Category Archives: Nursing Homes & Long Term Care

Mental Health Care: Better, Not Best

Source: Health Affairs, Volume 28, Number 3, May/June 2009
(subscription required)

From the introduction:
Clearly,well beyond implementation of parity laws,much remains to be done to improve both treatment and quality of life for the mentally ill. Robert Drake and colleagues focus on Social Security Disability Insurance, since more than a quarter of adults on SSDI have a primary psychiatric impairment.Most want to work but are limited to no more than twenty hours a week–when the evidence suggests that “supported employment” would both save money and help them do better.

What’s more, many proposals now popping up as health reform initiatives could improve mental health treatment immeasurably. Comparative effectiveness research has already established that the older generic antipsychotics work as well as a class as the newer, branded, more expensive atypical ones. And steppedup quality improvement efforts, write Audrey Burnam and colleagues, could increase the effectiveness of mental health treatments provided to veterans.

This issue of Health Affairs focuses on mental health reform. Some of the articles include:

Better But Not Best: Recent Trends In The Well-Being Of The Mentally Ill
Sherry A. Glied and Richard G. Frank

Trends In Mental Health Cost Growth: An Expanded Role For Management?

Richard G. Frank, Howard H. Goldman, and Thomas G. McGuire

Implementing Mental Health Parity: The Challenge For Health Plans

Keith Dixon

The Changing Role Of The State Psychiatric Hospital

William H. Fisher, Jeffrey L. Geller, and John A. Pandiani

Mental Illness In Nursing Homes: Variations Across States

David C. Grabowski, Kelly A. Aschbrenner, Zhanlian Feng, and Vincent Mor

Starvation Diet: Coping With Shrinking Budgets In Publicly Funded Mental Health Services

Steve Bogira

2009 Genworth Cost of Care Survey

Source: Genworth Financial, April 2009

The Genworth Cost of Care Survey was the first to publish cost of care results across 90 regions, touching every state. This year, Genworth expands the scope of the survey to help families, public policy representatives, financial planners and advisors, and others answer the question “What is the cost of long term care in my area?” This year’s expanded cost of care survey will cover 331 regions across America, including research within most Metropolitan Statistical Areas (“MSAs”). See full explanation and results starting on page 165 of the 2009 Genworth Cost of Care Survey.
See also:
Interactive map

Across the States 2009: Profiles of Long-Term Care and Independent Living

Source: Ari N. Houser, Wendy Fox-Grage, Mary Jo Gibson, AARP Public Policy Institute, Research Report, March 2009

From the summary:
Across the States 2009: Profiles of Long-Term Care and Independent Living is the eighth edition of the AARP Public Policy Institute’s state long-term care reference report. Published approximately every two years, the Across the States series was developed to help inform policy discussions among public and private sector leaders in long-term care throughout the United States. Across the States 2009 presents comparable state-level and national data for more than 140 indicators, drawn together from a wide variety of sources into a single convenient reference. This publication presents the most up-to-date data available at the time of production, and is displayed in easy-to-use maps, graphics, tables, and state profiles.
See also:
Executive Summary

Complexity in Geriatric Home Healthcare

Source: Christopher Murtaugh, Timothy Peng, Annette Totten, Beth Costello, Stanley Moore, Hakan Aykan, Journal for Healthcare Quality, Volume 31 Issue 2, March/April 2009
(subscription required)

From the abstract:
The aging population and the associated rise in the prevalence of chronic conditions suggest that the home health population is increasingly complex and challenging to manage. The purpose of this study was to use national administrative data (Outcome and Assessment Information Set assessments of persons discharged in 2004 and 2005) to examine the clinical complexity of older adults admitted to home healthcare. Our descriptive analyses confirm that multiple chronic conditions and cognitive impairment are common and result in longer lengths of stay. The findings support the need for geriatric home healthcare practices that effectively address multiple morbidities and cognitive function.

Health Care Reform: Thinking Long-Term

Source: Courtney Burke, Nelson A. Rockefeller Institute of Government, Observations, March 2009

What can be done to reform long-term care? For decades, states have been experimenting with ways to improve its quality and reduce its costs. State innovations could serve as models for nationwide reforms. Here are some examples.

Implementing Change in Long-Term Care: A Practical Guide to Transformation

Source: Barbara Bowers, Kim Nolet, Tonya Roberts, and Sarah Esmond, Commonwealth Fund, April 2009

From the summary:
Implementing Change in Long-Term Care: A Practical Guide to Transformation is a manual for nursing home staff that offers evidence-based recommendations on preparing a nursing home to take the first steps toward clinical and cultural changes, as well as methods to implement and sustain those changes.

Long-Term Care: Options In An Era Of Health Reform

Source: Joshua M. Wiener, SCAN Foundation, April 2009

As President Barack Obama and Congress debate health care reform, it is important that long-term care be included. While not central to providing basic health insurance to all Americans, long-term care should be part of efforts to improve health care for all Americans. Contrary to widespread belief that long-term care affects only a small minority of the population, 69 percent of people turning age 65 will need long-term care before they die and a third of the population will spend some time in a nursing home. In thinking about the place of long-term care in the health reform debate, four factors are important:
– First, with the aging of the population, the number of older people with disabilities is sure to grow
– Second, the federal and state governments spend substantial amounts of money on long-term care.
– Third, not only do older people and younger persons with disabilities use expensive long-term care services, they have high acute care expenses related to their underlying chronic diseases.
– Fourth, the current long-term care financing and delivery system is broken.

Family Caregiving: Emerging Practices & Tools for Professionals

Source: Family Caregiver Alliance, April 2009

This database is here to bridge the research-to-practice gap and ensure that professionals working with families have access to meaningful and quality programs and services. It will assist researchers, program administrators, and practitioners identify successful and innovative programs, and also provide an understanding of what makes these programs successful. The aim of this repository is to:

*highlight fresh ideas from emerging practices
*promote adoption of practices informed by research
*foster innovation

Family Caregiving: Emerging Practices & Tools for Professionals is the first step towards the creation of an Innovations Clearinghouse on Family Caregiving of cutting edge programs and policies in caregiving and aging. This online Clearinghouse will evolve to include evidence based practices, advocacy efforts and public policies that offer meaningful solutions, strengthen the caregiving voice and support families in their caregiving role. It will also provide dynamic educational opportunities and online communities of a national scope for professionals.

The information here is grouped into two categories:
1. Promising and Innovative Programs across the US
2. Practical Tools & Resources

Medicaid and Long‐Term Care: New York Compared to 18 Other States

Source: New York Health Policy Research Center, February 2009

This report provides a comparative analysis of New York State versus 18 selected states on various items related to long‐term care (LTC) such as state demographics for the elderly (defined as persons over age 65), poverty level, spending on long‐term care, long‐term care policies and services, and quality of nursing home care. The report is designed to demonstrate how New York State may differ from other states and inform hypotheses about why New York spends more Medicaid dollars on long‐term care delivery relative to most other states. The report was written for the New York State Department of Health, with funding support from the New York State Health Foundation.

Preparedness Resources for Healthcare Facilities

Source: Centers for Disease Control and Prevention, 2009

The Centers for Disease Control have unveiled a new website, which “provides all-hazards resources intended for individuals at healthcare facilities tasked with ensuring that their facility is as prepared as possible for an emergency. The healthcare facilities targeted by this page include hospitals, long-term acute and chronic care facilities, outpatient clinics and urgent care facilities, physicians’ offices, and pediatric offices and hospitals.”