Nursing home “no returns” policy, when residents are discharged to the emergency department at 4 am: what does the law say?

2019 ◽  
Vol 210 (8) ◽  
pp. 381
Author(s):  
Carmelle Peisah ◽  
Tiffany Jessop ◽  
Henry Brodaty
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
Returns Policy ◽  
The Law

Nursing home

2018 ◽  
Vol 209 (7) ◽  
pp. 324 ◽  
Author(s):  
Carmelle Peisah ◽  
Tiffany Jessop ◽  
Henry Brodaty
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
Returns Policy ◽  
The Law

Nursing Home Resident, Family, and Staff Perspectives on Hospital Transfers for End-of-Life Care

2021 ◽  
pp. 003022282199770
Author(s):  
Janet Sopcheck ◽  
Ruth M. Tappen
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Terminally Ill ◽  
South Florida ◽  
Care Planning ◽  
Life Care ◽  
Advance Care

Residents who are terminally ill often experience transfers to the emergency department resulting in hospitalizations, which may be potentially avoidable with treatment in the nursing home. This qualitative study explored the perspectives of 15 residents, 10 family members, and 20 nursing home staff regarding end-of-life care and the circumstances prompting resident transfers. Data analysis of participant interviews conducted January to May 2019 in a South Florida nursing home identified four themes related to transfer to the hospital: time left to live, when aggressive treatments would be unavailing, not knowing what the nursing home can do, and transfer decisions are situation-dependent. Study findings underscore the importance of increasing resident and family awareness of treatments available in the nursing home and person-centered advance care planning discussions. Further research should explore the reasons for residents’ and family members’ choice of aggressive therapies and their goals for care at the end of life.

scholarly journals SPMSQ for risk stratification of older patients in the emergency department

2019 ◽  
Vol 52 (S4) ◽  
pp. 222-228 ◽  
Author(s):  
A. Schönstein ◽  
H.-W. Wahl ◽  
H. A. Katus ◽  
A. Bahrmann
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
Risk Stratification ◽  
Predictive Validity ◽  
Older Patients ◽  
Area Under The Curve ◽  
Composite Endpoint ◽  
Adverse Outcomes ◽  
Nursing Home Admission ◽  
Initial Contact

Abstract Background Risk stratification of older patients in the emergency department (ED) is seen as a promising and efficient solution for handling the increase in demand for geriatric emergency medicine. Previously, the predictive validity of commonly used tools for risk stratification, such as the identification of seniors at risk (ISAR), have found only limited evidence in German geriatric patient samples. Given that the adverse outcomes in question, such as rehospitalization, nursing home admission and mortality, are substantially associated with cognitive impairment, the potential of the short portable mental status questionnaire (SPMSQ) as a tool for risk stratification of older ED patients was investigated. Objective To estimate the predictive validity of the SPMSQ for a composite endpoint of adverse events (e.g. rehospitalization, nursing home admission and mortality). Method This was a prospective cohort study with 260 patients aged 70 years and above, recruited in a cardiology ED. Patients with a likely life-expectancy below 24 h were excluded. Follow-up examinations were conducted at 1, 3, 6 and 12 month(s) after recruitment. Results The SPMSQ was found to be a significant predictor of adverse outcomes not at 1 month (area under the curve, AUC 0.55, 95% confidence interval, CI 0.46–0.63) but at 3 months (AUC 0.61, 95% CI 0.54–0.68), 6 months (AUC 0.63, 95% CI 0.56–0.70) and 12 months (AUC 0.63, 95% CI 0.56–0.70) after initial contact. Conclusion For longer periods of observation the SPMSQ can be a predictor of a composite endpoint of adverse outcomes even when controlled for a range of confounders. Its characteristics, specifically the low sensitivity, make it unsuitable as an accurate risk stratification tool on its own.

scholarly journals Repeat emergency department visits by nursing home residents: a cohort study using health administrative data

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Andrea Gruneir ◽  
Candemir Cigsar ◽  
Xuesong Wang ◽  
Alice Newman ◽  
Susan E. Bronskill ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Nursing Home ◽  
Administrative Data ◽  
Nursing Home Residents ◽  
Emergency Department Visits ◽  
Health Administrative Data

Construction and Validation of Risk-adjusted Rates of Emergency Department Visits for Long-stay Nursing Home Residents

Medical Care ◽  
2020 ◽  
Vol 58 (2) ◽  
pp. 174-182 ◽  
Author(s):  
Huiwen Xu ◽  
John R. Bowblis ◽  
Yue Li ◽  
Thomas V. Caprio ◽  
Orna Intrator
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Emergency Department Visits

scholarly journals Nursing home-acquired pneumonia presenting at the emergency department

2016 ◽  
Vol 11 (7) ◽  
pp. 999-1004 ◽  
Author(s):  
Rui Pereira ◽  
Sara Oliveira ◽  
André Almeida
Keyword(s):  
Emergency Department ◽  
Nursing Home
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