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    The Prevalence of Culture Change Practice in US Nursing Homes: Findings From a 2016/2017 Nationwide Survey

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    Authors
    Miller, Susan C.
    Schwartz, Margot L.
    Lima, Julie C.
    Shield, Renee R.
    Tyler, Denise A.
    Berridge, Clara W.
    Gozalo, Pedro L.
    Lepore, Michael J.
    Clark, Melissa A.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2018-12-01
    Keywords
    nursing home staffing
    Medicaid reimbursement
    person-centered care
    nursing home leadership
    nursing home turnover
    culture change
    Geriatrics
    Health Services Administration
    Health Services Research
    
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    Link to Full Text
    https://doi.org/10.1097/MLR.0000000000000993
    Abstract
    BACKGROUND AND OBJECTIVES: Given the dynamic nursing home (NH) industry and evolving regulatory environment, depiction of contemporary NH culture-change (person/resident-centered) care practice is of interest. Thus, we aimed to portray the 2016/2017 prevalence of NH culture change-related processes and structures and to identify factors associated with greater practice prevalence. RESEARCH DESIGN AND METHODS: We administered a nationwide survey to 2142 NH Administrators at NHs previously responding to a 2009/2010 survey. Seventy-four percent of administrators (1583) responded (with no detectable nonresponse bias) enabling us to generalize (weighted) findings to US NHs. From responses, we created index scores for practice domains of resident-centered care, staff empowerment, physical environment, leadership, and family and community engagement. Facility-level covariate data came from the survey and the Certification and Survey Provider Enhanced Reporting system. Ordered logistic regression identified the factors associated with higher index scores. RESULTS: Eighty-eight percent of administrators reported some facility-level involvement in NH culture change, with higher reported involvement consistently associated with higher domain index scores. NHs performed the best (82.6/100 weighted points) on the standardized resident-centered care practices index, and had the lowest scores (54.8) on the family and community engagement index. Multivariable results indicate higher index scores in NHs with higher leadership scores and in states having Medicaid pay-for-performance with culture change-related quality measures. CONCLUSIONS: The relatively higher resident-centered care scores (compared with other domain scores) suggest an emphasis on person-centered care in many US NHs. Findings also support pay-for-performance as a potential mechanism to incentivize preferred NH practice.
    Source

    Med Care. 2018 Dec;56(12):985-993. doi: 10.1097/MLR.0000000000000993. Link to article on publisher's site

    DOI
    10.1097/MLR.0000000000000993
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46767
    PubMed ID
    30234764
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1097/MLR.0000000000000993
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    Population and Quantitative Health Sciences Publications

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