Current Workforce and Quality Challenges in New York State Nursing Homes

03/21/2023

• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Workforce Issues

Exploring the Criterion Validity of Pragmatic Person-Centered Care/Culture Change Measures

08/05/2022

Nursing homes (NHs) are required to provide person-centered care, efforts often folded into broader culture change initiatives. Despite the known benefits of culture change, it is difficult to measure. This study aims to assess the criterion validity of the Preferences for Everyday Living Inventory (PELI) Implementation Indicator with other culture change measures. Findings suggest that the PELI Implementation Indicator can be used as a pragmatic indicator of a community’s adoption of...

• Long-Term Care Policy and Financing
• Long-Term Care - Other

Presentation - Choosing Home Care Services

07/13/2022

When you are entrusted with finding home care services for you or a loved one, you may be faced with making some difficult decisions. Choosing the right type of home care service can put you at ease during such a challenging time. It may be difficult to choose, but many people reported having a greater quality of life and happiness with in-home care services. The goal is to set up the right home care service for you or your loved one and hope to bring you peace of mind.

• Caregiving/Families
• Home and Community Based Services
• Long-Term Care Decision Making

Applying Agile Methodology to Reengineer the Delivery of Person-Centered Care in a Nursing Home: A Case Study

06/15/2022

This study presents a road map for breaking down care processes, prioritizing, and implementing iterative plan, do, study, act cycles using Agile methodology to enhance group collaboration on quality improvement cycles, to achieve our goal of providing preference-based PCC. The ready availability of preference-based reporting was critical to quickly informing new staff on how to meet residents’ most important preferences. Based on lessons learned, this study describes a developmental approach...

• Long-Term Care - Other

The Stability of Nursing Home Residents Ratings of Importance of Recreation Preferences Over One Year

05/04/2022

The long-term stability of nursing home (NH) residents’ everyday preferences remains unknown. This study examined 1-year stability in reports of importance of 34-recreational activity preferences (8-MDS 3.0 Section F items; 26-Preferences for Everyday Living Inventory-NH items) by NH residents (N = 161). This study examined mean differences in demographic and clinical characteristics of residents for preferences showing the change. Importance ratings of preferences were highly stable over...

• Long-Term Care - Other

The Association Between Preference Satisfaction and Satisfaction with Overall Care for Nursing Home Residents

05/01/2022

The Centers for Medicare and Medicaid Services mandate the provision of person-centered care (PCC), but there is limited evidence on how PCC impacts nursing home (NH) residents’ care experiences. This study examined the relationship between n = 163 NH residents’ ratings of satisfaction with care related to their preferences and their satisfaction with overall care. Residents with higher preference satisfaction ratings reported significantly higher levels of satisfaction with overall care....

• Long-Term Care - Other

Examining Face Validity of Visual Stimuli Used in Preference Assessments for Older Adults With Communication Impairments

03/28/2022

Preference assessment is integral to person-centered treatment planning for older adults with communication impairments. There is a need to validate photographs used in preference assessment for this population. Therefore, this study aimed to establish preliminary face validity of photographs selected to enhance comprehension of questions from the Preferences for Everyday Living Inventory–Nursing Home (PELI-NH) and describe themes in older adults' recommendations for revising photographic...

• Cognitive/Communication Challenges
• Long-Term Care - Other

Presentation - Sleep & Dementia: Why Sleep Matters and How to Improve It

03/18/2022

2014 MGS alumna Julia Larimer presents a "One for the Ages" lunchtime presentation on "Sleep & Dementia: Why Sleep Matters and How to Improve It."

• Caregiving/Families
• Dementia
• Long-Term Care Facilities
• Presentations

Validation of the Chinese version of the resident satisfaction in long-term care facilities

02/08/2022

Accurate measurements of resident satisfaction in long-term care settings can provide administrators with valuable information to improve the quality of care. However, such assessment has been insufficient in long-term care facilities of China due to limited validated measuring instruments. We aim to translate and validate a Chinese version of the resident satisfaction assessment based upon the Ohio Long-term Care Resident Satisfaction Survey (OLCRSS).

• Long-Term Care Facilities
• Research Methods

A Rising Tide Lifts All Boats: Equitable Nursing Home Policy Through Implementation Science

01/17/2022

At the time of this writing, at least 186,000 nursing home (NH) residents and staff have succumbed to coronavirus disease 2019 (COVID-19; AARP, 2021), and countless others have suffered the mental anguish of limited visits from family and isolation. The massive gap between well-resourced NHs and NHs in poor communities, often made up of residents and employees who are people of color, is an unacceptable certainty in this country. These populations are already marginalized, usually across...

• Long-Term Care Policy and Financing

Preference importance ratings among African American and white nursing home residents

12/28/2021

The Preferences for Everyday Living Inventory (PELI-NH) assesses the psychosocial preferences of nursing home (NH) residents. This study explored the association of race with importance ratings of self-dominion preferences (i.e., preferences for control). Results showed African Americans were younger and more functionally impaired. After accounting for the effects of gender (female), age (younger), anxiety (greater), and functional impairment (less) with higher reports of importance of...

• Long-Term Care - Other
• Religion/Spirituality

"By the time she got sick it was just kind of too late": A qualitative study on advanced care planning among bereaved lesbian, gay, and bisexual older women

12/21/2021

This study explores the experiences of bereaved lesbian, gay, and bisexual (LGB) older women to understand perspectives regarding advance care planning communication between clinicians, patients, and dyads. Four main themes emerged from the transcripts, LGB older women: (1) experience unclear advance care planning communication and end-of-life care support from clinicians, (2) often avoid advance care planning discussions with spouse or partners, (3) lack of knowledge about palliative or...

• Caregiving/Families
• End-of-Life Ethics
• Long-Term Care Decision Making
• Long-Term Care - Other

Facility and family communication during the COVID-19 visit restriction: Early perspectives of family members

08/23/2021

This study implemented an online survey of family members or friends of residents in long-term care facilities (LTCFs) from April 28 to June 19, 2020, using convenience sampling. A total of 174 responses nationwide reported the types of communications used, frequency of communication and alternative visits, and whether respondents had peace of mind, would recommend the facility, or were considering removing the resident from the facility. The results of the hierarchical logistic regression...

• Care Management
• Caregiving/Families
• Long-Term Care Facilities
• Program Evaluation

Using Local Initiatives to Fund In-Home Services: Ohio Leads the Nation

06/01/2021

As a result of limitations in federal and state funding for nonmedical supportive services, some communities across 15 states are utilizing local funding sources to support aging services for older adults and/or their family or friend caregivers. Local funding sources include property tax levies, payroll, and sales taxes. This research brief explores how communities across Ohio utilize local funding and analyzes the differences in various approaches such as amount of revenue generated, service...

• Home and Community Based Services
• Long-Term Care Policy and Financing

Evaluating the implementation of a pragmatic person-centered communication tool for the nursing home setting: PAL Cards

05/31/2021

The purpose of this quality improvement project was to evaluate the implementation of a person-centered communication tool in nursing homes (NH). The Preferences for Activity and Leisure (PAL) Cards were developed to communicate residents’ preferences for activities across care team members. The intervention can assist nursing home providers in meeting PCC regulations and contribute to building relationships between residents, family, and staff.

• Long-Term Care Decision Making
• Long-Term Care Facilities
• Quality Assurance

"It's been a whole new world": Staff perceptions of implementing a person-centered communication intervention during the COVID-19 pandemic

05/01/2021

The coronavirus disease 2019 (COVID-19) has challenged the way nursing homes deliver person-centered care (PCC). Preferences for Activity and Leisure (PAL) Cards are a tool to communicate residents' important preferences to staff.

• Care Management
• Case Studies/ Qualitative Research
• Long-Term Care Facilities

Residential Care: An Emerging Sector of the Ohio System of Long-Term Services

03/01/2021

This report utilized data from the Biennial Survey of Long-Term Care Facilities to show the expansive growth of residential care facilities and assisted living in Ohio over the last couple decades. The report provides a general picture of facility characteristics, resident characteristics, memory care, staffing, and cost of care. Policy and practice implications are also shared.

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

The Older Adult Population of Greene County Ohio

02/01/2021

This report provides a socio-demographic snapshot of the older adult population of Greene County, Ohio to inform current and future programming of the Greene County Concil on Aging and address the future needs of older adults in Greene County.

• Demographics
• Long-Term Care Decision Making
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Quality Assurance

Family satisfaction: Differences between nursing homes and residential care facilities

11/22/2020

This study compared differences in overall family satisfaction, specific satisfaction domains, and correlates of satisfaction between nursing homes (NHs) and residential care facilities (RCFs), using data from the 2016 Ohio Long-Term Care Family Satisfaction Survey.

