Artigos de revistas: "Nursing homes – Ireland – Costs"

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Rice, Niamh, e Charles Normand. "The cost associated with disease-related malnutrition in Ireland". Public Health Nutrition 15, n.º 10 (8 de fevereiro de 2012): 1966–72. http://dx.doi.org/10.1017/s1368980011003624.

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AbstractObjectiveThe present study aimed to establish the annual public expenditure arising from the health and social care of patients with diet-related malnutrition (DRM) in the Republic of Ireland.DesignCosts were calculated by (i) estimating the prevalence of DRM in health-care settings derived from age-standardised comparisons between available Irish data and large-scale UK surveys and (ii) applying relevant costs from official sources to estimates of health-care utilisation by adults with DRM. No attempt has been made to estimate separately the costs of DRM and any associated disease, since each can be a cause or consequence of the other. The methods used are adapted from an evaluation of the cost of malnutrition in the UK by the British Association for Parenteral and Enteral Nutrition (2009).SettingsHospitals, nursing homes, out-patient clinics, primary-care clinics and home care.SubjectsAll adult patients receiving hospital in-patient, out-patient or specified community health-care services.ResultsThe annual public health and social care cost associated with adult malnourished patients in Ireland is estimated at over €1·4 billion, representing 10 % of the health-care budget. Most of this cost arises in acute hospital or residential care settings (i.e. 70 %), with nutritional support estimated to account for <3 % of spend.ConclusionsThe cost associated with the care of patients with DRM is substantial and may rise as the proportion of older people within the population increases, a group at increased risk of DRM. Despite growing pressure on health-care budgets, little attention has been focused on the economic burden associated with DRM in Ireland or the potential for savings arising from improved detection and treatment of those at risk.

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McClean, Pamela, Michael Tunney, Deirdre Gilpin, Carole Parsons e Carmel Hughes. "Antimicrobial Prescribing in Nursing Homes in Northern Ireland". Drugs & Aging 28, n.º 10 (outubro de 2011): 819–29. http://dx.doi.org/10.2165/11595050-000000000-00000.

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Lipley, Nick. "Nursing homes say costs outweigh extra funding". Nursing Standard 16, n.º 20 (30 de janeiro de 2002): 4. http://dx.doi.org/10.7748/ns.16.20.4.s4.

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Mukamel, Dana B., William D. Spector, Rhona Limcangco, Ying Wang, Zhanlian Feng e Vincent Mor. "The Costs of Turnover in Nursing Homes". Medical Care 47, n.º 10 (outubro de 2009): 1039–45. http://dx.doi.org/10.1097/mlr.0b013e3181a3cc62.

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Kilgore, Meredith L. "Reflecting on Turnover Costs in Nursing Homes". Medical Care 47, n.º 10 (outubro de 2009): 1037–38. http://dx.doi.org/10.1097/mlr.0b013e3181ae558a.

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Shanagher, D. "70 NURSING HOME MODEL OF CARE POST COVID-19". Age and Ageing 50, Supplement_3 (novembro de 2021): ii9—ii41. http://dx.doi.org/10.1093/ageing/afab219.70.

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Abstract Background The COVID-19 pandemic is recognised as having a significant impact on older people, particularly on those within nursing homes. Prior to the pandemic, a significant focus was placed on the application of a social model of care within nursing homes. We know that COVID-19 has required the stringent application of infection prevention and control measures as well as the provision of increased amounts of clinical care. This has resulted in the recent stronger application of a medical model of care within nursing homes. Methods A roundtable event attended by twenty-six people took place. Attendees represented clinical Gerontology, the Irish College of General Practitioner, Sage Family Forum, The Health Information and Quality Authority, Nursing Homes Ireland and nursing home providers. A number of presentations were made, and a roundtable discussion took place about the model of nursing home care post pandemic. Key messages from presentations and the discussion were captured. A report was compiled and shared with attendees to check for accuracy. Results The following key messages were identified: 1. Social care is a cornerstone of nursing home care 2. Increased integration of nursing homes within the wider health and social care system is required 3. Increased access to services for nursing home residents is required 4. Regulatory reform is required 5. Resourcing of nursing home care needs to be appropriately addressed 6. The nursing home sector need to be included in conversations around policy and service development affecting nursing home care in Ireland. Conclusion Nursing homes are an essential part of the healthcare system in Ireland and have been shown to be adaptable throughout the course of the pandemic. A one size fits all approach is an unlikely fit for purpose approach as we look towards the future with COVID-19.

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Robinson, D. J., E. McGovern, E. Doorley, C. Hayden e D. O'Shea. "The Nursing Homes Support Scheme Act in Ireland – older persons’ views". European Geriatric Medicine 2, n.º 3 (julho de 2011): 130–33. http://dx.doi.org/10.1016/j.eurger.2011.04.006.

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MacGabhann, Patricia. "Caring for gay men and lesbians in nursing homes in Ireland". British Journal of Nursing 24, n.º 22 (10 de dezembro de 2015): 1142–48. http://dx.doi.org/10.12968/bjon.2015.24.22.1142.

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Ó Cathaoir, Katharina, e Ida Gundersby Rognlien. "The Rights of Elders in Ireland during COVID-19". European Journal of Health Law 28, n.º 1 (4 de janeiro de 2021): 81–101. http://dx.doi.org/10.1163/15718093-bja10035.

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Abstract This article reflects on COVID-19 restrictions imposed on elders in Ireland through the lens of the right to private and family life (Article 8 ECHR), focusing on stay at home orders and recommendations advising elders to avoid social contact. Furthermore, we examine restrictions on visiting nursing homes given the high death toll in that setting. In our analysis, we zero in on the principles of foreseeability and proportionality, highlighting areas of concern and aspects that we submit should be considered in a proportionality assessment. Ultimately, we argue that it is a mistake to view the COVID-19 pandemic solely as an emergency. In this manner, the solutions suggested through the law – restrictions on movement and visitation bans – are too narrow and fail to address the underlying structures, such as, issues in the healthcare system, the limited home help for elderly and poor conditions in nursing homes.

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Marihart, Cindy L., Ardith R. Brunt e Angela A. Geraci. "The High Price of Obesity in Nursing Homes". Care Management Journals 16, n.º 1 (março de 2015): 14–19. http://dx.doi.org/10.1891/1521-0987.16.1.14.

