scholarly journals Does More Therapy in Skilled Nursing Facilities Lead to Better Outcomes in Patients With Hip Fracture?

2016 ◽  
Vol 96 (1) ◽  
pp. 81-89 ◽  
Author(s):  
Hye-Young Jung ◽  
Amal N. Trivedi ◽  
David C. Grabowski ◽  
Vincent Mor
Keyword(s):  
Hip Fracture ◽  
Patient Outcomes ◽  
Resource Utilization ◽  
Minimum Data Set ◽  
Case Mix ◽  
Nursing Facilities ◽  
Data Set ◽  
Skilled Nursing ◽  
Minimum Data ◽  
Additional Therapy

Background Skilled nursing facilities (SNFs) have increasingly been providing more therapy hours to beneficiaries of Medicare. It is not known whether these increases have improved patient outcomes. Objective The study objectives were: (1) to examine temporal trends in therapy hour volumes and (2) to evaluate whether more therapy hours are associated with improved patient outcomes. Design This was a retrospective cohort study. Methods Data sources included the Minimum Data Set, Medicare inpatient claims, and the Online Survey, Certification, and Reporting System. The study population consisted of 481,908 beneficiaries of Medicare fee-for-service who were admitted to 15,496 SNFs after hip fracture from 2000 to 2009. Linear regression models with facility and time fixed effects were used to estimate the association between the quantity of therapy provided in SNFs and the likelihood of discharge to home. Results The average number of therapy hours increased by 52% during the study period, with relatively little change in case mix at SNF admission. An additional hour of therapy per week was associated with a 3.1-percentage-point (95% confidence interval=3.0, 3.1) increase in the likelihood of discharge to home. The effect of additional therapy decreased as the Resource Utilization Group category increased, and additional therapy did not benefit patients in the highest Resource Utilization Group category. Limitations Minimum Data Set assessments did not cover details of therapeutic interventions throughout the entire SNF stay and captured only a 7-day retrospective period for measures of the quantity of therapy provided. Conclusions Increases in the quantity of therapy during the study period cannot be explained by changes in case mix at SNF admission. More therapy hours in SNFs appear to improve outcomes, except for patients with the greatest need.

Nursing home residents with multiple sclerosis and dementia compared to other multiple sclerosis residents

2005 ◽  
Vol 11 (5) ◽  
pp. 610-616 ◽  
Author(s):  
Robert J Buchanan ◽  
Raymond A Martin ◽  
Linda Moore ◽  
Suojin Wang ◽  
Hyunsu Ju
Keyword(s):  
Multiple Sclerosis ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Clinical Analysis ◽  
Minimum Data Set ◽  
Nursing Home Admission ◽  
Nursing Facilities ◽  
Data Set ◽  
Minimum Data ◽  
Significant Symptom

Cognitive impairment may be a significant symptom in multiple sclerosis (MS), affecting about one half of MS patients in study samples similar to the general MS population. An interesting question is what role dementia, of any aetiology, plays in the cognitive ability of people with MS. The objective of this research is to learn more about nursing home residents with MS and dementia, identifying how they differ from other residents with MS. We developed profiles of MS residents with dementia using the Minimum Data Set and compared these profiles to other residents with MS. Nursing home residents with MS and dementia are admitted to nursing facilities at an older age and seem less likely to have physical impairments but more mood and behaviour problems than other MS residents at admission. A cortical variant of MS may be more prevalent than previously suspected and may be a factor responsible leading to nursing home admission in this subgroup of patients. Further clinical analysis of this subgroup would be necessary to support this contention.

Comments on a Process for Identifying Stages of Dementia in Residents of Nursing Facilities

1994 ◽  
Vol 75 (2) ◽  
pp. 743-746 ◽  
Author(s):  
Robert B. Williams ◽  
Michael B. Swift
Keyword(s):  
Functional Status ◽  
Functional Assessment ◽  
Rating Scale ◽  
Minimum Data Set ◽  
Nursing Facilities ◽  
Medical Conditions ◽  
Nursing Facility ◽  
Data Set ◽  
Minimum Data ◽  
Resident Assessment

This paper gives a description of how items of the Global Deterioration Scale's Brief Cognitive Rating Scale and Functional Assessment Staging can be verified by reviewing specific sections and items of the Minimum Data Set for Nursing Facility Resident Assessment and Care Screening which is completed annually and updated every three months or when significant changes in health occur. A likely outcome of such comparisons is improved understanding of the cognitive and functional status of residents with dementia and other medical conditions.

