Recently in Nursing Homes & Long Term Care Category

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.

Source: Charlene Harrington, Helen Carrillo, Brandee Woleslagle Blank, Department of Social and Behavioral Sciences, University of California, November 2009

This book presents calendar year data on nursing facilities, staffing, resident characteristics, and surveyor reports of quality deficiencies by state. These OSCAR data are from surveys collected by state agency surveyors on nursing facilities during the federal certification process during the calendar year.

Source: David Baer, Ellen O'Brien, AARP Public Policy Institute, Research Report, November 2009

From the summary:
To help make long-term care insurance more affordable, both federal and state governments provide tax subsidies for private long-term care insurance. This PPI research report describes federal and state tax subsidies for long-term care insurance, their value to taxpayers (by age and income), and where possible, their cost to federal and state governments.
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In Brief

Source: Matt Ozga, Paraprofessional Healthcare Institute (PHI), January 14, 2010

Supportive services workers who care for people with Medicaid in community-based residential care settings are not exempt from federal minimum wage and overtime requirements, confirmed a U.S. district court in Western Missouri.

The case of Solis v. Firstcall Staffing Solutions, Inc. (pdf) involved 10 developmentally disabled consumers sharing four dwellings in an Independence, MO, apartment complex. The employer, Firstcall Staffing Solutions, had argued that because the community-based care facility had been set up as individual apartments, it should be treated as the recipients' homes.

Source: Walter Leutz, Christine E. Bishop, and Lisa Dodson, The Gerontologist, published online Aug. 19, 2009
(subscription required)

From the Commonwealth Fund summary:
This Commonwealth Fund-supported study looks at a partnership that was formed between a New York City nursing home union and 40 nursing homes to help implement "person-centered care" at the facilities. Results showed an improvement in quality of life, with residents gaining more autonomy and privacy and many employees experiencing greater job satisfaction.

Source: Health Affairs, Volume 29, Number 1, January 2010
(subscription required)

Articles include:
Long-Term Care Legislation At Long Last?
John Iglehart

Long-Term Care: Who Gets It, Who Provides It, Who Pays, And How Much?
H. Stephen Kaye, Charlene Harrington, and Mitchell P. LaPlante

Medicare And Medicaid In Long-Term Care
Terence Ng, Charlene Harrington, and Martin Kitchener

Sizing Up The Market For Assisted Living
David G. Stevenson and David C. Grabowski

Lessons From Public Long-Term Care Insurance In Germany And Japan
John Creighton Campbell, Naoki Ikegami, and Mary Jo Gibson

Improving The Long-Term Care Workforce Serving Older Adults
Robyn Stone and Mary F. Harahan

And more

Source: Pamela Doty, Kevin J. Mahoney, and Mark Sciegaj, Health Affairs, Vol. 29 no. 1, 2010
(subscription required)

From the abstract:
Consumer-directed long-term care service programs give participants the flexibility they want, while reducing unmet need for home and community-based services and supports. States' efforts to expand such programs under Medicaid, including those supported by federal Cash and Counseling demonstration and evaluation grants, are often hindered by challenges related to costs, staffing and organizational issues, new infrastructure requirements, and resistance from stakeholders. Yet states have developed a number of successful strategies for overcoming these challenges, even in financially trying times. Their experiences offer valuable insights, guidance, and encouragement to other states contemplating consumer-directed service expansions.

Source: National Alliance for Caregiving in Collaboration with AARP; Funded by The MetLife Foundation, December 2009

From the summary:
Caregiving is still mostly a woman's job and many women are putting their career and financial futures on hold as they juggle part-time caregiving and full-time job requirements. This is the reality reported in Caregiving in the U.S. 2009, the most comprehensive examination to date of caregiving in America. The first national profile of caregivers, Family Caregiving in the U.S. was published in 1997, and an updated version of the study, Caregiving in the U.S., was reported in 2004.

The sweeping 2009 study of the legions of people caring for younger adults, older adults, and children with special needs reveals that 29 percent of the U.S. adult population, or 65.7 million people, are caregivers, including 31 percent of all households. These caregivers provide an average of 20 hours of care per week. The 2009 reports also begin to trend the findings from all three waves of the study.

Source: Steven P. Wallace, Valentine M. Villa, Lauren Smith, Delight E. Satter, Nadereh Pourat, D. Imelda Padilla-Frausto, Rosana Leos, Eva Durazo, A.E. (Ted) Benjamin, UCLA Center for Health Policy Research, October 2009

California was once a leader in innovating new ways to provide long-term care services that allow older adults and the disabled to remain safely in their homes as long as possible. In the early 1970s, for example, a San Francisco organization called On Lok innovated a comprehensive program that created an adult day health center and supportive in home services to allow seniors to remain out of nursing homes. By 1990 this model, now called the Program of All-inclusive Care for the Elderly (PACE), had been successfully replicated elsewhere and became a Medicare/Medicaid waiver program that is now available nationally (http://www.npaonline.org/website/article.asp?id=12). The state was also a laboratory for the development of the Social HMO, consumer directed home care services, and caregiver support services.

Hundreds of thousands of seniors are likely to lose some or all of the assistance they rely on to remain at home. Available program data suggest that budget cuts are not necessarily targeting the least disabled. Studies from other states document that such cuts increase emergency room, hospital and nursing home use. Experts from a range of organizations dealing with the elderly in California who served as key informants for this research concur that these are likely outcomes from California's budget cuts, along with increased stress on family caregivers (for those fortunate enough to have a family caregiver) and reduced jobs and benefits for paid caregivers. This report begins with a summary of the cuts and provides detailed discussions of how those cuts will impact the major programs and populations affected. It offers a summary of our key informant interviews on this topic as well as a summary of the published literature on the effectiveness of these types of programs. We end with a call for California to return to its past innovative spirit of designing new ways to help disabled older adults remain safely at home.
See also:
Policy Brief