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This article provides a commentary on the costs of obese nursing home patients. We conducted a comprehensive literature search, which found 46 relevant articles on obesity in older adults and effects on nursing home facilities. This review indicated obesity is increasing globally for all age groups and older adults are facing increased challenges with chronic diseases associated with obesity more than ever before. With medical advances comes greater life expectancy, but obese adults often experience more disabilities, which require nursing home care. In the United States, the prevalence of obesity in adults aged 60 years and older increased from 9.9 million (23.6%) to 22.2 million (37.0%) in 2010. Obese older adults are twice as likely to be admitted to a nursing home. Many obese adults have comorbidities such as Type 2 diabetes; patients with diabetes incurred 1 in every 4 nursing home days. Besides the costs of early entrance into nursing facilities, caring for obese residents is different than caring for nonobese residents. Obese residents have more care needs for additional equipment, supplies, and staff costs. Unlike emergency rooms and hospitals, nursing homes do not have federal requirements that require them to serve all patients. Currently, some nursing homes are not prepared to deal with very obese patients. This is a public health concern because there are more obese people than ever in history before and the future appears to have even a heavier generation moving forward. Policymakers need to become aware of this serious gap in nursing home care.

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McConkey, Roy. "Variations in residential accommodation for adults with intellectual disabilities: the example of Northern Ireland". Irish Journal of Psychological Medicine 23, n.º 2 (junho de 2006): 68–73. http://dx.doi.org/10.1017/s0790966700009605.

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AbstractObjectives: Over the past three decades, major changes have taken place internationally in the type of residential accommodation provided for people with intellectual disabilities but these appear to be less evident in Northern Ireland.Method: A census was undertaken of all persons in any form of residential placement using a range of existing databases to identify the population, with a short questionnaire completed for each resident.Results: Around 440 persons lived in hospitals and 1,970 in some other form of provision but mostly in large congregated settings such as residential care homes and nursing homes. This was more marked in certain Health and Social Service Boards than in others. Most places are provided by the private sector although voluntary organisations and housing associations now manage around one-third of places. People living in hospitals reportedly had different characteristics to those in all other settings while those in nursing homes tended to require greater personal care. However the characteristics of people living in residential homes, supported living arrangements and village communities were broadly comparable. Around one in 10 persons were deemed to benefit from a move; mostly from residential homes to more independent living arrangements.Conclusions: Compared to Britain and the Republic of Ireland there is an under-provision of residential placements in Northern Ireland. To date, funding from outside of health and social services has been the main driver for the type of accommodation provided. The implications for future policy and provision are discussed.

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Pisica–Donose, George, Matthieu Piccoli, Bastien Genet, Stéphane Bouee, Stefan Berechet, Ion Berechet, Antonin Dacasa Cortes et al. "Medico-economic comparison of two anticoagulant treatment strategies: Vitamin K antagonists vs. direct oral anticoagulants in older adults in nursing homes in France. The “MIKADO” study". PLOS ONE 18, n.º 4 (4 de abril de 2023): e0283604. http://dx.doi.org/10.1371/journal.pone.0283604.

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Objectives Currently, two classes of oral anticoagulants are available in nursing home residents: vitamin K antagonists (VKA) and direct oral anticoagulants (DOAC). DOACs have a higher net clinical benefit than VKAs but DOACs are about 10 times more expensive than VKAs. The objective of our study was to assess and compare the overall costs of anti-coagulant strategy (VKA or DOAC), i.e., including drugs, laboratory costs and time spent in human capital (nurses and medical time) in nursing homes in France. Methods This was an observational, multicenter, prospective study including nine nursing homes in France. Among these nursing homes, 241 patients aged 75 years and older and treated with VKA (n = 140) or DOAC (n = 101) therapy accepted to participate in the study. Results During the 3-month follow-up period, the adjusted mean costs per patient were higher for VKA than DOACs for nurse care (€327 (57) vs. €154 (56), p<.0001) for general practitioner care (€297 (91) vs. €204 (91), p = 0.02), for coordinating physicians care (€13 (7) vs. €5 (7), p < 0.07), for laboratory tests (€23 (5) vs. €5 (5), p<.0001), but were lower for drug costs (€8 (3) vs. €165 (3), p<.0001). The average overall cost for 3 months per patient was €668 (140) with VKA vs. €533 (139) with DOAC (p = 0.02). Conclusion Our study showed that in nursing homes despite a higher drug cost, DOAC therapy is associated with a lower total cost and less time used by nurses and physicians for drug monitoring when compared to VKA.

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Mukamel, Dana B., Yue Li, Charlene Harrington, William D. Spector, David L. Weimer e Lauren Bailey. "Does State Regulation of Quality Impose Costs on Nursing Homes?" Medical Care 49, n.º 6 (junho de 2011): 529–34. http://dx.doi.org/10.1097/mlr.0b013e318207ef9e.

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Meijers, Judith M. M., Ruud J. G. Halfens, Lisa Wilson e Jos M. G. A. Schols. "Estimating the costs associated with malnutrition in Dutch nursing homes". Clinical Nutrition 31, n.º 1 (fevereiro de 2012): 65–68. http://dx.doi.org/10.1016/j.clnu.2011.08.009.

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Jaqua, Ecler, e Terry Jaqua. "Markups and Contribution Margins of Nursing Homes". International Journal of Clinical Case Reports and Reviews 8, n.º 4 (30 de setembro de 2021): 01–02. http://dx.doi.org/10.31579/2690-4861/171.

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Markups and profit margins are different accounting terms that analyze similar transactions and use the same inputs but show additional information. The two use costs and revenues as in their calculations. The critical difference is that while profit margins refer to sales less the cost of goods sold, markups refer to the amount that needs to be added to the cost of goods to get to the final selling price. Understanding these two terms ensures that price setting is done correctly. Too low or high price setting may cause lost profits or sales. Also, with time, the price setting of a firm impacts its market share. This research paper discusses markups and contribution margins of nursing homes.

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Robinson, Katie, Christine Fitzgerald, Rose Galvin e Aisling O' Connor. "Exploring the facilitation of meaningful leisure activities in designated centres for older persons (nursing homes) in Ireland: A protocol for content documentary analysis of HIQA inspection reports." HRB Open Research 5 (18 de novembro de 2022): 76. http://dx.doi.org/10.12688/hrbopenres.13639.1.

