Purpose of the Study: Two consumer-derived measures of nursing home quality that have been underutilized by researchers are consumer complaints to the state certification agency between inspections and complaints to the Long-Term Care Ombudsman Program. This article describes these complaints, considers facility-level predictors of complaints, and…

The continued undertreatment of pain at the end of life is a substantive public health problem that has not been resolved through increased public awareness, the issuance of clinical guidance for providers, or expanded organizational commitments. In this forum, we illuminate the role of public policies in promoting pain management. We review…

Purpose: The purpose of this research is twofold. The first purpose is to utilize a new methodology (Bayesian networks) for aggregating various quality indicators to measure the overall quality of care in nursing homes. The second is to provide new insight into the relationships that exist among various measures of quality and how such measures…

Purpose: This article reports on a study to identify "building blocks" for quality report cards for geriatric care. Its aim is to present (a) the results of the study and (b) the innovative step-by-step approach that was developed to arrive at these results. Design and Methods: We used Concept Mapping/Structured Conceptualization to…

Studied the quality of terminal care in 40 patients in an acute care facility and a chronic care facility. Minimial difficulty was observed in making the transition from active to comfort care. An evaluation method and a model of terminal care emphasizing improved communication and emotional support are proposed. (Author/JAC)

Purpose: A national quality report card for nursing homes, Nursing Home Compare, has been published since 2002. It has been shown to have some, albeit limited, positive impact on quality of care. The objective of this study was to test empirically the hypothesis that nursing homes have responded to the publication of the report by adopting cream…

Purpose: The Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality sponsored a nationwide study to evaluate the federal paid feeding assistant (PFA) regulation that allows nursing homes to hire single-task workers to provide feeding assistance to nursing home residents. Organizers designed the PFA regulation…

Interviewed 140 elderly medical patients and found that the measured 22 percent prevalence of mental impairment was not reflected in the patients' utilization of mental health services or in their presenting complaints to their physicians. Subsequent interviews with their physicians revealed inadequate recognition, diagnosis, and treatment of…

Assessed service utilization and cost impacts of a consolidated model of long-term care for functionally impaired elders. Compared to traditional long-term care, this model reduces hospital and nursing home stays, redistributes funds to broad range of community-based services, and reduces overall cost of long-term care. (Author/NRB)

Examines feasibility and effectiveness of implementing a directive education program called "Let Me Decide" to veterans living in Ontario. Discusses two methods used to evaluate implementation of the program. Reports that 97% of the veterans found the education process beneficial whether or not they completed the directives. (Author/JDM)

Purpose: Our objective in this study was to compare the quality of care provided under the Minnesota Senior Health Options (MSHO), a special program designed to serve dually eligible older persons, to care provided to controls who received fee-for-service Medicare and Medicaid managed care. Design and Methods: Two control groups were used; one was…

Describes the intervention approaches, clients groups, and impacts on use of Medicaid and Medicare reimbursed services for five demonstrations included in the national evaluation of community-based long-term care. Only one project produced significant reductions in nursing home use. Unlike other projects, it identified potential clients through…

Set of articles consisting of an introduction (Barbara Silverstone, et al.) and case study concerning drug misuse in the elderly, and six papers examining the case from the perspectives of clinical pharmacology (William Simonson); pharmacology (Peter Lamy); psychiatry (Charles Gaitz and Nancy Wilson); nursing (Delores Alford); social work (Janet…

Examines the relationship between ownership type and care offered in 424 old age institutions (OAIs). Analysis revealed that the nonprofit sector allocates more money for direct patient care and as higher staff-patient ratios than proprietary institutions. The results are discussed in relation to previous research. (JAC)

Explores relationship, if any, between level of regulatory intensity upon, and subsequent service delivery within, the hospital industry. Some service retrenchment may be desirable, particularly if fewer iatrogenic events occur. A look at prior efforts may prove beneficial before the United States initiates overall health care reform. (61…