• Demographics
• Long-Term Care Decision Making
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Quality Assurance

Local initiatives to fund services for older Americans: A growing option for states

11/19/2020

This report is part of a series of promising practices and emerging innovations from the AARP Public Policy Institute 2020 LTSS State Scorecard. It describes the use of alternative funding strategies, such as local property tax levies, to address the growing need for programs to better serve older adults. It also examines how communities in three different states are utilizing local funding streams to support services for older adults.

• Aging Network
• Home and Community Based Services
• Long-Term Care Policy and Financing

Prevalence of COVID-19 in Ohio nursing homes: What's quality got to do with it?

10/11/2020

With nursing homes being hit hard by the COVID-19 pandemic, it is important to know whether facilities that have any cases, or those with particularly high caseloads, are different from nursing homes that do not have any reported cases. This analysis looked at the association between facility quality and the prevalence of COVID-19 in Ohio nursing homes.

• Long-Term Care Policy and Financing

End-of-Life Educational Needs of State Tested Nurse Aides in Ohio Long-Term Care Facilities

07/31/2020

This research brief shares the findings of a qualitative research study that solicited the opinions of current State Tested Nurse Aides (STNAs), registered nurses (RNs), and licensed practical nurses (LPNs) to gain an understanding of the culture of death and dying in long-term care and to assess the educational needs of STNAs in regards to end-of life care for residents in long-term care facilities.

• Case Studies/ Qualitative Research
• Education
• End-of-Life Ethics
• Long-Term Care - Other

Unmet and unimportant preferences among nursing home residents: What are key resident and facility indicators?

07/29/2020

The Preferences Assessment Tool (PAT) in the Minimum Data Set (MDS) 3.0 assesses 16 resident preferences for daily routines and activities. Although integrating important preferences into care planning is essential to provide person-centered care in nursing homes (NHs), preferences rated as important but unmet or unimportant may not receive much attention. This study aims to (1) identify the prevalence of unmet preferences and unimportant preferences, and (2) examine their associations with...

• Long-Term Care Facilities
• Quality Assurance
• Research Methods

Local initiatives to fund services for older Americans: Community recognition of the importance of social care

07/27/2020

Despite the growing proportion of older adults in the United States, federal and state funding for nonmedical supportive services remains limited. To meet increasing demand, some communities across the nation are exploring alternative funding sources for aging services. This article describes efforts to identify states where local funding is used to support aging services and the variety of local revenue streams used. Critical policy questions surrounding equity issues within and across states...

• Home and Community Based Services
• Long-Term Care Policy and Financing

Nursing home social work during COVID-19

07/10/2020

This letter highlights a few of the many challenges facing nursing home social services workers and departments during COVID-19 and highlights the ways that researchers can support practice colleagues at this difficult time, amplify their every-day efforts, and contribute to healing during this pandemic.

• Long-Term Care Facilities
• Workforce Issues

Medicaid nursing home policies and risk-adjusted rates of emergency department visits: Does rural location matter?

07/10/2020

Medicaid nursing home (NH) reimbursement rates and bed-hold policies have been shown to be associated with hospitalization of urban NH residents, but their relationships with emergency department (ED) visits, especially in rural NHs, remain unknown. This study explores the relationships of Medicaid NH policies with three NH quarterly risk-adjusted rates of ED use for long-stay residents and evaluates whether the associations differed by NHs' geographical locations.

• Long-Term Care Facilities

Changes over time in racial/ethnic differences in quality of life for nursing home residents: patterns within and between facilities

07/10/2020

The purpose of this study was to investigate trends in racial/ethnic differences in nursing home (NH) residents’ quality of life (QoL) and assess these patterns within and between facilities.

• Long-Term Care Facilities

Through the Montessori Looking-Glass: Barriers to Implementing a Montessori-Based Intervention

07/07/2020

Montessori methods are used with individuals with dementia to create meaningful, inclusive, failure-free activities that enhance quality of life. This research qualitatively explored the barriers to implementing a Montessori-based intervention for people living with dementia in a 24-hr memory care setting.

• Case Studies/ Qualitative Research
• Cognitive/Communication Challenges
• Dementia
• Long-Term Care Facilities
• Program Evaluation
• Workforce Issues

Primary care competition and quality of care: Empirical evidence from Medicare

07/06/2020

This paper explores the effects of primary care physician (PCP) practice competition on five distinct quality metrics directly tied to screening, follow-up care, and prescribing behavior under Medicare Part B.

• Long-Term Care Facilities

The family experience in long-term care during the COVID-19 visitation restriction

07/01/2020

This report provides results from an online survey of families with residents in long-term care settings during the COVID-19 suspension of visiting to facilities. Overall, despite the difficult situation, the majority of families had a positive view about the facility where their family or friend resided. Facilities played a critical role in helping families stay in touch; their communication strategies--or lack thereof-- were related to family perceptions about the facility.

• Caregiving/Families
• Long-Term Care Facilities

Policy does matter: Changing an unchangeable long-term services system

07/01/2020

Because long-term services policy is largely driven by state decisions, this study examines the impact of state-level changes on Ohio's long-term services system. Using longitudinal data collected over twenty-six years, this paper tracks system changes and documents the growth of in-home services, assisted living, and the increase in short-term institutional care.

• Long-Term Care Policy and Financing

Prevalence of COVID-19 in Ohio Nursing Homes

06/17/2020

This study examines the Prevalence of COVID-19 cases in Ohio nursing homes in the context of the Centers for Medicare and Medicaid Services (CMS) 5-star quality ratings. Data come from the June 3, 2020 Ohio Department of Health weekly report.

• Long-Term Care Facilities

Fast-track innovation: Area Agencies on Aging respond to the COVID-19 pandemic

06/09/2020

Millions of older Americans depend on services provided by Area Agencies on Aging to support their nutritional, social, and health needs. Social distancing requirements and the closure of congregate activities due to COVID-19 resulted in a rapid and dramatic shift in service delivery modes. Area Agencies on Aging were able to quickly pivot due to their long-standing expertise in community needs assessment and cross-sectoral partnerships. The federal Coronavirus relief measures also infused one...

• Aging and Developmental Disabilities
• Aging Network
• Home and Community Based Services
• Long-Term Care Policy and Financing

Does living in a higher proportion minority facility improve quality of life for racial/ethnic minority residents in nursing homes?

06/05/2020

The proportion of racial/ethnic minority older adults in nursing homes (NHs) has increased dramatically and will surpass the proportion of white adults by 2030. Yet, little is known about minority groups’ experiences related to the quality of life (QOL). QOL is a person-centered measure, capturing multiple aspects of well-being. NH quality has been commonly measured using clinical care indicators, but there is growing recognition for the need to include QOL. This study examines the role of...

• Long-Term Care Facilities

COVID-19 pandemic: Exacerbating racial/ethnic disparities in long-term services and supports

05/31/2020

What services are available and where racial and ethnic minorities receive long-term services and supports (LTSS) have resulted in a lower quality of care and life for racial/ethnic minority users. These disparities are only likely to worsen during the COVID-19 pandemic, as the pandemic has disproportionately affected racial and ethnic minority communities both in the rate of infection and virus-related mortality. By examining these disparities in the context of the pandemic, this article brings...

• Home and Community Based Services
• Long-Term Care - Other
• Workforce Issues

Quality concerns in nursing homes that serve large proportions of residents with serious mental illness

05/31/2020

Nursing homes (NHs) are serving greater proportions of residents with serious mental illness (SMI), and it is unclear whether this affects NH quality. This article analyzes the highest and lowest quartiles of NHs based on the proportion of residents with SMI and compare these NHs on facility characteristics, staffing, and quality stars.

• Long-Term Care Facilities
• Mental Health

Promising Practices in Adult Guardianship in Ohio

05/11/2020

This research brief highlights innovative strategies used by five Ohio counties to address common challenges in adult guardianship.

• Aging and Developmental Disabilities
• Care Management
• Legal/ Advocacy
• Long-Term Care Decision Making

Nursing home social services and post-acute care: Does more qualified staff improve behavioral symptoms and reduce antipsychotic drug use?

03/01/2020

An increasing number of post-acute care patients are admitted to skilled nursing facilities (SNFs) with behavioral symptoms such as wandering and rejecting care, which can interfere with care and place a patient at risk of social isolation or injury. This study examines whether increasing the qualifications of social service staff through using a greater proportion of qualified social workers (QSWs) instead of paraprofessionals improves patients' behavioral symptoms and reduces the use of...

• Long-Term Care Facilities
• Workforce Issues

Construction and validation of risk-adjusted rates of emergency department visits for long-stay nursing home residents

02/01/2020

Long-stay nursing home (NH) residents are at high risk of having emergency department (ED) visits, but current knowledge regarding risk-adjusted ED rates is limited. In this study, the authors calculated quarterly NH risk-adjusted ED rates from 2011 Q2 to 2013 Q3 national Medicare claims and Minimum Data Set data, validated these rates against Nursing Home Compare overall 5-star quality ratings, and examined their associations with hospitalization rates to provide a quality context.

• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Research Methods

A comparison of emergency preparedness policies by long-term care setting type in Ohio: Assisted living care settings lag behind nursing homes in key areas

01/01/2020

Skilled nursing facilities (SNFs) have received regulatory attention in relation to their emergency preparedness. Yet, assisted living settings (ALs) have not experienced such interest due to their classification as a state-regulated, home- and community-based service. However, the growth in the number of ALs and increased resident acuity levels suggest that existing disaster preparedness policies, and therefore, plans, lag behind those of SNFs. This study examined differences in emergency...

• Dementia
• Home and Community Based Services
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Long-Term Care - Other

Maybe You Can Go Home Again: Ohio's Strategy to Provide Long-Term Services and Supports for a Growing Older Population

01/01/2020

This report provides findings from a study of long-term services and supports utilization trends from 1993 to 2017. Information on nursing homes, residential care facilities, and PASSPORT is provided. Findings show that Ohio has made considerable progress in creating a more balanced system of residential and community long-term services and supports. However, the demographic changes faced in the future indicate that the state has even greater challenges ahead.

• Long-Term Care Policy and Financing

Quality of Care in Ohio's Skilled Nursing Facilities: How Are We Doing Compared to the Nation Overall?

01/01/2020

This research brief compares the quality of Ohio's nursing homes to the nation over three time periods from 2013 to 2017. The quality of Ohio's skilled nursing facilities improved over this time frame, but Ohio still has improvements to make.

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

Dedicated Memory Care Units in Ohio's Long-Term Services Settings: Structure and Practices

11/01/2019

This report provides information about memory care units in Ohio's nursing homes and residential care facilties. Findings are based on questions included in the Biennial Survey of Long-Term Care Facilities. Results include characteristics of residents, staffing and staff training, environmental amenities and care practices.

• Dementia
• Long-Term Care Facilities

Resident preferences and CNA empowerment: Testing validity and reliability of a culture change survey tool

10/29/2019

Culture change (CC) is an innovation to improve nursing home resident quality of life. Inconsistencies in how CC is measured make the interpretation of findings inconclusive. The purpose of this study is to determine the underlying factors of CC among Ohio nursing homes to extract the core essence of CC. Two valid and reliable scales to advance the measurement of CC are presented that can be used to explore both residents' preferences for care and CNA empowerment components as predictors or...

• Long-Term Care Decision Making
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Long-Term Care - Other
• Quality Assurance
• Research Methods

Social lives and cliques in senior housing communities

07/10/2019

A better understanding of social environments will benefit facilitation of social cultures within senior housing communities. Social cliques naturally form among groups of people, particularly those living in close proximity. Research has shown that often older adults experience stigma based upon their health status and are excluded from social groups. This study examined residents’ perceptions of life in senior housing, social stigma, and cliques.

• Long-Term Care - Other
• Psychology of Aging

Occupational licensing of social services and nursing home quality: A regression discontinuity approach

06/25/2019

Social service departments in nursing homes can be staff with either qualified social workers or unlicensed paraprofessionals. Using a federal regulation which requires nursing homes with 121+ beds to employ at least one full-time qualified social worker, this study used a regression discontinuity design to explore whether nursing homes just above the 121-bed threshold have social service departments with similar staffing levels and composition as just below the threshold.

• Business/Economics of Aging
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Long-Term Care - Other
• Workforce Issues

A preference-based model of care: An integrative theoretical model of the role of preferences in person-centered care

06/01/2019

This article proposes a theoretical model of person-centered care (PCC) entitled the Preference-Based Model of Care that integrates the Theory of Human Motivation, Self-determination Theory, the Competence-Press Model of person and environment fit, the Living Systems Framework, and the Broaden-and-Build theory of positive emotions to deepen our understanding of the processes through which preference-based care affects well-being among older adults receiving LTSS.

• Long-Term Care - Other

Ohio Person-Centered Staff Engagement Project Evaluation

06/01/2019

This report describes the Person-Centered Staff Engagement Project, funded by Resident Rights funds to the Ohio Department of Aging from the Ohio Department of Medicaid. The report describes participating nursing homes, activities, and evaluation results.

• Long-Term Care Facilities

"A bone of contention...": Perceived barriers and situational dependencies to food preferences of nursing home residents

05/27/2019

This study investigated barriers to fulfilling food preferences from nursing home (NH) residents’ perspectives, and the reasons preferences changed (situational dependencies).

• Case Studies/ Qualitative Research
• Long-Term Care Facilities
• Long-Term Care - Other

Implementation of the 2018 Ohio Nursing Home and Residential Care Facility Family Satisfaction Surveys

05/15/2019

In 2018, the Scripps Gerontology Center conducted the ninth biennial Ohio Nursing Home and the second Ohio Residential Care Facility Family Satisfaction Surveys under a contract to the Ohio Department of Aging. This report provides information about survey implementation, psychometric properties of the two survey tools, and overall statewide facility results. Copies of the tools and survey materials are included.

• Long-Term Care Facilities
• Research Methods

Care managing together: A review of the Aetna and Area Agency on Aging MyCare partnership in Ohio

05/01/2019

There is a growing interest in Medicaid managed long-term services and recent expansion legislation now allows Medicare Advantage plans to incorporate an array of community-based services into their benefit packages. This study was a first step in gaining a better understanding of the care management plan models used in the Ohio MyCare Demonstration, focusing on the Aetna unified care management model implemented in three regions of the state in partnership with three area agencies on aging...

• Home and Community Based Services
• Long-Term Care Policy and Financing
• Long-Term Care - Other

The impact of long-term care ombudsman presence on nursing home survey deficiencies

03/25/2019

This study examines whether deficiency outcomes from nursing home annual survey inspections vary with the presence of a long-term care ombudsman at the survey.

• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Quality Assurance

Impact of social service staffing on nursing home quality and resident outcomes

03/14/2019

Social service staff play a key role in nursing homes and are responsible for providing psychosocial services to residents and their families. This brief report highlights findings from several studies that utilized national data to examine social service staffing trends in nursing homes and how staffing levels and the qualifications of staff within social service departments affect quality and resident outcomes.

• Long-Term Care Facilities
• Long-Term Care - Other
• Workforce Issues

Association of health related quality of life domains with daytime sleepiness among elderly recipients of long-term services and supports

03/07/2019

Excessive daytime sleepiness (EDS) is prevalent in older adults; however, data are lacking that examine EDS across living environments. The aims of this secondary data analysis were to identify the prevalence and predictors of EDS among older adults receiving long-term services and supports (LTSS) in assisted living communities (ALCs), nursing homes (NHs), and the community.

• Health/Physical Activity
• Home and Community Based Services
• Long-Term Care Facilities
• Long-Term Care - Other
• Mental Health

The impact of nursing home residents' characteristics on ratings of importance of autonomy preferences in daily care over time

03/05/2019

This study examined the rate of change in reports of importance of 27 autonomy-related everyday preferences from the Preferences for Everyday Living Inventory over 3-months and the demographic and clinical characteristics associated with change for nursing home residents.

• Long-Term Care Facilities
• Long-Term Care - Other

Exploring preference fulfillment among older adults receiving long-term care: Consistency of satisfaction ratings

02/28/2019

This study sought to understand the consistency of ratings over a 3-day test-retest period for how satisfied long-term care recipients were with the fulfillment of important everyday preferences.

• Long-Term Care Facilities
• Long-Term Care - Other

Mapping core concepts of person-centered care in long-term services and supports

01/29/2019

This study used an empirical concept mapping approach to identify core components of person-centered care (PCC) used in long-term services and supports (LTSS). The aim is to help providers and researchers develop a unified set of domains that can be used to assess and improve the quality of PCC in real-world settings.

• Aging Network
• Long-Term Care - Other

It is not your parents' long-term services system: Nursing homes in a changing world

12/21/2018

The article argues that administrative and regulatory practices have not kept pace with the dramatic changes in how nursing homes are now being used in the long-term services system. Using detailed nursing home utilization data from the Minimum Data Set, this study tracks three cohorts of first-time nursing home admissions in Ohio from 1994 through 2014.

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

The change in nursing home residents' preferences over time

12/15/2018

This study examined the change in nursing home residents' (n = 255) preferences for everyday living over a 3-month period. Participants were recruited from 28 NHs in the suburbs of a major metropolitan East Coast area of the United States.

• Long-Term Care Facilities
• Long-Term Care - Other

Is the quality of nursing homes countercyclical? Evidence from 2001 through 2015

12/07/2018

This study examines whether nursing homes (NHs) provide better quality when unemployment rates rise (countercyclical) and explores mechanisms contributing to the relationship between quality and unemployment rates.

• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Workforce Issues

Private equity ownership and nursing home quality: An instrumental variable approach

10/24/2018

There is a concern that when private equity firms purchase nursing homes, they will lower quality of care in order to increase profits. Using an instrumental variable procedure to adjust for resident selection into nursing homes, this study explores whether private equity owned nursing homes lower quality of care for long-stay residents.