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Background: Nursing homes (NHs) in Ireland are regulated by the Health Information and Quality Authority (HIQA). Regulations for nursing homes under the Health Act 2007 (as amended) states that registered providers must provide residents with facilities for occupation and recreation, and opportunities to participate in activities in accordance with their interests and capacities (Government of Ireland, 2013 - S.I. No. 415/2013). Despite the proven benefits of engagement in meaningful activities, when an older person enters a NH, they often lose autonomy in occupational roles, and engagement in meaningful activities (Causey-Upton, 2015). In 2019, HIQA highlighted that there were relatively high levels of non-compliance in the area of residents’ rights (HIQA, 2020). Aim: Given the central role of leisure activities to older adults’ health and well-being, this study aims to understand how NH residents in Ireland were afforded opportunities for meaningful engagement in activities prior to and throughout the COVID-19 pandemic (2019 – 2021). This will be conducted through analysing a sample of publicly available HIQA inspection reports for NHs from 2019 – 2021. Methods: A content documentary analysis will be conducted using a qualitative deductive approach. Purposive sampling will be used to select 21 nursing home reports for the years 2019, 2020 and 2021. The sample will include nursing homes reported to be non-compliant, substantially compliant and compliant in the regulation of residents’ rights. An inspection report for each of these NHs (n=21) for the year 2019, 2020 and 2021 will create a sample of 63 reports for analysis. This sample will capture three time points for the 21 NHs pre-pandemic and throughout the pandemic.

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Janus, Sarah I. M., Jeannette G. van Manen, Maarten J. IJzerman e Sytse U. Zuidema. "Psychotropic drug prescriptions in Western European nursing homes". International Psychogeriatrics 28, n.º 11 (29 de julho de 2016): 1775–90. http://dx.doi.org/10.1017/s1041610216001150.

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ABSTRACTBackground:Despite the numerous warnings of European and national drug agencies as well as clinical guidelines since the year 2004, psychotropic drugs are still frequently used in dementia. A systematic review comparing the use of psychotropic drugs in nursing homes from different European countries is lacking.Objective:The aim of this study was to examine prescription rates of psychotropic drug use in nursing home patients between different Western European countries since the first warnings were published.Methods:A literature review was performed and the various psychotropic prescribing rates in European nursing homes were investigated. The prescription rates of antipsychotic and antidepressants were pooled per country. Other classes of psychotropic drugs could not be pooled because of the limited number of studies found.Results:Thirty-seven studies on antipsychotic drug use and 27 studies on antidepressant drug use conducted in 12 different European countries. The antipsychotic use in nursing homes ranged from 12% to 59% and antidepressant use from 19% to 68%. The highest rates of antipsychotic drug prescription were found in Austria, Ireland, and Belgium while for antidepressants in Belgium, Sweden, and France.Conclusions:Despite warnings about the side effects and recommendation to focus on non-pharmacological interventions, antipsychotics and antidepressants are commonly used drugs in nursing homes. The data suggest that Norway does best with regards having a low antipsychotic drug usage. Studies are needed to explain the differences between Norway and other European countries.

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O'Neill, Katherine, Fiona Dixon, Glenda Fleming, Michael Scott, James McAuley, Andrea Linton e Emer McLean. "Oral nutritional supplements in care homes". Journal of Prescribing Practice 5, n.º 10 (2 de outubro de 2023): 426–37. http://dx.doi.org/10.12968/jprp.2023.5.10.426.

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The aim of this project was to test the concept of dietetic-led ordering of oral nutritional supplements (ONS) for residents in care homes in Northern Ireland without the need for generation of a GP prescription. A new model of dietetic-led ordering was developed involving extensive stakeholder engagement. Data was audited for a 1-week period at the start (April 2021) and end (June 2021) of the pilot. The new model described in this project demonstrated dietitian-recommended, formulary compliant practice with a range of benefits to residents, clinicians and care workers, delivering the right product at the right time to the resident, resulting in cost savings, improved supply mechanisms for care homes, and reduced requirement for GP input. The project demonstrated benefits for care home residents, clinicians and the Health and Social Care system. The results improve understanding of ways to improve the adoption and implementation of evidence-based nutritional support interventions into routine practice.

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Ribbe, M. W. "Care for the Elderly: The Role of the Nursing Home in the Dutch Health Care System". International Psychogeriatrics 5, n.º 2 (setembro de 1993): 213–22. http://dx.doi.org/10.1017/s1041610293001541.

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Nursing homes, or verpleeghuizen, play an important role in the health care system in the Netherlands. These multifunctional institutions provide clinical and ambulatory (day hospital) care for somatic and psychogeriatric elderly with multiple pathology, disabilities, and handicaps. Quantitative data on morbidity, admission, and discharge of (psychogeriatric) nursing home patients are presented. The data on the nursing home institutions—number of residents, costs, and staff ratios—are placed in the context of the whole health care system. A new trend is to organize nursing home care in homes for the aged via substitution projects and dependences.

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Weech-Maldonado, Robert, Dennis Shea e Vincent Mor. "The Relationship Between Quality of Care and Costs in Nursing Homes". American Journal of Medical Quality 21, n.º 1 (janeiro de 2006): 40–48. http://dx.doi.org/10.1177/1062860605280643.

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Kapp, Marshall B. "Increasing Liability Risks Among Nursing Homes: Therapeutic Consequences, Costs, and Alternatives". Journal of the American Geriatrics Society 48, n.º 1 (janeiro de 2000): 97–99. http://dx.doi.org/10.1111/j.1532-5415.2000.tb03037.x.

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Colomer, Jordi, e Jan de Vries. "Person-centred dementia care: a reality check in two nursing homes in Ireland". Dementia 15, n.º 5 (27 de julho de 2016): 1158–70. http://dx.doi.org/10.1177/1471301214556132.

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Nakagawa, Sage, e Henry O'Lawrence. "Payer Source for Single, Elderly Women in Nursing Homes". Journal of Health and Human Services Administration 38, n.º 1 (março de 2015): 44–66. http://dx.doi.org/10.1177/107937391503800102.

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This study seeks to determine the payer source for single, elderly women in nursing homes by using secondary data from the 2004 National Nursing Home Survey was extracted and analyzed for the aforementioned hypotheses. By determining the payer source for single, elderly women, the next generation of women can prepare for high nursing home costs by saving earlier or investing in long-term care insurance. The analyses indicated self-pay and Medicaid was the primary sources for elderly women in nursing homes. Marital status did not have an impact on the payer source for elderly women. Single women did not have different payer sources than married elderly women. However, the study did not focus on payer sources for single, elderly women in nursing homes, but the demographic population as a whole.

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Ankuda, Claire, e Katherine Ornstein. "Medicare Costs by Disability and Community-Dwelling Status". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 117. http://dx.doi.org/10.1093/geroni/igab046.450.

