursing Homes

2020 ◽  
Author(s):  
Xiao (Joyce) Wang ◽  
Jennifer Gaudet Hefele
Keyword(s):  
Quality Improvement ◽  
Nursing Homes ◽  
Acute Care ◽  
Long Term Care ◽  
Care Quality ◽  
Term Care ◽  
Post Acute Care

The Prevalence of Fecal Colonization With VRE Among Residents of Long-Term–Care Facilities in Melbourne, Australia

2001 ◽  
Vol 22 (9) ◽  
pp. 576-578 ◽  
Author(s):  
Alexander A. Padiglione ◽  
Elizabeth Grabsch ◽  
Rory Wolfe ◽  
Kimberly Gibson ◽  
M. Lindsay Grayson
Keyword(s):  
Nursing Homes ◽  
Confidence Interval ◽  
Acute Care ◽  
Long Term Care ◽  
Prevalence Survey ◽  
Term Care ◽  
Point Prevalence Survey ◽  
Care Facilities ◽  
General Community

AbstractA point-prevalence survey performed among residents of eight nursing homes in Melbourne, Australia, found a rate of fecal VRE colonization of 3.1% (9/292; 95% confidence interval, 1.1-5.1), allvanBEnterococcusfaecium.This is a higher rate than in the general community (3.1% vs 0.2%). Many residents (16%) had been inpatients in acute-care hospitals in the previous 3 months.

scholarly journals LONG-TERM CARE II EFFECTS OF A NEW VALUE-BASED REIMBURSEMENT SYSTEM ON EXPENDITURES AND CARE QUALITY IN MINNESOTA NURSING HOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S743-S743
Author(s):  
Zachary Hass ◽  
Valerie Cooke ◽  
Greg Arling
Keyword(s):  
Nursing Homes ◽  
Policy Change ◽  
Long Term Care ◽  
Quality Metrics ◽  
Care Quality ◽  
Quality Data ◽  
Term Care ◽  
Related Services ◽  
Quality Incentive

Abstract Although several states have implemented Value Based Reimbursement (VBR) systems in long-term care; little is known of their impact. In 2016, Minnesota passed new VBR legislation to tie payment to quality with increased funding earmarked for nursing and other care-related services. We evaluated the effect of the policy change on care-related expenditures and measures of care quality. Data sources were cost reports and quality measures for the years 2013-2017 from 348 Minnesota nursing homes. Analysis consisted of descriptive tables, time plots, and linear growth curve modeling. We found increased expenditures for nursing and care-related services, particularly nursing assistants, during the first year; while quality metrics did not appear to be impacted by the policy change. Some differentiation was seen across facilities in their response to the policy change based on occupancy rate, rural-urban continuum code, attachment to a hospital, and resident acuity. The lack of an improvement in care quality might be attributable to VBR design as the quality incentive affected very few facilities. Additionally, there is the challenge of improving quality metrics even with additional resources. The legislature is currently considering changes to VBR policies in response to the report from this study.

scholarly journals A Health System Response to COVID ‐19 in Long‐Term Care and Post‐Acute Care: A Three‐Phase Approach

2020 ◽  
Vol 68 (6) ◽  
pp. 1155-1161 ◽  
Author(s):  
Gina Kim ◽  
Mengru Wang ◽  
Hanh Pan ◽  
Giana H. Davidson ◽  
Alison C. Roxby ◽  
...  
Keyword(s):  
Health System ◽  
Acute Care ◽  
Long Term Care ◽  
System Response ◽  
Term Care ◽  
Phase Approach ◽  
Three Phase ◽  
Post Acute Care

Health Care Use Before and After Entering Long-Term Services and Supports

2016 ◽  
Vol 37 (1) ◽  
pp. 26-40 ◽  
Author(s):  
Robert Newcomer ◽  
Charlene Harrington ◽  
Denis Hulett ◽  
Taewoon Kang ◽  
Michelle Ko ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Long Term Care ◽  
Health Care Use ◽  
Care Providers ◽  
Term Care ◽  
Before And After ◽  
Ed Visits ◽  
Post Acute Care

Objective: We examined the health care utilization patterns of Medicare and Medicaid enrollees (MMEs) before and after initiating long-term care in the community or after admission to a nursing facility (NF). Method: We used administrative data to compare hospitalizations, emergency department (ED) visits, and post-acute care use of MMEs receiving long-term care in California in 2006-2007. Results: MMEs admitted to a NF for long-term care had much greater use of hospitalizations, ED visits, and post-acute care before initiating long-term care than those entering long-term care in the community. Post-entry, community service users had less than half the average monthly hospital and ED use compared with the NF cohort. Conclusion: Hospital and ED use prior to and following NF and personal care program entry suggest a need for reassessing the monitoring of these high-risk populations and the communication between health and community care providers.

Methicillin-resistantStaphylococcus aureus(MRSA) in the institutionalized older patient

2009 ◽  
Vol 19 (1) ◽  
pp. 13-23 ◽  
Author(s):  
M Eveillard ◽  
ML Joly-Guillou
Keyword(s):  
Nursing Homes ◽  
Acute Care ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities ◽  
Surgical Antibiotic Prophylaxis ◽  
Cross Transmission ◽  
Mrsa Infection ◽  
Low Incidence

SummaryNursing homes and long-term care facilities are usually considered as reservoirs for methicillin-resistantStaphylococcus aureus(MRSA) carriers. Actually, there are major differences in MRSA carriage between institutions, with variations from 1% to more than 30%. Overall there is a low incidence of MRSA infection in these institutions, even though carriage is associated with a higher risk of subsequent MRSA infection, with high mortality rates. The main risk factors for carriage are well known: recent hospitalization in an acute-care ward, skin wounds and recent antimicrobial therapy. Age over 75 years is also a risk factor. Residents of nursing homes and long-term care facilities pose a risk of MRSA transfer to acute-care wards, with potential consequences in terms of infection control strategy or surgical antibiotic prophylaxis. No well-designed study has identified the best strategy for MRSA control in institutions for older people and strategies that have been proposed are controversial. Studies to elucidate this would be useful, as well as studies specifically designed to identify the relative importance of different ways of MRSA transmission in these institutions (cross-transmission via healthcare workers or the environment, or direct transmission from one resident to another). Finally, a first important step towards MRSA control is a strict application of standard precautions, particularly good compliance with hand hygiene.

scholarly journals STAFF-CENTERED CASE CONFERENCE FOR STAFF WELL-BEING AND CARE QUALITY IMPROVEMENT IN LONG-TERM CARE

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 411-411
Author(s):  
N Yamamoto-Mitani ◽  
Y Saito ◽  
M Takaoka ◽  
A Igarashi
Keyword(s):  
Quality Improvement ◽  
Long Term Care ◽  
Well Being ◽  
Care Quality ◽  
Case Conference ◽  
Term Care
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