• Business/Economics of Aging
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Long-Term Care - Other

Workforce retention and wages in nursing homes: An analysis of managerial ownership

08/31/2018

Healthcare providers can be managed by salaried managers or owner-managers that have a significant equity stake in their facility. Using data on Ohio-based nursing homes from 2005 to 2015, this study examines whether salaried or owner-managed nursing homes have higher workforce retention and whether this is driven by differences in wage rates.

• Business/Economics of Aging
• Long-Term Care Facilities
• Long-Term Care - Other
• Workforce Issues

Family satisfaction with nursing home care: Findings and implications from two state comparison

08/17/2018

Most studies of family satisfaction are restricted to one state. This study compares the organizational and structural factors associated with higher family satisfaction in the states of Minnesota and Ohio.

• Long-Term Care Decision Making
• Long-Term Care Facilities

Functional status and adaptation: Measuring activities of daily living and device use in the national health and aging trends study

08/15/2018

This study compared Dr. Sidney Katz's original dichotomous measure of dependence in performing activities of daily living (ADL) with the National Health and Aging Trends Study's (NHATS) broader spectrum of functional status, demonstrating that many community-dwelling older adults can adapt to functional impairment rather than requiring assistance from another person in completing ADL.

• Health/Physical Activity
• Home and Community Based Services
• Long-Term Care - Other
• Products/Design/Planning for an Aging Society

The principal-agent problem and owner-managers: An instrumental variables application to nursing home quality

07/02/2018

This paper expands the literature on the heterogeneity among nursing home facilities by determining whether quality at for-profit nursing homes managed by owner-managers is different from those operated by salaried managers.

• Business/Economics of Aging
• Long-Term Care Facilities
• Long-Term Care - Other

Cost-effective adjustments to nursing home staffing to improve quality

06/08/2018

This study holistically examines which type of nursing home staffing (nursing, social service, activities) yields better quality as measured by number of deficiencies and deficiency scores.

• Business/Economics of Aging
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Long-Term Care - Other
• Workforce Issues

A machine learning recommender system to tailor preference assessments to enhance person-centered care among nursing home residents

05/21/2018

Nursing homes (NHs) using the Preferences for Everyday Living Inventory (PELI-NH) to assess important preferences and provide person-centered care find the number of items to be a barrier to using the assessment. With a sample of 255 NH resident responses to the PELI-NH, this study used the 16 preference items from the MDS 3.0 Section F to develop a machine learning recommender system to identify additional PELI-NH items that may be important to specific residents.

• Long-Term Care Facilities
• Long-Term Care - Other

The impact of nurse turnover on quality of care and mortality in nursing homes: Evidence from the great recession

05/02/2018

This paper uses a sample of California nursing homes to causally identify whether higher staff turnover leads to worse quality.

• Long-Term Care Facilities
• Long-Term Care - Other
• Workforce Issues

The impact of state nursing home bed relocation policy in Ohio

04/10/2018

As Ohio's population aged and shifted across county lines, an imbalance in the supply of nursing home beds to 65+ population has occurred. For example, in 2008 the ratio of nursing home beds to 65+ population varied from a high of 130 beds per 1,000 persons aged 65 and older in Holmes County to a low of 20 in Portage County. Faced with this disparity the Ohio legislation passed a law that allows controlled transfer of beds across counties. This brief report examines the impact of this...

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

Our Family, Our Way: A Family Communication and Care Coordination Guide for Aging Parents and their Adult Children

04/04/2018

This report highlights the development, implementation, and evaluation of a guide designed to facilitate family communication about care and support. The guide provides a structured format for talking about what's needed, happening, wanted, and possible in the care arrangement, culminating in a Shared Assessment and a Family Care and Support Plan.

• Caregiving/Families
• Home and Community Based Services
• Long-Term Care Decision Making

Delivering Person-Centered Care: Important preferences for recipients of long-term services and supports

02/05/2018

Although assessing individual consumer preferences is important first step in providing person-centered care, the purpose of this study was to identify the top 10 shared preferences that are important to a majority of consumers receiving long-term services and supports.

• Care Management
• Home and Community Based Services
• Long-Term Care Decision Making
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Long-Term Care - Other
• Quality Assurance

Cross-Sectoral Partnerships By Area Agencies On Aging: Associations With Health Care Use And Spending

02/01/2018

Cross-Sectoral Partnerships By Area Agencies On Aging: Associations With Health Care Use And Spending

• Aging Network
• Home and Community Based Services
• Long-Term Care Facilities
• Research Methods

A New Group of Medicaid Nursing Home Residents: The Unexpected Trend of Those Under age 65 Using Nursing Homes in Ohio

11/09/2017

Typically thought of as a long-term care option for older residents, the proportion of Ohio’s long-stay Medicaid nursing home residents under the age of 65 has tripled over the last 20 years.

• Long-Term Care Decision Making
• Long-Term Care Policy and Financing
• Mental Health

Ohio Guardianship, Guardians, and the Courts: Findings from a Survey of Adult Guardianship in Ohio

08/28/2017

This report highlights findings from a survey of the guardianship practices of Ohio’s probate courts. In a first of its kind survey, this study examined the challenges faced by the probate courts in managing guardianships, the resources used to support guardians and persons under guardianship, and the promising practices that have emerged as courts work to help persons under guardianship live a high-quality life and to help guardians be successful in executing their responsibilities.

• Aging and Developmental Disabilities
• Care Management
• Long-Term Care Decision Making

Implementation of the 2016 Ohio Nursing Home and Residential Care Facility Family Satisfaction Surveys

08/18/2017

This report summarizes the implementation process and results from the 2016 Family Satisfaction Surveys conducted in Ohio nursing homes and residential care facilities. Psychometric properties of the instruments and survey tools and materials are included.

• Long-Term Care - Other
• Research Methods

Policy Does Matter: Continued Progress in Providing Long-Term Services and Supports for Ohio's Older Population

08/17/2017

Policy Does Matter: Continued Progress in Providing Long-Term Services and Supports for Ohio's Older Population

• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Long-Term Care - Other

Family involvement in the nursing home and perceived resident quality of life

07/25/2017

This study focuses on the relationship between family involvement and family perceptions of nursing home residents’ quality of life (QOL).

• Caregiving/Families
• Long-Term Care Facilities

Managerial ownership in nursing homes: Staffing, quality, and financial performance

06/20/2017

This paper uses facility-level data to determine whether staffing levels, quality, and financial performance is different among nursing homes operated as a nonprofit, a for-profit with an owner-manager, and a for-profit with a salaried manager.

• Business/Economics of Aging
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Long-Term Care - Other

Quality of life trajectories of older adults living in senior housing

06/14/2017

Quality of life (QoL) in the face of declining health, mobility, and social losses is a central issue for older adults. This study examined changes in QoL over time for older adults residing in independent senior housing within continuing care retirement communities (CCRCs) and estimated how residents’ social engagement during their first year influenced QoL over the next 4 years.

• Long-Term Care Facilities
• Long-Term Care - Other
• Psychology of Aging

Using National Data to Examine the Quality of Care in Ohio's Skilled Nursing Facilities

05/08/2017

This study compares the quality of Ohio's skilled nursing facilities to the nation overall. Findings show that Ohio facilities had fewer inspection deficiencies, slightly lower direct care staffing rates, and on average lower quality outcomes on resident care.

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

Who hires social workers? Structural and contextual determinants of social service staffing in nursing homes

01/25/2017

Although nurse staffing has been extensively studied within nursing homes (NHs), social services has received less attention. The study describes how social service departments are organized in NHs and examines the structural characteristics of NHs and other macro-focused contextual factors that explain differences in social service staffing patterns using longitudinal national data (Certification and Survey Provider Enhanced Reports, 2009–2012).

• Long-Term Care Facilities
• Workforce Issues

How does rurality influence the staffing of social service departments in nursing homes?

01/10/2017

This paper examines how social service departments in nursing homes are staffed by rurality.

• Long-Term Care Facilities
• Workforce Issues

Multiple chronic conditions and hospitalizations among recipients of long-term services and supports

12/15/2016

Among older adults receiving long-term services and supports (LTSS), debilitating hospitalizations is a pervasive clinical and research problem. Multiple chronic conditions (MCCs) are prevalent in LTSS recipients. However, the combination of MCCs and diseases associated with hospitalizations of LTSS recipients is unclear. The purpose of this analysis was to determine the association between classes of MCCs in newly enrolled LTSS recipients and the number of hospitalizations over a 1-year period...

• Chronic Illness/ Disability
• Home and Community Based Services
• Long-Term Care - Other

Activities in dementia care: A comparative assessment of activity types

12/06/2016

This exploratory study compares the impact of five activity types on the well-being of institutionalized people with dementia: the intergenerational art program Opening Minds through Art, art and music therapies, creative activities, non-creative activities, and no activities at all. We validated the Scripps Modified Greater Cincinnati Chapter Well-Being Observational Tool, and used that instrument to systematically observe N?=?67 people with dementia as they participated in different activity...