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Abstract Understanding population-level Medicare expenditure patterns for older adults with functional disability is critical to focus supports to reduce costly and potentially burdensome health care use. We used the National Health and Aging Trends Study (NHATS) to assess quarterly Medicare expenditures over the 12 months following NHATS interview. We examine Medicare expenditure patterns for older adults in nursing homes (N=386), in the community and without disability (N=20,103), with disability and dementia (N=2,008), and with disability but not dementia (N=2,945). One-year mortality ranged from 2.0% for those without disability in the community to 25.9% for those residing in nursing homes. Among those surviving 1 year, Medicare expenditures the first quarter after NHATS survey ranged from $1,794 (95% CI $1,690-$1,898) for those with no disability to $5,177 (95% CI $4,535-$5,818) for those with disability and dementia. We assess trends over the following two years, and find that trajectories vary by clinical grouping.

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Yu, Wei, e Garnett Bradford. "Rural-Urban Differences in Nursing Home Access, Quality and Cost". Journal of Agricultural and Applied Economics 27, n.º 2 (dezembro de 1995): 446–59. http://dx.doi.org/10.1017/s1074070800028492.

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AbstractRural-urban differences in the supply of nursing home services are hypothesized to be jointly affected by competitive and regulatory forces, government policies, and the cost structure. Study findings indicate that rural services are slightly less accessible and lower in quality. A translog cost share function reveals no difference in the operating cost structure of rural and urban homes. Cost shares for nursing care are directly related to the degree of skilled nursing provided by homes. Significant scale economies were not detected for any of the major operating costs.

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Buylova Gola, A., S. Morris, B. Candy, S. Davis, M. King, N. Kupeli, G. Leavey et al. "Healthcare utilization and monetary costs associated with agitation in UK care home residents with advanced dementia: a prospective cohort study". International Psychogeriatrics 32, n.º 3 (17 de janeiro de 2020): 359–70. http://dx.doi.org/10.1017/s1041610219002059.

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ABSTRACTObjective:Nearly half of care home residents with advanced dementia have clinically significant agitation. Little is known about costs associated with these symptoms toward the end of life. We calculated monetary costs associated with agitation from UK National Health Service, personal social services, and societal perspectives.Design:Prospective cohort study.Setting:Thirteen nursing homes in London and the southeast of England.Participants:Seventy-nine people with advanced dementia (Functional Assessment Staging Tool grade 6e and above) residing in nursing homes, and thirty-five of their informal carers.Measurements:Data collected at study entry and monthly for up to 9 months, extrapolated for expression per annum. Agitation was assessed using the Cohen-Mansfield Agitation Inventory (CMAI). Health and social care costs of residing in care homes, and costs of contacts with health and social care services were calculated from national unit costs; for a societal perspective, costs of providing informal care were estimated using the resource utilization in dementia (RUD)-Lite scale.Results:After adjustment, health and social care costs, and costs of providing informal care varied significantly by level of agitation as death approached, from £23,000 over a 1-year period with no agitation symptoms (CMAI agitation score 0–10) to £45,000 at the most severe level (CMAI agitation score >100). On average, agitation accounted for 30% of health and social care costs. Informal care costs were substantial, constituting 29% of total costs.Conclusions:With the increasing prevalence of dementia, costs of care will impact on healthcare and social services systems, as well as informal carers. Agitation is a key driver of these costs in people with advanced dementia presenting complex challenges for symptom management, service planners, and providers.

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Furniss, Lee, Alistair Burns, Sarah Kathryn Lloyd Craig, Susan Scobie, Jonathan Cooke e Brian Faragher. "Effects of a pharmacist's medication review in nursing homes". British Journal of Psychiatry 176, n.º 6 (junho de 2000): 563–67. http://dx.doi.org/10.1192/bjp.176.6.563.

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BackgroundOlder people in nursing and residential homes often have complex disabilities and behavioural disturbances. Recent publicity has highlighted the dangers of medication in this group, and controls over prescribing have been suggested.AimsTo investigate the effect of a review of medication by a pharmacist.MethodAn 8-month prospective trial of an active medication review by a pharmacist was carried out on 330 residents in nursing homes in Manchester.ResultsThe intervention group experienced greater deterioration in cognitive function and behavioural disturbance than the control group, but the changes in depression and quality of life were similar for both groups. The number of drugs prescribed fell in the intervention group, but not in the control group, with a corresponding saving in drug costs. The number of deaths was significantly smaller in the intervention homes during the intervention period (4 v. 14) but not overall during the study period as a whole (26 v. 28).ConclusionThis clinical intervention reduced the number of medicines prescribed to elderly people in nursing homes, with minimal impact on their morbidity and mortality.

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McConkey, Roy, Fiona Keogh, Brendan Bunting, Edurne Garcia Iriarte e Sheelah Flatman Watson. "Relocating people with intellectual disability to new accommodation and support settings". Journal of Intellectual Disabilities 20, n.º 2 (7 de janeiro de 2016): 109–20. http://dx.doi.org/10.1177/1744629515624639.

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Internationally the relocation of people with intellectual disability from institutions has brought significant gains to their quality of life. This study contrasted three groups of persons in Ireland who moved either to personalized arrangements ( n = 29) or to community group homes ( n = 31) with those who remained in congregated settings awaiting relocation ( n = 29). Persons moving to rented accommodation with personalized support tended to be younger and had fewer support needs than those in group homes. They had greater control and choice in their lives, more community engagement and increased personal relationships compared to residents in group homes but those remaining in congregated settings fared worse of all. However, average staff costs were significantly higher in the latter settings. The implications for the future provision of group living arrangements are discussed along with the need for further longitudinal research to assess the sustained impact of personalized arrangements and their funding.

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Murphy, E., E. Burke, J. O'Donoghue, D. Xidous, T. Grey, S. Kennelly e D. O'Neill. "212 BUILT ENVIRONMENT OF NURSING HOMES AND INFECTION CONTROL AND PANDEMIC PREPAREDNESS". Age and Ageing 50, Supplement_3 (novembro de 2021): ii9—ii41. http://dx.doi.org/10.1093/ageing/afab219.212.

