Article
Geriatrics & Gerontology
Juan Camilo David Gomez, Amy Cochran, Maureen Smith, Gabriel Zayas-Caban
Summary: This study found that the characteristics of patients and skilled nursing facilities (SNFs) significantly affect the risks of rehospitalization and mortality. Patients with cardiac, orthopedic, and neuropsychiatric conditions have better outcomes when assigned to SNFs with higher resource capacity (beds, staff, physical and occupational therapy), while patients with conditions related to cancer or chronic renal failure have better outcomes when assigned to SNFs with lower resource capacity.
Article
Medicine, General & Internal
Rachel A. Prusynski, Andrew Humbert, Tracy M. Mroz
Summary: This study aimed to determine the SNF characteristics associated with changes in ownership and whether these changes were associated with differences in short-stay patient outcomes. The results showed that nonprofit and government SNFs were less likely to undergo ownership changes compared to for-profit SNFs. The study also found that ownership changes were associated with a short-term increase in emergency department visits.
Article
Geriatrics & Gerontology
Mark Toles, Alesia Frerichs, Jennifer Leeman
Summary: The study evaluated the effectiveness of a learning collaborative in implementing transitional care interventions in skilled nursing facilities, finding significant improvements in patient reach, adoption rate, and fidelity to the implementation strategies.
Article
Geriatrics & Gerontology
Rachel Prusynski
Summary: The article introduces an adapted framework based on Donabedian's model for evaluating quality of care and applies it to decades of Medicare payment policy to provide a historical view of how payment policy changes have impacted rehabilitation processes and patient outcomes for Medicare beneficiaries in SNFs. The review demonstrates how SNF responses to Medicare payment policy have historically varied based on organizational factors, highlighting the importance of considering such organizational factors in monitoring policy response and patient outcomes. This historical perspective underscores the mixed success of previous Medicare policies impacting rehabilitation and patient outcomes for older adults receiving care in SNFs, which can help in predicting SNF industry response to current and future Medicare policy changes.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2021)
Article
Geriatrics & Gerontology
Robert E. Burke, Yao Xu, Ashley Z. Ritter
Summary: The study compared outcomes of Medicare beneficiaries with and without a diagnosis of dementia in skilled nursing facilities (SNFs). It found that beneficiaries with dementia had lower odds of mortality but reduced odds of discharge to the community during their SNF stay.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2021)
Article
Gerontology
Colleen Kummet, Kathy Schneider, Chong Wang, Nyaradzo Longinaker, Maria Joseph-King, Karyn Anderson, Andrew Brecher, Sara Vitolo
Summary: This study examined the length of stay in skilled nursing facilities (SNF) and found that dual eligibility, racial or ethnic minority, depression, and Alzheimer's disease are associated with longer stays. Additionally, facilities that serve a higher proportion of vulnerable populations tend to have longer average length of stay.
JOURNAL OF APPLIED GERONTOLOGY
(2022)
Article
Geriatrics & Gerontology
Terry Hawk, Elizabeth M. White, Courtney Bishnoi, Lindsay B. Schwartz, Rosa R. Baier, David R. Gifford
Summary: This study examined the nurse staffing levels in skilled nursing facilities (SNFs) in the United States and estimated the costs and personnel needed to meet proposed minimum levels. The findings showed that only a small percentage of SNFs met the proposed standards, and achieving the minimum staffing levels would require substantial financial investment and targeted support for low-resource facilities. Rural SNFs in particular faced challenges in meeting all categories, primarily due to fierce competition at the county level.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2022)
Article
Geriatrics & Gerontology
Sandra M. Shi, Brianne Olivieri-Mui, Gahee Oh, Ellen McCarthy, Jonathan F. Bean, Dae H. Kim
Summary: This study examines the association between a claims-based frailty index and time at home in Medicare beneficiaries. The findings suggest a positive correlation between frailty and short time at home, indicating the need for additional resources and interventions to prevent health decline and poor quality of life.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2023)
Article
Geriatrics & Gerontology
Rachel A. Prusynski, Andrew Humbert, Natalie E. Leland, Bianca K. Frogner, Debra Saliba, Tracy M. Mroz
Summary: Implementation of PDPM and COVID-19 had negative impacts on therapy staffing in SNFs, with larger declines for assistants and contractors. SNFs that historically engaged in profit-maximizing behaviors had larger staffing declines during PDPM compared to other SNFs. Therapy staffing fluctuated during COVID-19, but PDPM-related reductions persisted 2 years into the pandemic, especially in rural SNFs.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Geriatrics & Gerontology
Mark Toles, John S. Preisser, Cathleen Colon-Emeric, Mary D. Naylor, Morris Weinberger, Ying Zhang, Laura C. Hanson
Summary: This study tested the efficacy of the Connect-Home transitional care intervention on patient and caregiver preparedness for care at home, and other patient and caregiver-reported outcomes. The results showed that the intervention did not improve outcomes in the planned statistical analysis. However, post-hoc analyses revealed a potential association between the intervention and increased patient preparedness and decreased return to acute care, considering the impact of COVID-19.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Health Care Sciences & Services
Caroline Strickland, Nancy Chi, Laura Ditz, Luisa Gomez, Brittin Wagner, Stanley Wang, Daniel J. Lizotte
Summary: This study provides a comprehensive analysis of the factors that impact whether a patient referral to a skilled nursing facility (SNF) is accepted or denied. The key drivers found include the patient's primary diagnosis and insurance type, as well as the facility's overall 5-star rating and urban versus rural status. Understanding these factors is essential for improving decision-making processes and achieving appropriate occupancy levels.