• Arts and Aging
• Long-Term Care - Other

"Calm, satisfied, comforting": The experience and meaning of rabbit-assisted activities for older adults

11/28/2016

Animal-assisted activity programs are commonly used in long-term care facilities to enhance the well-being of older residents. Although research suggests that older adults benefit from these programs, little is known about the experience from the perspective of older adults themselves. In this qualitative study, we used direct observation and in-depth interviews to gain an understanding of the experience of participating in a unique rabbit-assisted activity program delivered in a Midwestern...

• Long-Term Care Facilities
• Products/Design/Planning for an Aging Society

The Residential Long-Term Care Role in Health Care Transitions

11/11/2016

The objective of the current study is to describe the activities long-term care facilities are undertaking to reduce hospital admissions and readmissions by working to improve health care transitions. The data were collected via an online survey from 888 nursing facilities (NFs) and 527 residential care facilities (RCFs) that completed the care integration module of the Ohio Biennial Survey of Long-Term Care. Questions focused on partnerships, current work, type of care model, and perceived...

• Long-Term Care Facilities

Expanding Self Direction and Its Impact on Quality

10/18/2016

The premise of this paper is that self-direction has impacted service and system design and approaches to quality. Admittedly, the system still strives to improve, but it has made major advances over the past two decades, and some of these important changes we believe were inspired by the development and expansion of self-direction.Public Policy Aging Report, 26 (4), 138-142. doi:https://doi.org/10.1093/ppar/prw022Publication available online, subscription may be required.

• Home and Community Based Services
• Long-Term Care Policy and Financing

Unpaid Caregivers: Growing Demand and Limited Supply

09/26/2016

Several recent studies indicate that the supply of informal caregivers is declining and this change in potential support could have major policy implications.

• Demographics
• Families/Caregiving
• Long-Term Care Policy and Financing
• Workforce Issues

Serving an Increasing Older Population with Severe Disability: Serious Challenges Await Ohio Over the Next Twenty Years

09/26/2016

Ohio faces a demographic and financing challenge as its population ages in the next 20 years. The number of people age 60 and older with a severe disability is projected to increase by 60% while the overall population growth will be at two percent.

• Demographics
• Long-Term Care Policy and Financing

Changes over time in emotional status among older adults new to receiving long-term services and supports

09/01/2016

This article examines the natural history of changes in emotional status as measured through emotional well-being and depressive symptoms over a two-year period among older adults new to long-term services and supports (LTSS). In-person interviews were conducted with 470 older adults within sixty days of entry into LTSS and then quarterly through twenty-four months. Multivariate generalized estimating equation models indicate improvements in emotional status, with depressive symptoms decreasing...

• Long-Term Care - Other
• Psychology of Aging

How Does Medicaid Reimbursement Impact Nursing Home Quality? The Effects of Small Anticipatory Changes

09/01/2016

In 2006, Ohio changed its Medicaid reimbursement methodology for nursing homes (NHs) to promote more efficient staffing levels. This study examines the impacts of this policy change on quality. We examine resident outcomes constructed from the Minimum Data Set, deficiency citations, staffing levels, and satisfaction scores for residents and families as measures of quality. Nursing homes in the group receiving increased reimbursement showed an increase in nursing and nursing aide staffing levels....

• Home and Community Based Services
• Long-Term Care Policy and Financing

Ohio's Nursing Home and Residential Care Facility Satisfaction: Survey Testing and Development for Residents and Families

04/30/2016

This report describes a project to update consumer surveys for residents and families in Ohio's nursing homes and residential care facilities. It also includes a newly created survey for families of residential care facility residents. Results include findings from focus groups, cognitive interviews, and a mailed pretest.

• Long-Term Care Facilities
• Research Methods

Honoring nursing home resident preferences for recreational activities to advance person-centered care

02/16/2016

Nursing homes are embracing person-centered care, an approach that emphasizes “knowing the person” and honoring each individual’s preferences. As providers shift toward person-centered care, they need timely, efficient tools and methods to gauge whether they are meeting consumer preferences and to identify areas in need of improvement. The Preference Match Tracker is a new tool that measures alignment between resident preferences and recreational activities. The Preference Match Tracker can...

• Care Management
• Long-Term Care Facilities

Opening Minds through Art For One (OMA41): Direct Care Workers and Volunteers as Creative Arts Facilitators of Older Adults

01/30/2016

This brief describes the pilot implementation and evaluation of OMA For One (OMA41). OMA41 is an adaptation of Opening Minds through Art (OMA), a visual arts program for elders with cognitive impairments. OMA41 is conducted one on one, rather than in a group setting and uses direct care workers or volunteers as facilitators.

• Aging and Developmental Disabilities
• Arts and Aging
• Families/Caregiving
• Home and Community Based Services
• Long-Term Care - Other

Factors associated with changes in perceived quality of life among elderly recipients of long-term services and supports

01/01/2016

The objective is to advance knowledge about changes in multiple dimensions of health related quality of life (HRQoL) among older adults receiving long-term services and supports (LTSS) over time and across settings. Findings advance knowledge regarding what is arguably the most important outcome of elderly LTSS recipients: quality of life. Understanding associations between multiple HRQoL domains and quality of life over time and directly from LTSS recipients represents a critical step in...

• Home and Community Based Services
• Long-Term Care Facilities

Are Ohio's Nursing Homes Ready for an Emergency?

12/22/2015

Study Identifies Strengths, Leads to Strategies for Improvement in Ohio Nursing Home Disaster PlanningOn any given day in Ohio's nursing homes, there are nearly 78,000 residents with physical or cognitive impairments. This means that nursing homes may be vulnerable during emergencies that require either evacuation or necessitate sheltering in place. A module regarding preparedness and planning in Ohio nursing homes was included in the 2013 Biennial Long-term Care Survey administered by the...

• Aging Network
• Long-Term Care Facilities

Factors Associated with Changes in Perceived Quality of Life Among Elderly Recipients of Long-Term Services and Supports

09/26/2015

The study is based on a prospective, observational, longitudinal cohort design, with 470 older adults from nursing homes, assisted living facilities and community as participants. Single-item quality-of-life measure assessed every 3 months over 2 years. Health related quality of life (HRQoL) domains of emotional status, functional status, and social support were measured using standardized instruments. Findings advance knowledge regarding what is arguably the most important outcome of elderly...

• Home and Community Based Services
• Long-Term Care - Other
• Research Methods

Implementation of the 2014 Ohio Nursing Home Family Satisfaction Survey

09/22/2015

In 2014 the Scripps Gerontology Center conducted the 7th biennial Ohio Nursing Home Family Satisfaction Survey under a contract with the Ohio Dept. of Aging.  This year the survey had 947 facilities--the same number as in 2012--representing 98% of Ohio's nursing homes and 23, 639 families.  Information about the survey process, psychometric analyses of the survey, and recommendations for future implementation are included.Full Report (471.0Kb)

• Long-Term Care Facilities
• Research Methods

The Role of the Family in Nursing Homes: Recommendations to Increase Family Satisfaction with Care

09/22/2015

Families are important consumers of long-term care services who are likely to remain involved in the care of their resident loved one after placement.  The aims of this brief report are (1) to increase the understanding of the role of family members in long-term care facilities in Ohio, (2) to examine the resident, family member, and facility characteristics that are associated with higher family satisfaction, and (3) to propose strategies to improve family satisfaction.Research Brief (225.7Kb)

• Long-Term Care Facilities
• Long-Term Care - Other

Neighborhood Assistants Pilot: A Program Evaluation of Person-Centered Staffing

07/28/2015

The purpose of this study was to pilot test and evaluate an innovative staffing approach called the Neighborhood Assistant (NA) at the Francis E. Parker Memorial Home.  The goal of the program was to support the certified nursing assistants by empowering them to partner with the NA to regain person-centered moments with residents.  To evaluate the pilot testing of this program, a pre- and post-implementation evaluation was conducted that included employee observations, focus groups,...

• Case Studies/ Qualitative Research
• Long-Term Care Decision Making
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Workforce Issues

Predictors of adult education program satisfaction in urban community-dwelling older adults

07/16/2015

Lifelong learning is receiving greater attention due to population aging in modern societies. Lifelong learning benefits individuals by supporting their physical, psychological, social, and economic well-being. However, older adults generally have lower motivation for learning than younger adults, and facilitating long-term participation in learning activities is still challenging. Results from proportional odds ordinal logistic regression analysis demonstrated that gender, number of household...

• Education
• Long-Term Care Facilities

The Road to Balance: Two Decades of Progress in Providing Long-Term Services and Supports for Ohio's Older Population

06/15/2015

This report documents two decades of progress in delivering long-term services in Ohio. In 1992, more than nine of the 10 older people in Ohio supported by Medicaid were in nursing homes. Today, the ratio is approaching 50/50. This study, now in its 22nd year, is designed to provide Ohio policy makers, providers and consumers with the information needed to make good decisions in an effort to ensure that Ohio has an efficient and effective long-term services and supports systemFull Report (PDF -...