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Abstract Background The disproportionately high death rate of nursing home (NH) residents from COVID-19 in many countries, including Ireland, has focussed attention on infection prevention and control, including the built environment, in nursing homes. This has been a poorly researched topic to date, and we undertook a systematic review of evidence for architectural design measures which support infection control and pandemic preparedness. Methods Databases were screened for keywords related to NHs, built environment, infection prevention and control, and COVID-19; relevant papers were uploaded onto Covidence and screened for relevance. Data extracted from included articles was tabulated under 8 specific aspects of the built environment. Results Of 17 papers included in the final analysis, four studies found that larger nursing homes carried an increased risk of COVID-19 infection. Crowding in NHs was also a risk factor for infection, with a high crowding index associated with COVID-19 infection in five studies. Green House care homes, which are based on small clusters of domestic dwellings, fared better than traditional NHs. Two papers found an association between the location of NHs and the risk of COVID-19 infection, with urban NHs and those in areas of high prevalence being more at risk. Two papers identified internal fittings as a target for infection prevention and control. Seven papers highlighted the role of adequate ventilation in NHs in the prevention of spread of COVID-19. Only one paper described easy access to the outdoors as beneficial to infection control. Conclusion Residents of NHs are amongst the most vulnerable to COVID-19 infection. When designing and building NHs, the role of the built environment in controlling the spread of the virus should not be underestimated. This research supported by Science Foundation Ireland.

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Seo, Jeong Min, e Sang Yun Cho. "Reflection and suggestion of cohort isolation of elderly nursing homes by Covid-19: Cohort isolation from the perspective of nursing home". Forum of Public Safety and Culture 22 (31 de maio de 2023): 1–16. http://dx.doi.org/10.52902/kjsc.2023.22.1.

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This study dealt with cohort isolation conducted by the government due to Covid-19, a biological factor in social change experienced by nursing homes. Cohort isolation has caused serious problems in the operation and management of nursing homes as a form of government quarantine. The risks and severity of Covid-19 encountered in nursing homes have become serious problems for nursing homes in the early and mid-term of the Covid-19 pandemic. Recently, it has been gradually decreasing since the expansion of Covid-19. In the study, very serious problems such as operational problems according to the cohort, fatigue of caregivers and managers, and above all, labor law problems are connected. In addition, due to the nature of the Covid-19 epidemic, the difficulties experienced in places where group life takes place are very different from the difficulties thought in society. In particular, nursing homes where highly inactive elderly people reside are exposed to these risks without protection, while countermeasures or specific solutions have no special way other than time. Therefore, cohort isolation due to Covid-19 confirmed patients in elderly care facilities has been repeated from time to time. In addition, the study suggested smooth cooperation with public health centers and local governments, clear regulations on cohort isolation, limitations of cohort isolation, discrimination in labor costs due to cohort isolation, and recent claims for residents.

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Roghmann, Mary-Claire, Alison Lydecker, Lona Mody, C. Daniel Mullins e Eberechukwu Onukwugha. "Strategies to Prevent MRSA Transmission in Community-Based Nursing Homes: A Cost Analysis". Infection Control & Hospital Epidemiology 37, n.º 8 (13 de maio de 2016): 962–66. http://dx.doi.org/10.1017/ice.2016.96.

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OBJECTIVETo estimate the costs of 3 MRSA transmission prevention scenarios compared with standard precautions in community-based nursing homes.DESIGNCost analysis of data collected from a prospective, observational study.SETTING AND PARTICIPANTSCare activity data from 401 residents from 13 nursing homes in 2 states.METHODSCost components included the quantities of gowns and gloves, time to don and doff gown and gloves, and unit costs. Unit costs were combined with information regarding the type and frequency of care provided over a 28-day observation period. For each scenario, the estimated costs associated with each type of care were summed across all residents to calculate an average cost and standard deviation for the full sample and for subgroups.RESULTSThe average cost for standard precautions was $100 (standard deviation [SD], $77) per resident over a 28-day period. If gown and glove use for high-risk care was restricted to those with MRSA colonization or chronic skin breakdown, average costs increased to $137 (SD, $120) and $125 (SD, $109), respectively. If gowns and gloves were used for high-risk care for all residents in addition to standard precautions, the average cost per resident increased substantially to $223 (SD, $127).CONCLUSIONSThe use of gowns and gloves for high-risk activities with all residents increased the estimated cost by 123% compared with standard precautions. This increase was ameliorated if specific subsets (eg, those with MRSA colonization or chronic skin breakdown) were targeted for gown and glove use for high-risk activities.Infect Control Hosp Epidemiol 2016;37:962–966

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Hindle, Tony, Adam Hindle e Martin Spollen. "Resource Allocation Modelling for Home-Based Health and Social Care Services in Areas Having Differential Population Density Levels: A Case Study in Northern Ireland". Health Services Management Research 13, n.º 3 (agosto de 2000): 164–69. http://dx.doi.org/10.1177/095148480001300304.

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This project arose from deliberations within the Department of Health and Social Services (DHSS) in Northern Ireland concerning the acceptability of the revenue resource allocation methodology they were using. One problem with the method being used had been the absence of a component that adequately reflected the relative costs associated with the differential population densities of the four health boards into which the Province is divided. This study investigates a particular element of this issue, viz differences in the travelling distances and times of those health and social service professionals who provide visiting services to patients in their own homes. A modelling approach has been developed and used in conjunction with a comprehensive spatial and geographical information system for Northern Ireland. An important outcome of the study has been estimates of the targets that should be set for the annual health and social care travelling distances and times per head of population in the boards, for a range of home-based services. Also, the project has contributed to decisions made by the DHSS in Northern Ireland concerning the annual financial compensations required by boards for costs associated with their relative population densities.

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Lan, Xiuyan, Huimin Xiao e Ying Chen. "Psychosocial Reactions to Relocation to Nursing Homes in Chinese Older Adults". Innovation in Aging 4, Supplement_1 (1 de dezembro de 2020): 385. http://dx.doi.org/10.1093/geroni/igaa057.1240.

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Abstract This study aimed to elicit psychosocial reactions to relocation to nursing homes from older adults’ perspectives with a qualitative interview design. Narratives from 23 Chinese nursing home residents from Fuzhou, China in a life review program were recorded, transcribed into sentences, and analyzed with the qualitative content analysis. It revealed five stages of psychosocial reactions to relocation to nursing homes as fear, struggle, compromise, acceptance, and contribution. The first stage resulted from negative labels attached to nursing homes, disconnection to the society, difficulties in establishing new relationships, and being abandoned by their families. The second stage described the behaviors of struggle: complain about family members, think of going back home, pray to have a change, and take action to leave. The third stage described the keys to compromise: choices between maintaining the harmony in family relation and companionship of relatives, choices between professional care and family care, and choices between costs and effects of family care and nursing home care. The fourth stage described how they accept nursing home life: accept the life and yet with worries, affirm benefits of living in nursing homes, and embrace the nursing home life. The last stage resulted from sense of ownership and giving full play to self-worth. This study generated new insights into the knowledge on psychosocial reactions to relocation to nursing homes and provided both family members and nursing home staff with a direction for how to promote a smoother relocation process.

