Rurality and Nursing Home Quality: Evidence From the 2004 National Nursing Home Survey

Kang, Yu; Meng, Hongdao; Miller, Nancy A.

doi:10.1093/geront/gnr065

Cited by 30 publications

(34 citation statements)

References 29 publications

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“…Second, facilities located in metropolitan areas performed better. A previous study argued that rural facilities were less likely to provide mental health services and lacked accreditations or special care programs …”

Section: Discussionmentioning

confidence: 99%

“…A previous study argued that rural facilities were less likely to provide mental health services and lacked accreditations or special care programs. 19 Fewer years in business contributed to a reduced care-need deterioration only in the model of residents excluding lost to follow-up. However, a non-significant relationship between ADL change and facility age was shown in a previous study.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, multilevel framework of assessing facility effect of quality of care posit that both resident and facility level should be examined and relation that residents are nested within facilities should be considered …”

Section: Introductionmentioning

confidence: 99%

“…17 Furthermore, multilevel framework of assessing facility effect of quality of care posit that both resident and facility level should be examined and relation that residents are nested within facilities should be considered. 14,18,19 In Japan, there are three types of long-term care facilities for older adults as follows: long-term care welfare facilities (LTCWF), long-term care health facilities and long-term care medical facilities. In the present study, we focused on LTCWF because among the three types of facilities, LTCWF have the highest number of users and the longest mean length of stay.…”

Section: Introductionmentioning

confidence: 99%

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Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Jin

Tamiya

Jeon

et al. 2018

Geriatrics Gerontology Int

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Aim: To determine the resident and facility characteristics associated with residents' care-need level deterioration in long-term care welfare facilities in Japan.Methods: A nationally representative sample of 358 886 residents who lived in 3774 long-term care welfare facilities for at least 1 year from October 2012 was obtained from long-term care insurance claims data. Facility characteristics were linked with a survey of institutions and establishments for long-term care in 2012. We used a multilevel logistic regression according to the inclusion and exclusion of lost to follow-up to define the resident and facility characteristics associated with resident care-need level deteriorations (lost to follow-up: the majority were hospitalized residents or had died; were treated as deterioration in the including loss to follow-up model).Results: Adjusting for the covariates, at the resident level, older age and lower care-need level at baseline were more likely to show deterioration in the care-need level. At the facility level, metropolitan facilities, unit model (all private room settings) and mixed-model facilities (partly private room settings) were less likely to experience careneed level deterioration. A higher proportion of registered nurses among all nurses was negatively related to careneed level deterioration only in the model including lost to follow-up. A higher proportion of registered dietitians among all dietitians and the facilities in business for fewer years were negatively associated with care-need level deterioration only in the model excluding lost to follow-up. Conclusions:The present study could help identify residents who are at risk of care-need level deterioration, and could contribute to improvements in provider quality performance and enhance competence in the market. Geriatr Gerontol Int 2018; 18: 758-766.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Jin

Tamiya

Jeon

et al. 2018

Geriatrics Gerontology Int

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“…Originally, nursing homes were sampled using a stratified two-stage probability design, including primary strata of facility size and metropolitan area; data were collected using a computer-assisted personal interview combined with a self-administered mail survey of the NHA (National Center for Health Statistics, 2011). The NNHS has been used extensively to measure the relationships between nursing home organizational context, nurse staffing and quality of care and has demonstrated adequate data reliability and validity (Kang, Meng, & Miller, 2011; Krause, 2011; Luo et al, 2010; Tak, Sweeney, Alterman, Baron, & Calvert, 2010; Temple, Dobbs, & Andel, 2010). We downloaded the public-use files from the NNHS website for analysis.…”

Section: Methodsmentioning

confidence: 99%

Jurisdiction Over Nursing Care Systems in Nursing Homes

et al. 2012

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Background In the context of declining registered nurse (RN) staffing levels in nursing homes, professional nursing jurisdiction over nursing care systems may erode. Objectives The purpose of this study is to develop a typology of professional nursing jurisdiction in nursing homes in relation to characteristics of RN staffing, drawing upon Abbott's (1988) tasks and jurisdictions framework. Method The study was a cross-sectional, observational study using the 2004 National Nursing Home Survey (N=1,120 nursing homes). Latent class analysis tested whether RN staffing indicators differentiated facilities in a typology of RN jurisdiction, and compared classes on key organizational environment characteristics. Multiple logistic regression analysis related the emergent classes to presence or absence of specialty care programs in 8 clinical areas. Results Three classes of capacity for jurisdiction were identified, including ‘low capacity’ (41% of homes) with low probabilities of having any indicators of RN jurisdiction, ‘mixed capacity’ (26% of homes) with moderate to high probabilities of having higher RN education and staffing levels, and ‘high capacity’ (32% of homes) with moderate to high probabilities of having almost all indicators of RN jurisdiction. ‘High capacity’ homes were more likely to have specialty care programs relative to ‘low capacity’ homes; such homes were less likely to be chain-owned, and more likely to be larger, provide higher technical levels of patient care, have unionized nursing assistants, have a lower ratio of LPNs to RNs, and a higher education level of the administrator. Discussion Findings provide preliminary support for the theoretical framework as a starting point to move beyond extensive reliance on staffing levels and mix as indicators of quality. Further, findings indicate the importance of RN specialty certification.

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Impact of Voluntary Accreditation on Short-Stay Rehabilitative Measures in U.S. Nursing Homes

Wagner

McDonald

Castle

2013

Rehabilitation Nursing

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Rurality and Nursing Home Quality: Evidence From the 2004 National Nursing Home Survey

Cited by 30 publications

References 29 publications

Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Resident and facility characteristics associated with care‐need level deterioration in long‐term care welfare facilities in Japan

Jurisdiction Over Nursing Care Systems in Nursing Homes

Impact of Voluntary Accreditation on Short-Stay Rehabilitative Measures in U.S. Nursing Homes

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