• Aging Network
• Home and Community Based Services
• Long-Term Care Decision Making
• Long-Term Care Facilities
• Long-Term Care - Other

How Does Medicaid Reimbursement Impact the Quality of Ohio Nursing Homes?

05/20/2015

Study examines the changes in Medicaid nursing home reimbursement between 2007 and 2012 as Ohio moved to a "new price system". Findings showed that the quality of Ohio nursing homes did not change as a result of the system reimbursement changes.

• Long-Term Care Policy and Financing

Long-term services and supports (LTSS): A growing challenge for an aging America

04/29/2015

Because most Americans do not plan for the likelihood that we will need formal assistance because of a disability, many end up using the public assistance Medicaid program as the safety net for LTSS. The breadth and depth of issues surrounding LTSS, the number of individuals and families that will need LTSS both now and in the future, and the implications that this system will have on private and public resources suggests that the White House Conference on Aging, the Public, the Administration,...

• Legal/ Advocacy
• Long-Term Care Policy and Financing

"Make me feel at ease and at home" Differential care preferences of nursing home residents

04/15/2015

Assessing and honoring older adults’ preferences is a fundamental step in providing person-centered care in long-term care facilities. Researchers and practitioners have begun to develop measures to assess nursing home (NH) residents’ everyday preferences. However, little is known about how residents interpret and conceptualize their preferences and what specific clinical response may be needed to balance health and safety concerns with preferences. Results contribute to an emergent body of...

• Care Management
• Long-Term Care Facilities

Describing and Assessing Leadership for Person-Centered Care: Final Project Report

01/22/2015

This report provides brief highlights from a study of leadership in nursing homes with a person-centered or traditional approach to care.PDF(214.5Kb)

• Long-Term Care Decision Making

Long-Term Care Management Turns 40: What We Know and What We Don’t

09/02/2014

This article focuses on care management with older people experiencing chronic disability. Care management, including a systematic assessment, arrangement and coordination of services, and monitoring the quality of the consumer experiences, has become a core element of the home and community-based delivery system. In addition, private care management has developed for individuals and families who have the necessary income to purchase their own services, but who still need assistance in...

• Care Management
• Chronic Illness/ Disability
• Home and Community Based Services
• Long-Term Care Decision Making

It makes me feel like myself Person-centered versus traditional visual arts activities for people with dementia

07/21/2014

During February 2010 and April 2011, video data on people with dementia were collected during a person-centered and intergenerational arts activity program called Opening Minds through Art (OMA) at three different long-term care facilities in Ohio. A modified version of the Greater Cincinnati Chapter Well-Being Observation Tool was used to code the intensity and frequency of observed domains of well-being and ill-being.

• Arts and Aging
• Long-Term Care - Other
• Mental Health

The Nursing Home Five Star Rating: How does it compare to resident and family views of care?

05/21/2014

In 2008, the Centers for Medicare and Medicaid Services (CMS) implemented a five-star rating system of nursing homes in the United States. These star ratings have been widely publicized both by CMS and the national and state media. Although the components of the star rating system take into account various dimensions of quality, satisfaction of nursing home residents and their families is not taken into consideration. The current study compares the CMS star rating system to nursing home...

• Care Management
• Long-Term Care Facilities

Ohio's Nursing Homes and Residential Care Facilities in the Economic Downturn: How Have They Adjusted?

04/30/2014

Long-term care facilities have been impacted by the economic downturn and other changes in the long-term care system. This research brief describes strategies most often implemented by Ohio's nursing homes and residential care facilities to enhance economic prospects.Research Brief -  (PDF 425KB)

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

Everyone’s Talking About It, But Does It Work?

10/16/2013

In response to increasing Medicaid expenditures and consumer preferences, states are reforming their long-term care systems to provide more community-based services. One popular reform is renewed efforts to prevent unnecessary long-term nursing home placement (diversion) and to provide nursing home residents an opportunity to return to the community (transition). This research tracked outcomes for consumers and evaluated the implementation of the new program. An agency-level process analysis...

• Business/Economics of Aging
• Home and Community Based Services
• Long-Term Care Decision Making

Influence of Late Life Stressors on the Decisions of Older Women to Relocate into Congregate Senior Housing

10/01/2013

The primary aim of this study is to elucidate the push-pull factors associated with moving into congregate senior housing. The secondary aim is to investigate the decision-making processes and stresses associated with moving into a congregate living environment. Interviews were conducted with 26 women who were new residents in congregate senior housing. Relocation, as expected, was considered to be stressful although individual differences were found among perceptions of relocation stresses....

• Long-Term Care Facilities
• Psychology of Aging

Maybe Elephants Can Dance: Two Decades of Progress in Delivering Long-Term Services and Supports in Ohio

07/31/2013

This longitudinal study, initiated by the General Assembly in 1993 and continuously funded by the Ohio Department of Aging, tracks how long-term utilization has changed over the past two decades in the state of Ohio.Full Report (PDF 1.5MB)Research Brief (PDF 442KB)

• Long-Term Care Policy and Financing

Integrated Care and the Aging Network: The Next Frontier or the End of an Era?

07/01/2013

The strong push to integrate Medicare and Medicaid services has been driven by the federal government through the Centers for Medicare & Medicaid Services, and by states, in response to two major system concerns: quality and cost. But nationwide system change has been slow and inconsistent. This article lays out the many issues that have come forward as the aging services industry experiences this change. Much about how healthcare is delivered in our nation is yet to be determined: the...

• Aging Network
• Business/Economics of Aging
• Legal/ Advocacy
• Long-Term Care Policy and Financing

Leveraging Resources between the Senior Community Service Employment Program and the Long-Term Care Ombudsman Program

06/28/2013

The project sought to determine the role the Senior Community Service Employment Program (SCSEP) might play in supporting the Long-Term Care Ombudsman program in their expanded role in the HOME Choice transitions program. This report describes potential responsibilities of the SCSEP program participant and suggested training to carry out those duties. Full Report (PDF 1.8MB)

• Home and Community Based Services
• Long-Term Care - Other
• Workforce Issues

Childless Elders in Assisted Living: Findings from the Maryland Assisted Living Study

04/10/2013

We compared data drawn from a random sample of 399 current assisted living (AL) residents and a subsample of 222 newly admitted residents for two groups: childless AL residents and AL residents with children. The percentage of childless AL residents (26%) in our study was slightly higher than US population estimates of childless persons age 65 and over (20%). In the overall sample, the two groups differed significantly by age, race and women’s years of education. The childless group was...

• Demographics
• Families/Caregiving
• Long-Term Care - Other

International Approaches to Long-term Services and Supports

04/02/2013

For older adults who may experience significant disability from injury or disease, the daily activities present challenges that may require ongoing assistance from family members, friends, or a formal care service provider. Longterm services and supports enable those who need continual help because of physical, cognitive, or developmental disabilities to accomplish the necessary tasks of daily living.Generations, Spring 2013, pgs. 59-65.Publication available online, subscription may be required.

• Global Aging
• Long-Term Care Policy and Financing

Delivering Long-Term Services to Ohio Elders: Good Progress, But Challenges Await

03/30/2013

*An earlier version of this report contained an error. This error has been corrected and a new report was posted on 07/16/2013.Research Brief (PDF 450KB)

• Long-Term Care Policy and Financing

Implementation of the 2012 Ohio Nursing Home Family Satisfaction Survey

03/01/2013

In 2012, the Scripps Gerontology Center conducted the sixth biennial Ohio Nursing Home Family Satisfaction Survey under a contract to the Ohio Department of Aging. The 2012 survey had the largest number of facilities participating at 99% and over 27,000 family and friends responding. Numerous changes were implemented, most importantly a process that no longer requires nursing homes to distribute surveys to family members.The report includes information about the survey process, psychometric...

• Long-Term Care - Other

Evaluation of Ohio's Program of All Inclusive Care for the Elderly (PACE)

10/08/2012

In 2011, the Ohio Legislature asked the Scripps Gerontology Center to evaluate Ohio's two PACE sites and make recommendations for further expansion.Full Report (PDF 1.4MB)Research Brief (PDF 334KB)

• Long-Term Care Policy and Financing

Ohio Long-Term Services and Supports Factbook

01/16/2012

This factbook provides a broad overview of Ohio's system of long-term services and supports. Numerous charts provide descriptions of those who use services, kinds of services, payment systems and other topics. It is designed to be reference and resource guide.Factbook (PDF 6MB)

• Long-Term Care - Other

Coming of Age: Tracking the Progress and Challenges of Delivering Long-Term Services and Supports in Ohio

06/07/2011

In a 16 year tracking of utilization trends for institutional and home and community-based services, we learned that Ohio has made considerable change in its approach to delivering and funding long-term care services. The main finding revealed that now more than four in ten older people with severe disability on Medicaid received assistance in a non-institutional setting.Full Report (PDF 523KB)Research Brief (PDF 2.7MB)

• Home and Community Based Services
• Long-Term Care Facilities
• Long-Term Care Policy and Financing
• Long-Term Care - Other

Implementation of the 2010 Ohio Nursing Home Family Satisfaction Survey: Final Report

03/01/2011

In 2010, the Scripps Gerontology Center conducted the fifth biennial Ohio Nursing Home Family Satisfaction Survey under a contract to the Ohio Department of Aging. This year the survey had the largest number of family response ever, with 97% of facilities participating and nearly 30,000 involved family and friends responding. An online version of the family survey was also made available for the first time. The report includes information about the survey process, psychometric analysis of the...