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Meiiers, J. M. M., L. Wilson, J. Schols e R. Halfens. "PP039 ESTIMATING THE EXTRA COSTS ASSOCIATED WITH MALNUTRITION IN DUTCH NURSING HOMES". Clinical Nutrition Supplements 5, n.º 2 (janeiro de 2010): 38. http://dx.doi.org/10.1016/s1744-1161(10)70116-2.

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Dor, Avi. "The costs of Medicare patients in nursing homes in the United States". Journal of Health Economics 8, n.º 3 (dezembro de 1989): 253–70. http://dx.doi.org/10.1016/0167-6296(89)90021-0.

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Han, Xu, Niam Yaraghi e Ram Gopal. "Winning at All Costs: Analysis of Inflation in Nursing Homes’ Rating System". Production and Operations Management 27, n.º 2 (20 de novembro de 2017): 215–33. http://dx.doi.org/10.1111/poms.12804.

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Lord, Justin, Midge Ray, Amy Landry, Heather Lee, Nataliya Ivankova, Ivan Herbey e Robert Weech-Maldonado. "Exploring the Role of Contextual Factors in Medicaid Nursing Homes' Performance: A Qualitative Perspective". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 21. http://dx.doi.org/10.1093/geroni/igab046.075.

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Abstract This study explored the role of tested contextual factors (structural, market, and management) in high Medicaid (under resourced) nursing homes performance. Four nursing homes in geographically diverse states were purposefully selected for site visits based on high and low performance (quality/ profitability) indicators. Eight nursing home administrators and directors of nursing, and twenty-one nursing staff (RNs, LPNs, and CNAs) and providers of support services were interviewed. Data were analyzed using an inductive thematic approach with NVivo 12 Plus. Within and across case analysis was used to compare participants’ perspectives across nursing homes and across administrators and staff. Several themes provide insight into varied influences of contextual factors on these nursing homes’ performance: focus on quality care, team-based approach, community support and engagement, and staffing retention. Providing quality care to residents was strategic priority in all facilities, which was enhanced by an adopted team-based leadership approach, open-door policy and home-like atmosphere. Community reputation and availability of local training opportunities for CNAs affected nursing staffing which some facilities addressed using creative retention strategies. These research findings will facilitate interventions, such as leadership training and organizational development activities, aimed at improving the performance of low performing facilities in terms of lower costs and better quality.

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Cohen-Mansfield, Jiska, William J. Culpepper e Patricia Carter. "Nursing Staff Back Injuries". AAOHN Journal 44, n.º 1 (janeiro de 1996): 9–17. http://dx.doi.org/10.1177/216507999604400106.

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This report describes the period prevalence and costs of back injuries to nursing staff of long term care facilities in comparison to nurses employed industry wide and to other occupations industry wide. The period prevalence of back injuries to nursing staff in long term care facilities was highest for nurse aides, followed by LPNs and then RNs. Nurses (combined) had a period prevalence of back injuries nearly 1.5 times higher than all employees of long term care facilities and 6 times higher than all occupations combined industry wide. Within long term care facilities, nurses sustaining back injuries were younger and had been employed for a shorter period of time than the average for all nurses employed in long term care facilities. Back injuries accounted for more than half of the indemnity and medical costs for all injuries incurred in nursing homes and industry wide. The findings highlight the need for better prevention and rehabilitation.

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López, Rachel E. "The Unusual Cruelty of Nursing Homes Behind Bars". Federal Sentencing Reporter 32, n.º 5 (junho de 2020): 264–71. http://dx.doi.org/10.1525/fsr.2020.32.5.264.

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The elderly prison population continues to rise along with higher rates of dementia behind bars. To maintain the detention of this elderly population, federal and state prisons are creating long-term care units, which in turn carry a heavy financial burden. Prisons are thus gearing up to become nursing homes, but without the proper trained staff and adequate financial support. The costs both to taxpayers and to human dignity are only now becoming clear. This article squarely addresses the second dimension of this carceral practice, that is the cost to human dignity. Namely, it sets out why indefinitely incarcerating someone with dementia or other neurocognitive disorders violates the Eighth Amendment of the United States Constitution’s prohibition on cruel and unusual punishment. This conclusion derives from the confluence of two lines of U.S. Supreme Court precedent. First, in Madison v. Alabama, the Court recently held that executing someone (in Madison’s case someone with dementia) who cannot rationally understand their sentence amounts to cruel and unusual punishment. Second, in line with Miller v. Alabama, which puts life without parole (LWOP) sentences in the same class as death sentences due to their irrevocability, this holding should be extended to LWOP sentences. Put another way, this article explains why being condemned to life is equivalent to death for someone whose neurodegenerative disease is so severe that they cannot rationally understand their punishment.

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O'Brien, Judith A., e J. Jaime Caro. "Alzheimer's Disease and Other Dementia in Nursing Homes: Levels of Management and Cost". International Psychogeriatrics 13, n.º 3 (setembro de 2001): 347–58. http://dx.doi.org/10.1017/s1041610201007736.

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Objective: To estimate comparative mangement levels and the annual cost of caring for a nursing home resident with and without dementia. Method: Data from the 1995 Massachusetts Medicaid nursing home database were used to examine residents with Alzheimer's disease, other types of dementia, and no dementia to determine care and dependency levels. Massachusetts Medicaid 1997 per-diem rates for each of 10 designated management levels were applied accordingly to residents in each level to estimate annual care costs. Costs from this analysis are reported in 1997 U.S. dollars. Results: Of the 49,724 nursing home residents identified, 26.4% had a documented diagnosis of dementia. On average, a resident with dementia requires 229 more hours of care annually than one without dementia, resulting in a mean additional cost of $3,865 per patient with dementia per year. Conclusions: Dementia increases the care needs and cost of caring for a nursing home resident.

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Murphy, Claire, Una Molloy, Sarah McLean e Daniel Ryan. "230 The Impact of a Palliative Care ECHO Programme on Symptom Severity Scores and Phases Score in a Nursing Home Population". Age and Ageing 48, Supplement_3 (setembro de 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.139.

