Recently in Nursing Homes & Long Term Care Category

Source: Linda S. Noelker, et al., Public Policy & Aging Report, Winter/Spring 2010
(subscription required)

From a PHI abstract:
This article outlines the preliminary recommendations made by a panel of long-term care experts convened by the Benjamin Rose Institute on behalf of the Institute of Medicine. The panel was tasked with devising ways to strengthen the direct-care workforce. Some of the recommendations include: increasing the supply of direct-care workers by bolstering recruiting efforts; advocating for more intensive federal and state training requirements; and instituting higher standards of evaluation for direct-care workers.

Source: Courtney Burke, Barbara Stubblebine and Kelly Stengel, Nelson A. Rockefeller Institute of Government, The New York State Health Policy Research Center, August 2010

New York State's assumption of county Medicaid administration could reduce costs, but big savings will depend on improved administrative processes, according to this Institute report. The report examines differences in Medicaid nursing home eligibility denials among counties as an illustration of the challenges the state will face in taking over administration of Medicaid.
See also:
Press release

Source: James W. Fossett and Courtney E. Burke, Nelson A. Rockefeller Institute of Government, Health Policy Research Center, August 2010

Institute experts have applied an interactive measure that proves better at explaining wide variations in states' long-term care spending than individual measures analyzed in previous research. The index considers multiple factors, including coverage policies, nursing home payment rates and others. It may assist states in developing new policies to enhance care for elderly and disabled residents, while limiting costs.
See also:
Press release

Source: Paraprofessional Healthcare Institute (PHI), July 2010

From the summary:
A new PHI PolicyWorks analysis finds that a growing number of states report that personal and home care aides are receiving wages that put them at risk of poverty.

In 2009, 36 states reported average hourly wages that fell below 200 percent of the Federal Poverty Level, up from 32 states in 2008, according to the analysis reported in PHI's updated State Chart Book on Wages for Personal and Home Care Aides (pdf).

Wages below 200 percent of the federal poverty level ($10.42) are low enough to qualify workers for many state and federal public assistance programs.

Source: Susan Letvak, Christopher J. Ruhm, Geriatric Nursing, Volume 31, Issue 3, May 2010
(subscription required)

From the abstract:
Long-term care (LTC) facilities face many challenges, including retention of qualified and caring staff and maintaining high-quality care. In 2008, the Institute of Medicine (IOM) reported widespread consensus that there are insufficient numbers of competent licensed and direct care staff to manage, supervise, and deliver high-quality care to the elderly population. Although examples of excellence in nursing home care exist, average quality of care has remained persistently low, and little progress has been made to improve safety in LTC. The Nursing Home Reform Act (which was included in the 1987 Omnibus Budget Reconciliation Act) mandates minimum staffing levels in Medicare and Medicaid certified LTC facilities. Although research has documented the importance of adequate staffing for quality of care, little attention has been placed on the productivity of staff and how this may impact care. The purpose of this article is to discuss the issue of worker presenteeism (reduced productivity due to health problems) and how this may be affecting quality of resident care. Strategies for nurse managers to recognize and address presenteeism are also discussed.

Source: Genworth Financial, April 2010

From the summary:
Nearly two-thirds of people over age 65 will need long term care at home or through adult day health care, or care in an assisted living facility or nursing home. And while most people think of long term care as impacting only those in senior years, 40 percent of people currently receiving long term care services are ages 18 to 64.*

The 2010 Genworth Cost of Care Survey can help families evaluate options and cover the growing cost of long term care. For the seventh year, Genworth Financial has surveyed the cost of long term care across the U.S. to help Americans prudently plan for the potential cost of this type of care in their preferred location and setting. The most comprehensive study of its kind, Genworth's 2010 Cost of Care Survey, conducted by CareScout®, covers nearly 13,000 long term care providers in 436 regions nationwide.
See also:
- Key Findings
- Methodology
- Regions

Source: Candace Howes, Ph.D., Connecticut College, Published with Paraprofessional Healthcare Institute, May 2010

From the press release:
A new study released today by the Institute for Women's Policy Research (IWPR) and PHI concludes that reducing In Home Support Services (IHSS) in California will be costly for taxpayers. Currently, California's Medicaid long-term care program, which includes IHSS, places among the top five states in terms of coverage, balance between nursing home and home- and community-based care, and cost effectiveness.

The study, Costs and Benefits of IHSS for the Elderly and People with Disabilities: A California Case Study, by Dr. Candace Howes, Professor of Economics at Connecticut College, refutes findings of a January 21, 2010, report from California's Legislative Analyst's Office (LAO) on the fiscal impact of the IHSS program, which provides daily supports for seniors and people with disabilities. The study shows the LAO underestimated the increase in costs that will be borne by taxpayers if Governor Schwarzenegger's 2010-2011 budget proposal to reduce or eliminate IHSS services for 444,000 people were to be implemented. The IWPR-PHI study also shows that the state could achieve nearly equivalent savings and improve the quality of life for seniors and people with disabilities by shifting some of those who are in nursing homes into community care.

Source: Janice Heineman, Institute for the Future of Aging Services and the American Association of Homes and Services for the Aging, January 2010

A review of the literature and national professional association Web sites as well as attempts at personal communication with leaders of these same associations yielded little information about retention strategies and programs for long-term care professionals. Some research, although still very little, could be found in the literature about job satisfaction among professional long-term care staff and factors influencing their intention to stay in or leave their positions. Overall, however, there is a paucity of information to be found about strategies and/or programs aimed at retaining quality professional staff within the long- term care field. Moreover, anecdotal evidence and communication with leaders in the field indicate that the minimal literature and information to be found on retention strategies reflect a true lack of such strategies and not merely a lack of published information describing these strategies.

Due to the lack of defined and tested retention strategies and programs for professional long-term care staff, what follows is a summary of information and research pertaining to turnover and staffs' intentions to stay or leave. Section I presents research conducted on this topic by various groups and individuals. Section II summarizes the information, albeit minimal, uncovered on specific retention strategies and programs.

Source: Denise A. Tyler, Hye-Young Jung, Zhanlian Feng, Vincent Mor, The Gerontologist, published online: February 25, 2010
(subscription required)

From the abstract:
This report shows that the prevalence of CNA training programs within the nursing home setting dropped from 1997 to 2007. Consequently, aspiring CNAs are increasingly forced to seek outside training. The report describes two main problems with this scenario. First, it creates a disincentive to join the direct-care field, since CNAs must pay a larger share of their own training costs. Second, outside training programs are harder to monitor than training provided within nursing homes.

Source: Howard Gleckman, Commonwealth Fund, Volume 1368, February 17, 2010

From the summary:
Broad health care reform legislation being considered by Congress would effect a major change in the way the United States finances long-term care. This paper reviews the experiences of France, Germany, Japan, the Netherlands, and the United Kingdom, and highlights some of the lessons the United States can learn from each.