• Long-Term Care Facilities

Criminal Offenders in Ohio Nursing Homes: Facility Practices, Prevalance, Problems

01/30/2011

This brief report presents findings from the 2009 Ohio Biennial Survey of Nursing Facilities. Nursing home respondents answered a brief series of questions about practices related to prospective residents with criminal backgrounds and current residents with violent or sex offender backgrounds.Research Brief (PDF 609KB)

• Long-Term Care - Other

Locally Funded Services for the Older Population: A Description of Senior-Service Property-Tax Levies in Ohio

01/01/2011

*If you downloaded the full report "Locally Funded Services for the Older Population: A Description of Senior-Service Property-Tax Levies in Ohio" prior to March 13 at 1:30 p.m. THERE WAS AN ERROR IN TABLE 1: Carrol County's 'Per Capita' levy amount should have been $24 not $245. The error has been corrected and you may download it below by clicking "Download Full Report (PDF 28 pages)".Updated 07/09/2012: Full report corrected to show the levy passage date in Washington county as 2001.Full...

• Home and Community Based Services
• Long-Term Care Policy and Financing

A Review of Ohio's Nursing Home Certificate of Need Program: Implications for Practice and Policy

12/01/2010

One of the critical questions states like Ohio face as they plan for an aging population involves estimates about the optimum number of nursing homes that will be needed in the future. Using a novel geographic information systems (GIS) approach, this report reviews Ohio's nursing home certificate of need (CON) and provides recommendations for state policy makers and the nursing home industry about the CON legislation.Research Brief (PDF 7.1MB)

• Long-Term Care Policy and Financing

Opening Minds Through Art (OMA) at Colonial: Berkeley Square and Westover

06/09/2010

This report covers activity from the start of implementation to the end of the first OMA term in May 2010. It includes a description of the details of OMA activities at Colonial, and summaries of quantitative and qualitative evaluations that assess the impact of the OMA program.Full Report (PDF 773KB)

• Arts and Aging
• Education
• Long-Term Care - Other

Enriching Now with Then: Connecting Nursing Home Residents and Nursing Home Staff Through Oral History

01/26/2010

This study was funded in part by the Ohio Long-Term Care Research Project through the support of the Ohio Board of Regents. We are grateful to AARP Ohio for their contribution toward report production.Full Report (PDF 9MB)Research Brief (PDF 527.8KB)

• Case Studies/ Qualitative Research
• Long-Term Care Facilities

Disability in Ohio: Managing The Projected Need for Long-Term Services and Supports

01/18/2010

This report examines Ohio's projected long-term care needs and its implications for the state budget. In an effort to contain Medicaid long-term care expenditures several ways that demand for services and supports could be reduced or redirected to home and community based care examined.Full Report (PDF 284KB)Research Brief (PDF 378KB)

• Business/Economics of Aging
• Long-Term Care Policy and Financing

Pandemic Influenza Preparedness in Licensed Nursing Homes and Residential Care Facilities in Ohio

12/09/2009

The purpose of this study was to determine the extent of influenza pandemic preparedness in nursing homes and other residential care facilities in Ohio. The majority of nursing homes and other residential care facilities are planning for pandemic influenza and are positioned to deal with it if necessary.Research Brief (PDF 419KB)

• Long-Term Care Facilities

Technology in Ohio Nursing Homes: A Report on the State of the Art

07/15/2009

This report examines the use of information technology in Ohio nursing homes. Key findings indicate that despite the known benefits that information technology holds for resident care, fewer than half of Ohio's nursing homes are making even moderate use of that technology.Research Brief (PDF 1MB)

• Long-Term Care Facilities

Disability in Ohio: Long-Term Care Providers and Programs

06/28/2009

To obtain information concerning the cost and to order printed copies of the full report, contact Scripps Gerontology Center at: 513/529-2914 or scripps@miamioh.edu. 

• Aging and Developmental Disabilities
• Home and Community Based Services
• Long-Term Care Facilities
• Long-Term Care - Other

An Assessment of Long-Term Care Service and Support Needs and Utilization in the TriHealth SeniorLink Region and Concordia Care Region

06/04/2009

These reports project the potential needs for long-term care services and supports in the two regions of the state of Ohio where the two Programs for All-inclusive Care for theElderly(PACE) operate. An examination of the current availability of providers and programs in each region, their utilization patterns and the characteristics of the consumers that they serve is the focal point of this study. Each PACE site operates in a region with a unique population; a comparison of the characteristics...

• Long-Term Care Facilities
• Long-Term Care - Other

Providing Long-Term Services and Supports to an Aging Ohio: Progress and Challenges

05/03/2009

This report details trends in Ohio long-term care service utilization over 14 years. It also provides information about the characteristics of those in different settings such as PASSPORT, nursing homes, and residential care facilities. Recommendations for Ohio’s long-term care system are included.Full Report (PDF 250KB)Research Brief (PDF 325KB)

• Home and Community Based Services
• Long-Term Care Policy and Financing
• Long-Term Care - Other

An Evaluation of the Assisted Living Medicaid Waiver Program

03/26/2009

This research project evaluates the state’s experiences in the implementation of the Ohio Assisted Living Medicaid Waiver Program. We present a profile of assisted living waiver participants and review the state’s enrollment tracking process. Further, we present findings on the satisfaction of waiver participants, analyses of the program’s Medicaid costs and overall program design, issues faced in the implementation of the program based on a qualitative assessment with potential residents...

• Long-Term Care Facilities

Implementation of the 2008 Ohio Nursing Home Family Satisfaction Survey: Final Report

03/02/2009

Refinements to the survey instrument showed continued high reliability of domain areas and the instrument as a whole. Changes in instructions to families, and a number of processes were changed this year that resulted in fewer family and facility calls requesting assistance from the toll-free hotline. Comparisons of 2006 and 2008 responses show some significant improvements statewide, with more items showing statewide averages of 90 and above.The family satisfaction survey is one important...

• Long-Term Care Facilities
• Research Methods

Aging and Long-Term Care Issues in Ohio

02/02/2009

This summary report focuses on aging and disability in Ohio as well as on utilization and Medicaid costs of long-term care for older Ohioans.Brief Report (PDF 500KB)

• Demographics
• Long-Term Care Policy and Financing

Disability in Ohio: Long-Term Care Providers and Programs

01/28/2009

This report describes the range of options used in Ohio’s long-term care system. For each provider or program, we report the eligibility requirements, consumer characteristics, capacity, utilization rate, average monthly cost of care, and major payers for services. The programs and providers include Medicaid waiver programs, nursing facilities, adult day service providers, residential care or assisted living facilities, intermediate care facilities for persons with mental retardation, and...

• Aging and Developmental Disabilities
• Home and Community Based Services
• Long-Term Care Facilities
• Long-Term Care - Other

Worker Injuries and Safety Equipment in Ohio Nursing Homes

11/16/2008

A survey of nursing homes was conducted in 2006 to evaluate a number of facility-specific characteristics including worker injury rates. The nursing home worker injury rate was 6.6 per 100 workers with higher injury rates observed in larger facilities, homes that were part of chains and homes with a higher proportion of wheelchair bound residents. A broad range of patient-transfer safety equipment was observed to be in use; however, the presence of these devices were not predictive of lower...

• Long-Term Care Facilities

Enhancing the Performance of Local Long-Term Care Ombudsman Programs in Ohio Chartbook

06/17/2008

This is a state-level case-study of the performance of local Long-Term Care Ombudsman Programs in Ohio. In surveying all of the local program directors in Ohio, along with a group of key informants, we identify major strengths and challenges the program is likely to face in the future. Funding and staffing emerge as prominent issues, particularly in determining the longer-term educational and advocay roles these programs ideally fulfill.This study was funded by the Cleveland Foundation.Chartbook...