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Abstract Background In Ireland most deaths occur in acute hospitals however 20% of deaths occur in residential facilities. Less than 30% receive specialist palliative care input. ECHO (extension for community healthcare outcomes) is a palliative care education programme consisting of a 10 part lecture series. Twenty nursing homes and 353 staff participated. A phases score is a 5-point rating scale classifying the status of a palliative care patient ranging from stable to bereaved. Methods Data collected by palliative care professionals from September 2017 to December 2018 was analysed. This included demographic features, a phases score and scores for pain, carer stress, spiritual and psychological need. Nursing homes that attended ≤ 3 ECHO sessions were excluded, 15 participating nursing homes were included. Age matched control subjects were selected from non-participating nursing homes on a 2:1 basis. Data was analysed using the paired T Test and Chi squared was analyzed for frequency data. Results There were 40 patients in the intervention group and 80 in the control group. Mean ages were 83yrs and 82yrs respectively. Palliative care referral numbers did not change significantly between the two groups (111 and 114). The Phases score was significantly reduced in the ECHO group compared to controls (P=< 0.007). There was no significant reduction in the phases score in the ECHO group pre and post intervention (P=0.29). There was no difference in Pain scores between groups (P=0.98) Conclusion The ECHO intervention led to a reduction in the overall phases score in participating nursing homes. This was not the result of increased palliative care referrals. We would infer it is a reflection of better control of symptoms overall. We did not demonstrate a significant reduction in individual symptoms. The phases score is an overall representation of a patient’s status. With the expansion of the ECHO programme on-going analysis will be performed.

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Cormi, Clément, Jan Chrusciel, Antoine Fayol, Michel Van Rechem, Khuloud Abou-Amsha, Matthieu Tixier, Myriam Lewkowicz, David Laplanche e Stéphane Sanchez. "The Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital". International Journal of Environmental Research and Public Health 18, n.º 21 (23 de outubro de 2021): 11148. http://dx.doi.org/10.3390/ijerph182111148.

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Evaluating the use and impact of telemedicine in nursing homes is necessary to promote improvements in the quality of this practice. Even though challenges and opportunities of telemedicine are increasingly becoming well documented for geriatrics (such as improving access to healthcare, patient management, and education while reducing costs), there is still limited knowledge on how to better implement it in an inter-organizational context, especially when considering nursing homes. In this regard, this study aimed first to describe the telemedicine activity of nursing homes when cooperating with a general hospital; and then understand the behavioral differences amongst nursing homes while identifying critical factors when implementing a telemedicine project. We conducted a sequential, explanatory mixed-method study using quantitative then qualitative methods to better understand the results. Three years of teleconsultation data of twenty-six nursing homes (15 rural and 11 urban) conducting teleconsultations with a general hospital (Troyes Hospital, France) were included for the quantitative analysis, and eleven telemedicine project managers for the qualitative analysis. Between April 2018 and April 2021, 590 teleconsultations were conducted: 45% (n = 265) were conducted for general practice, 29% (n = 172) for wound care, 11% (n = 62) for diabetes management, 8% (n = 47) with gerontologist and 6% (n = 38) for dermatology. Rural nursing homes conducted more teleconsultations overall than urban ones (RR: 2.484; 95% CI: 1.083 to 5.518; p = 0.03) and included more teleconsultations for general practice (RR: 16.305; 95% CI: 3.505 to 73.523; p = 0.001). Our qualitative study showed that three critical factors are required for the implementation of a telemedicine project in nursing homes: (1) the motivation to perform teleconsultations (in other words, improving access to care and cooperation between professionals); (2) building a relevant telemedicine medical offer based on patients’ and treating physicians’ needs; and (3) it’s specific organization in terms of time and space. Our study showed different uses of teleconsultations according to the rural or urban localization of nursing homes and that telemedicine projects should be designed to consider this aspect. Triggered by the COVID-19 pandemic, telemedicine projects in nursing homes are increasing, and observing the three critical factors presented above could be necessary to limit the failure of such projects.

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Phillips, C. D., C. Hawes e B. E. Fries. "Reducing the use of physical restraints in nursing homes: will it increase costs?" American Journal of Public Health 83, n.º 3 (março de 1993): 342–48. http://dx.doi.org/10.2105/ajph.83.3.342.

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Gozalo, Pedro, Michael Plotzke, Vincent Mor, Susan C. Miller e Joan M. Teno. "Changes in Medicare Costs with the Growth of Hospice Care in Nursing Homes". New England Journal of Medicine 372, n.º 19 (7 de maio de 2015): 1823–31. http://dx.doi.org/10.1056/nejmsa1408705.

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Schnelle, John F., V. A. Sowell, T. W. Hu e B. Traughber. "Reduction of Urinary Incontinence in Nursing Homes: Does It Reduce or Increase Costs?" Journal of the American Geriatrics Society 36, n.º 1 (janeiro de 1988): 34–39. http://dx.doi.org/10.1111/j.1532-5415.1988.tb03431.x.

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Panneman, M. J. M., C. S. Sterke, M. J. Eilering, B. M. Blatter, S. Polinder e E. F. Van Beeck. "Costs and benefits of multifactorial falls prevention in nursing homes in the Netherlands". Experimental Gerontology 143 (janeiro de 2021): 111173. http://dx.doi.org/10.1016/j.exger.2020.111173.

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Caucat, Marie, Alice Zacarin, Vanessa Rousseau, Jean-Louis Montastruc e Haleh Bagheri. "The Cost of Potentially Inappropriate Medications in Nursing Homes in West Occitanie". Pharmacy 8, n.º 1 (11 de março de 2020): 39. http://dx.doi.org/10.3390/pharmacy8010039.

