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In this article, the authors report on the development and testing of a set of indicators of quality of care in nursing homes, using resident-level assessment data. These quality indicators (QIs) have been developed to provide a foundation for both external and internal quality-assurance (QA) and quality-improvement activities. The authors describe the(More)
OBJECTIVES The authors examined the relationships between different types of nursing home staffing and nursing home deficiencies to test the hypothesis that fewer staff hours would be associated with higher numbers of deficiencies. METHODS Data were from the On-Line Survey, Certification, and Reporting System for all certified nursing homes in the United(More)
BACKGROUND Nursing home quality indicators (QIs) provide a way to support quality assurance and improvement activities and to help ensure that cost savings are based on increased efficiency and not on decreased quality of care. OBJECTIVES QIs values are expected to change over time. However, to be good indicators of quality, they should be reasonably(More)
OBJECTIVES To obtain information from decision makers about attitudes toward hospitalization and the factors that influence their decisions to hospitalize nursing home residents. DESIGN Cross-sectional survey. SETTING Four hundred forty-eight nursing homes, 76% of which were nonprofit, from 25 states. PARTICIPANTS Medical directors and directors of(More)
Quality indicators and a quality-monitoring system developed for use in the regulatory survey process offer a quality improvement tool for nursing home staff. The systematic use of resident assessment data can aid in the identification of quality of care problems and the determination of the nature of those problems. This approach is particularly useful for(More)
OBJECTIVES A rapid evolution has occurred in state policy and industry practices relative to assisted living and expanded use of residential care facilities for people with physical and cognitive frailty, yet relatively little is known about the interrelationship between this housing supply and nursing-home case mix. METHODS The association between(More)
During the period 1980 to 1985, growth in the number of persons served by Medicare home health was the largest source of growth in Medicare home health expenditures. Population growth was in part responsible for the increase in beneficiaries using Medicare home health, but more important was growth in the number of persons served per 1000 elderly(More)
The purpose of this study was to develop a method for risk adjusting nursing home quality indicators (QI's). The QI's measure incidence and prevalence of resident-level care processes and outcomes which are indicative of care quality. Risk adjustment was carried out by stratifying residents into risk groups (high and low), calculating QI rates within(More)
OBJECTIVE To compare outcomes in patients with the clinical diagnosis of probable dementia of the Alzheimer type (DAT) cared for in a Dementia Special Care Unit (DSCU) with those in traditional long-term care (TLTC). DESIGN Two-year prospective cohort study. SETTING Two Veterans Administration Hospitals. The DSCU concentrated on assuring patients'(More)
Although Medicaid's coverage of home and community-based services and the program's capacity to provide such services have increased markedly in recent years, relatively little is known about the population that uses these services. We combined Medicaid and Medicare data to characterize the national Medicaid population of service users by key demographic(More)