• Education
• Long-Term Care Facilities

Disability in Ohio: Current and Future Demand for Services

04/20/2008

In an effort to project the size of Ohio’s Medicaid long-term care expenditures between now and the year 2020, this report first projected the size of the population with severe physical and/or cognitive, intellectual and/or developmental, and mental illness disabilities. Then, assuming different rates of medical and long-term care inflations the author projected both the total Medicaid and Medicaid long-term care expenditures.Full Report (PDF 582KB)Research Brief (PDF 350KB)

• Business/Economics of Aging
• Demographics
• Long-Term Care Policy and Financing

Access to Long-Term Care Services

04/02/2008

Enabling consumers to remain in their own homes through the provision of home and community-based long-term care; Empowering consumers to stay active and healthy through disease prevention and health promotion services; Streamlining access to home and community-based services; and Enhancing organizational capacity of the aging network for home and community-based long-term care systems. This research brief provides key findings from the assessment as they relate to four topics: Current Status...

• Long-Term Care - Other

Evolution of the Aging Network: Modernization and Long-Term Care Initiatives

03/11/2008

This article examines how the aging network has evolved since its inception, mandated by the Older Americans Act of 1965. It explores the broadened mission of the network and the progress being made to modernize long-term care. The article also includes findings from a national survey of area agencies on aging (conducted through a partnership between the National Association of Area Agencies on Aging and the Scripps Gerontology Center) that help describe the nature of the aging network and its...

• Aging Network
• Home and Community Based Services
• Long-Term Care Policy and Financing

2007 Ohio Residential Care Facility Resident Satisfaction Survey: Instrument Refinements

03/02/2008

This report describes psychometric testing and other evaluation of the 2007 Ohio Residential Care Resident Satisfaction Survey. Recommendations include removal of items to shorten the survey and refinement of other items.Full Report (PDF 165KB)

• Long-Term Care Facilities
• Research Methods

PASSPORT Consumer Eligibility

06/21/2007

This report examined the PASSPORT population for nursing home level of care and Medicaid financial eligibility. In addition, factors impacting length of stay in PASSPORT and transfer to nursing home are explored.Full Report (PDF 355KB)Research Brief (PDF 100KB)

• Home and Community Based Services
• Long-Term Care Policy and Financing
• Long-Term Care - Other

Evaluation of Ohio's Assisted Living Medicaid Waiver Program: Assessment and Service Plan Development Process

06/17/2007

This report is one among four that represents an evaluation of Ohio’s Assisted Living Medicaid Waiver program. This part of the evaluation assessed how well the program performed in developing and delivering services. Specifically, the evaluation addressed the effectiveness of the service plan process in preserving the consumers’ independence, privacy, and choice. It also looked at the factors that lead to service tier change in the first 90 days after enrollment and those that result in a...

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

Evaluation of Ohio's Assisted Living Medicaid Waiver Program: Final Summary Report

06/14/2007

This study evaluated the performance of Ohio’s Assisted Living Medicaid Waiver program during its initial implementation period; it is one report among four. Enrollment in the program was slower than originally anticipated; during that initial implementation 134 participants were enrolled. Findings: Assisted living waiver residents on average report higher levels of disability compared to PASSPORT participants, but are not as impaired as nursing home residents. Participants report high levels...

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

Evaluation of Ohio's Assisted Living Medicaid Waiver Program: Consumer Access and Satisfaction

06/14/2007

This report is one among four that represents an evaluation of Ohio's Assisted Living Medicaid Waiver program. This part provides a profile of individuals who enrolled in the Assisted Living Waiver Program. Data on the demographic and functional health of residents and their satisfaction with services are presented for those who enrolled during the initial implementation period. The report also presents information on those who were found to be eligible, but chose not to enroll and those who...

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

Evaluation of Ohio's Assisted Living Medicaid Waiver Program: Report on Program Costs

06/14/2007

This report is one among four that represents an evaluation of Ohio's Assisted Living Medicaid Waiver program. This report examines the costs and characteristics of those individuals who enrolled in the assisted living waiver program during its initial implementation. Assisted living resident characteristics (demographic and functional) are compared to Medicaid nursing home residents and PASSPORT enrollees. The costs of assisted living residents are compared to nursing home residents in the same...

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

PASSPORT Assessment and Services

06/08/2007

The purpose of our evaluation component was to determine the effectiveness of the PASSPORT assessment process in ensuring that PASSPORT consumers are supported in making informed choices about long-term care; and whether the service plans developed for enrolled PASSPORT consumers are based on the assessed needs of and the informed choices made by the consumer.Full Report (PDF 158KB)Research Brief (PDF 125KB)

• Home and Community Based Services
• Long-Term Care Policy and Financing

Program Evaluation of PASSPORT: Ohio's Home and Community-Based Medicaid Waiver

05/15/2007

The goal for the evaluation of the PASSPORT program was to determine whether the program is providing efficient and cost-neutral services as an alternative to facility-based long-term care, and to assess the extent to which the program complies with the assurances Ohio agreed to in its waiver application. Although findings and recommendations are discussed briefly in this report, they are covered in greater detail in the six topical reports that support this document. See the following reports:...

• Home and Community Based Services
• Long-Term Care Policy and Financing

PASSPORT Cost Neutrality

05/10/2007

This report explores the costs of caring for a person age 60 and older in the community (through PASSPORT) versus caring for a person age 60 and older in a nursing home. Medicaid costs and all other public program costs are taken into consideration in this study.Full Report (PDF 286KB)Research Brief (PDF 103KB)

• Home and Community Based Services
• Long-Term Care Policy and Financing
• Long-Term Care - Other

PASSPORT Evaluation: Accountability for Finances, Compliance, and Fairness

05/09/2007

This research is an evaluation of the mechanisms and processes in place to assure that PASSPORT funds are managed properly and procurements are undertaken in a fair and open manner.Full Report (PDF 147KB)Research Brief (PDF 304KB)

• Home and Community Based Services
• Long-Term Care Policy and Financing

PASSPORT Quality Assurance and Quality Management

05/09/2007

This report addresses findings related to the quality standards of the PASSPORT program. Although all evaluation components address aspects of quality assurance and improvement, this study addressed issues regarding the safety and welfare of program participants and the congruence of the PASSPORT program with the CMS Home and Community-Based Service Quality Framework. Findings show that there are numerous structures and processes in place to safeguard program participants. In addition, a strong...

• Home and Community Based Services
• Long-Term Care Policy and Financing

Providing Quality Home and Community-Based Services Through PASSPORT

05/02/2007

This report is part of a larger evaluation of Ohio's PASSPORT Program. It examines issues of provider tenure, provider certification, and provider quality assurance. Data were collected in focus groups, interviews, and a mailed survey.Full Report (PDF 1.3MB)Research Brief (PDF 409KB)

• Home and Community Based Services
• Long-Term Care Policy and Financing

The Changing Face of Long-Term Care: Ohio's Experience 1993-2005

04/07/2007

This report details trends in Ohio long-term care service utilization over 12 years. It also provides information about the characteristics of those in different settings such as PASSPORT, nursing homes, and residential care facilities.Full Report (PDF 127KB)

• Long-Term Care Facilities
• Research Methods

Implementation of the 2006 Ohio Nursing Home Family Satisfaction Survey

03/18/2007

Refinements to the survey instrument showed continued high reliability of domain areas and the instrument as a whole. Changes in instructions to families, and a number of processes were changed this year that resulted in fewer family and facility calls requesting assistance from the toll-free hotline operated by the Margaret Blenkner Research Institute at Benjamin Rose.Comparisons of 2001 and 2006 responses show some significant improvements statewide, with more items showing statewide averages...

• Long-Term Care Facilities
• Research Methods

Ohio Long-Term Care Factbook

06/16/2006

This research was funded by a grant from the State of Ohio through the Ohio Long-Term Care Research Project.Factbook (PDF 3MB)

• Long-Term Care - Other

Nursing home use in Ohio: Who stays, who pays?

02/03/2006

This study also indicates that the discharge rate was higher among Medicare and private pay residents compared to Medicaid residents. By the end of the first year, one-third of those residents who were initially private payers and who were still in a nursing home came to rely on Medicaid to pay for their care. The proportion of residents switching to Medicaid increased to over one-half by the end of second year and to two-thirds by the end of the third year. However, this proportion at the end...

• Long-Term Care Facilities
• Long-Term Care Policy and Financing

An overview of Ohio's In-Home Service Program for Older People (PASSPORT)

05/11/2005

This research presents an overview of Ohio's Medicaid waiver program, known as PASSPORT, which serves Ohioans who are 60 years and older, who are chronically disabled, and who meet the eligibility criteria for nursing home care.

• Home and Community Based Services
• Long-Term Care Policy and Financing

Long-term care utilization in Ohio 1993-2003

05/04/2005

This study was funded by the Ohio Department of Aging and the Ohio Long-Term Care Research Project through the Ohio Board of Regents.Research Brief (PDF 68KB)

• Long-Term Care Facilities

A review of nursing home resident characteristics in Ohio: Tracking changes from 1994-2004

03/05/2005

This briefing paper presents the profile of Ohio nursing home residents in both 2004 and 1994, and describes trends over the past decade.

• Long-Term Care Facilities
• Long-Term Care Policy and Financing