JOURNAL OF MEDICAL INTERNET RESEARCH
(2023)
Article
Management
Ginger Zhe Jin, Ajin Lee, Susan Feng Lu
Summary: The Medicare reimbursement rule, known as the three-day rule, affects patients' choice of skilled nursing facilities (SNFs) and leads to higher hospital readmission rates, particularly for infection-related cases. This perverse effect is more prominent when local SNFs have lower occupancy rates and higher deficiency citations.
MANAGEMENT SCIENCE
(2022)
Article
Medicine, General & Internal
Julia Adler-Milstein, Katherine Raphael, Terrence A. O'Malley, Dori A. Cross
Summary: The study surveyed US SNFs on the performance of receiving patient transition information from hospitals, finding significant shortcomings in information completeness, timeliness, and usability. Shared clinicians and participation in hospital accountable care organizations were associated with improved information sharing, though potentially costly.
Article
Health Care Sciences & Services
Victoria L. Bartlett, Joseph S. Ross, Lilanthi Balasuriya, Taeho Greg Rhee
Summary: Patients with psychiatric diagnoses and Medicaid coverage who are discharged to skilled nursing facilities tend to have longer lengths of stay compared to patients with medical diagnoses and Medicare coverage.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Geriatrics & Gerontology
Becky A. Briesacher, Brianne L. Olivieri-Mui, Benjamin Koethe, Jane S. Saczynski, Donna Marie Fick, John W. Devlin, Edward R. Marcantonio
Summary: A positive delirium screen at skilled-nursing facility (SNF) admission is associated with an increased risk of receiving psychoactive medication within 7 days, particularly in patients with incident dementia. Future research should explore strategies to reduce inappropriate psychoactive medication prescribing in older adults admitted with delirium to SNFs.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2022)
Article
Health Care Sciences & Services
Brian E. McGarry, David C. Grabowski
MEDICAL CARE RESEARCH AND REVIEW
(2020)
Article
Health Care Sciences & Services
Lacey Loomer, Ashvin Gandhi, Fangli Geng, David C. Grabowski
Summary: This study used a new data source, Caregiverlist, to collect private-pay prices for 12,000 nursing homes nationwide and found factors that affect prices.
MEDICAL CARE RESEARCH AND REVIEW
(2021)
Letter
Surgery
Andrew D. Wilcock, Michael L. Barnett, J. Michael McWilliams, David C. Grabowski, Ateev Mehrotra
Editorial Material
Medicine, General & Internal
David C. Grabowski, Vincent Mor
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2020)
Editorial Material
Medicine, General & Internal
David C. Grabowski, Karen E. Joynt Maddox
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2020)
Article
Geriatrics & Gerontology
Anne Tumlinson, William Altman, Jon Glaudemans, Howard Gleckman, David C. Grabowski
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2020)
Letter
Geriatrics & Gerontology
Scott A. Goldberg, Charles T. Pu, Ryan W. Thompson, Eden Mark, Thomas D. Sequist, David C. Grabowski
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2020)
Article
Geriatrics & Gerontology
Joseph G. Ouslander, David C. Grabowski
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2020)
Article
Health Care Sciences & Services
Kelsi Carolan, David C. Grabowski, Ateev Mehrotra, Laura A. Hatfield
JOURNAL OF MEDICAL INTERNET RESEARCH
(2020)
Letter
Medicine, General & Internal
Brian E. McGarry, Gillian K. SteelFisher, David C. Grabowski, Michael L. Barnett
JAMA INTERNAL MEDICINE
(2021)
Article
Geriatrics & Gerontology
David C. Grabowski
Summary: Nursing homes in the United States often lack adequate nursing staff and a homelike environment, which was further exacerbated during the pandemic. The main reasons for these issues are the low reimbursement from state Medicaid payment systems and the lack of government accountability for how nursing homes spend their funding. To address these problems, reforms are needed in the payment system and oversight of nursing home expenditures.
INNOVATION IN AGING
(2022)
Article
Geriatrics & Gerontology
Brian E. McGarry, David C. Grabowski
Summary: Although some states have concerns about the woodwork effect, our study shows that expanding Medicaid HCBS does not lead to increased enrollment. Instead, it is associated with reduced nursing home population and institutional Medicaid LTSS spending. Each dollar directed to HCBS leads to $0.26 savings from decreased nursing home use, allowing states to serve more LTSS recipients at a lower cost.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Editorial Material
Health Care Sciences & Services
Bruce Pyenson, David C. Grabowski
AMERICAN HEALTH AND DRUG BENEFITS
(2020)
Article
Medicine, General & Internal
Michael L. Barnett, Karen E. Joynt Maddox, E. John Orav, David C. Grabowski, Arnold M. Epstein
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2020)
Article
Gerontology
Hari Sharma, Marcelo Coca Perraillon, Rachel M. Werner, David C. Grabowski, R. Tamara Konetzka
JOURNAL OF APPLIED GERONTOLOGY
(2020)