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Introduction: As of 2019, people older than 65 years represent 20% of the French population. Despite several guidelines suggesting to avoid potentially inappropriate medication (PIM) use in elderly, the prevalence of their prescription remains high (25%). Furthermore, PIM could lead to preventable adverse drug reactions (ADRs). The main objective of this study was to determine the direct cost of PIM in older persons living in residential care homes for the elderly (nursing homes). A secondary objective was to assess the potential impact of PIM deprescribing on drug-related health care costs. Methods: We undertook a multicenter, retrospective study in 19 care homes for the elderly including 1240 residents. The analysis of prescriptions was carried out according to the European EU(7) PIM list. The cost of each drug was estimated according to the French Medication Insurance database. Furthermore, patient’s comorbidities were studied using Charlson’s comorbidity index. In order to estimate the economic impact of PIM, we used the list of alternative appropriate drugs suggested by EU(7) PIM list and French National Health Authority. An incremental cost per patient was calculated by the difference in costs between PIMs and alternative drugs. Results: A total of 7768 lines of drug prescriptions were analyzed. The mean age was 87.6 ± 7.6 years. About 70% (n = 872) of residents received more than five drugs. We identified 959 residents (77.3%) with at least one PIM. The mean cost of PIM was 0.58 euros versus 0.48 euros for alternatives. PIM substitution by alternatives led to save 12 centimes/resident/day. The mean cost of prescription with PIM was 2.8 euros per resident per day (28% of the overall cost of prescription). According to these results, more than 25 million euros can be overall saved for aged persons living in nursing homes for the older people in France per year. Conclusion: The prevalence of PIMs among the elderly in nursing homes is high and leads to a significant cost. Deprescribing of these medications could decrease both drug misuse and cost of drug prescription. Further research is needed to estimate the overall cost of PIM exposure outcomes, taking into account the ADRs leading to hospitalization.

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Hughes, Kelly, Micah Segelman, Kristie Porter, Miranda Diaz e Iara Oliveira. "NURSING HOME CLOSURES DURING THE COVID-19 PANDEMIC". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 344. http://dx.doi.org/10.1093/geroni/igad104.1145.

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Abstract Nursing homes experienced unprecedented financial challenges during the COVID-19 pandemic, raising concerns about closures. This study identified closures from 2020-2021 using certification surveys and examined characteristics associated with closures using multivariate analysis. We interviewed nursing home industry experts and providers about pandemic-related challenges and policies affecting closure. Closures did not increase in 2020 and 2021 relative to 2011-2019. However, nursing homes with more staff shortages and COVID-19 infections were more likely to close. Additional characteristics associated with closure include smaller size, lower occupancy rate, and fewer Medicare residents. Interviews noted the following financial challenges: costly contract staffing, increased PPE and COVID-19 testing costs, reduced occupancy rates, and increased internal resources needed to implement new infection guidance. Interviews suggested that strategies to mitigate staffing shortages and federal and state monetary assistance may have prevented closures in 2020 and 2021, but continuing attention to closures is needed in 2022 and 2023 as funding ends.

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Gussin, Gabrielle M., James A. McKinnell, Raveena D. Singh, Ken Kleinman, Amherst Loren Miller, Raheeb Saavedra, Lauren Heim et al. "Decreased Hospitalizations and Costs From Infection in Sixteen Nursing Homes in the SHIELD OC Regional Decolonization Initiative". Infection Control & Hospital Epidemiology 41, S1 (outubro de 2020): s7—s8. http://dx.doi.org/10.1017/ice.2020.479.

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Distinguished OralBackground: Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, California (SHIELD OC) was a CDC-funded regional decolonization intervention from April 2017 through July 2019 involving 38 hospitals, nursing homes (NHs), and long-term acute-care hospitals (LTACHs) to reduce MDROs. Decolonization in NH and LTACHs consisted of universal antiseptic bathing with chlorhexidine (CHG) for routine bathing and showering plus nasal iodophor decolonization (Monday through Friday, twice daily every other week). Hospitals used universal CHG in ICUs and provided daily CHG and nasal iodophor to patients in contact precautions. We sought to evaluate whether decolonization reduced hospitalization and associated healthcare costs due to infections among residents of NHs participating in SHIELD compared to nonparticipating NHs. Methods: Medicaid insurer data covering NH residents in Orange County were used to calculate hospitalization rates due to a primary diagnosis of infection (counts per member quarter), hospital bed days/member-quarter, and expenditures/member quarter from the fourth quarter of 2015 to the second quarter of 2019. We used a time-series design and a segmented regression analysis to evaluate changes attributable to the SHIELD OC intervention among participating and nonparticipating NHs. Results: Across the SHIELD OC intervention period, intervention NHs experienced a 44% decrease in hospitalization rates, a 43% decrease in hospital bed days, and a 53% decrease in Medicaid expenditures when comparing the last quarter of the intervention to the baseline period (Fig. 1). These data translated to a significant downward slope, with a reduction of 4% per quarter in hospital admissions due to infection (P < .001), a reduction of 7% per quarter in hospitalization days due to infection (P < .001), and a reduction of 9% per quarter in Medicaid expenditures (P = .019) per NH resident. Conclusions: The universal CHG bathing and nasal decolonization intervention adopted by NHs in the SHIELD OC collaborative resulted in large, meaningful reductions in hospitalization events, hospitalization days, and healthcare expenditures among Medicaid-insured NH residents. The findings led CalOptima, the Medicaid provider in Orange County, California, to launch an NH incentive program that provides dedicated training and covers the cost of CHG and nasal iodophor for OC NHs that enroll.Funding: NoneDisclosures: Gabrielle M. Gussin, University of California, Irvine, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

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Travers, Jasmine. "RECOMMENDATIONS TO IMPROVE NURSING HOME QUALITY: A DISCUSSION OF THE 2022 NASEM REPORT". Innovation in Aging 6, Supplement_1 (1 de novembro de 2022): 58. http://dx.doi.org/10.1093/geroni/igac059.226.

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Abstract Every year approximately four million persons receive care in approximately 15,000 nursing homes across the U.S. The costs of this care exceed $168 billion per year and are projected to grow to $274 billion by 2024. Nursing homes have long been plagued by problems with quality of care.In 1986, the Institute of Medicine released, Improving the Quality of Care in Nursing Homes, a landmark report that fundamentally changed the nation’s approach to nursing home operation and regulation. However, three decades later, significant challenges with nursing home quality remain, many of which were brought to light during the COVID-19 pandemic. As a result, in 2020, the National Academies of Sciences, Engineering, and Medicine (NASEM) convened a panel of 17 experts in nursing home care to examine our nation’s approach to nursing home care, including clinical care, staffing, financing and payment, and regulation, with the goal of making recommendations for improving the quality of care in today’s nursing homes and ensuring the safety and well-being of nursing home residents and staff. Expert members represented areas of diversity, policy, regulation, education, technology, quality measurement and reporting, and clinical practice. The release of this report is April 2022.In this symposium, four committee members will present the main findings and recommendations from the forthcoming and highly-anticipated report, with a particular focus on care delivery, workforce, quality assurance & policy, and equity. During this session, an emphasis will be placed on how the presented recommendations can be incorporated into policy and practice.

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