Analyses of nursing home residents with multiple sclerosis and depression using the Minimum Data Set

2003 ◽  
Vol 9 (2) ◽  
pp. 171-188 ◽  
Author(s):  
Robert J Buchanan ◽  
Suojin Wang ◽  
Ming Tai-Seale ◽  
Hyunsu Ju
Keyword(s):  
Mental Health ◽  
Multiple Sclerosis ◽  
Nursing Home ◽  
Racial Differences ◽  
Nursing Home Residents ◽  
Mental Healthcare ◽  
Minimum Data Set ◽  
Nursing Facilities ◽  
Data Set ◽  
Minimum Data

Depression is the most common psychiatric condition among people with multiple sclerosis (MS). A total of 14 009 people with MS at admission to a nursing facility were analyzed using the Minimum Data Set and 36% also had depression. This study developed profiles of nursing home residents with MS who also had depression and compared them with other residents with MS. MS residents with depression were significantly more likely to be female and younger than other MS residents, with significant racial differences as well. MS residents with depression were significantly more likely than other MS residents to have a history of mental health conditions, exhibit mood indicators, and have unsettled relationships. Both groups of MS residents had high levels of physical disability, although MS residents with depression tended to be slightly less disabled. MS residents with depression were more likely than other MS residents to experience daily pain and more likely to have the diseases common to all residents with MS. This research found that most MS residents with depression did not receive mental health services, demonstrating that nursing facilities must improve the mental healthcare provided to residents with MS with depression.

The Relationship Between Minimum Data Set Ratings and Scores on Measures of Communication and Hearing Among Nursing Home Residents With Dementia

2001 ◽  
Vol 10 (4) ◽  
pp. 370-381 ◽  
Author(s):  
Tammy Hopper ◽  
Kathryn A. Bayles ◽  
Frances P. Harris ◽  
Audrey Holland
Keyword(s):  
Nursing Home ◽  
Rating Scale ◽  
Assessment Tool ◽  
Nursing Home Residents ◽  
Minimum Data Set ◽  
Nursing Facilities ◽  
Data Set ◽  
Minimum Data ◽  
Hearing Function ◽  
The Relationship

The Minimum Data Set (MDS) is a federally mandated assessment tool used to evaluate individuals residing in skilled nursing facilities, a large percentage of whom have dementia. Best described as a rating scale, it comprises items related to 16 domains of functioning, including communication and hearing. Typically, the MDS is completed by a nurse. When a deficit is observed, Resident Assessment Protocols (RAPs) are designed to address the impairment and provide information for appropriate plans of care. The purposes of this study were to: (a) comprehensively assess the communication and hearing function of nursing home residents with dementia, (b) evaluate the relationship between ratings on MDS communication and hearing items and the performance of dementia patients on standardized assessments, and (c) determine the number of residents with MDS-identified deficits who received a referral for further evaluation. Fifty-seven individuals with a medical diagnosis of dementia participated. All exhibited deficits in communication and hearing function; however, the majority of participants were rated as having normal or adequate communication and hearing on the MDS. Of those participants with MDS-identified impairments in communication and hearing, none was referred for further evaluation. Implications for policy and care for nursing home residents with dementia are discussed.

scholarly journals Preferred Provider Relationships Between Medicare Advantage Plans and Skilled Nursing Facilities Reduce Switching Out of Plans: An Observational Analysis

2018 ◽  
Vol 55 ◽  
pp. 004695801879741
Author(s):  
Elizabeth M. Goldberg ◽  
Laura M. Keohane ◽  
Vincent Mor ◽  
Amal N. Trivedi ◽  
Hye-Young Jung ◽  
...  
Keyword(s):  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Medicare Advantage ◽  
Data Set ◽  
Skilled Nursing ◽  
Minimum Data ◽  
Lower Likelihood ◽  
Information Set ◽  
Enrollment Data ◽  
Effectiveness Data

Unlike traditional Medicare, Medicare Advantage (MA) plans contract with specific skilled nursing facilities (SNFs). Patients treated in an MA plan’s preferred SNF may benefit from enhanced coordination and have a lower likelihood of switching out of their plan. Using 2011-2014 Medicare enrollment data, the Medicare Healthcare Effectiveness Data and Information Set, and the Minimum Data Set, we examined Medicare enrollees who were newly admitted to SNFs in 2012-2013. We used the Centers for Medicare & Medicaid Services star rating to distinguish between MA plans and show how SNF concentration experienced by patients varies between patients in plans with different star ratings. We found that highly rated MA plans steer their patients to a smaller number of SNFs, and these patients are less likely to switch out of their plans. Strengthening the MA plan–SNF relationship may lower disenrollment rates for SNF beneficiaries, imparting benefits to both patients and payers.

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