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dc.contributor.authorMiller, Susan C.
dc.contributor.authorSchwartz, Margot L.
dc.contributor.authorLima, Julie C.
dc.contributor.authorShield, Renee R.
dc.contributor.authorTyler, Denise A.
dc.contributor.authorBerridge, Clara W.
dc.contributor.authorGozalo, Pedro L.
dc.contributor.authorLepore, Michael J.
dc.contributor.authorClark, Melissa A.
dc.date2022-08-11T08:10:35.000
dc.date.accessioned2022-08-23T17:13:36Z
dc.date.available2022-08-23T17:13:36Z
dc.date.issued2018-12-01
dc.date.submitted2018-11-08
dc.identifier.citation<p>Med Care. 2018 Dec;56(12):985-993. doi: 10.1097/MLR.0000000000000993. <a href="https://doi.org/10.1097/MLR.0000000000000993">Link to article on publisher's site</a></p>
dc.identifier.issn0025-7079 (Linking)
dc.identifier.doi10.1097/MLR.0000000000000993
dc.identifier.pmid30234764
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46767
dc.description.abstractBACKGROUND 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.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=30234764&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1097/MLR.0000000000000993
dc.subjectnursing home staffing
dc.subjectMedicaid reimbursement
dc.subjectperson-centered care
dc.subjectnursing home leadership
dc.subjectnursing home turnover
dc.subjectculture change
dc.subjectGeriatrics
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.titleThe Prevalence of Culture Change Practice in US Nursing Homes: Findings From a 2016/2017 Nationwide Survey
dc.typeJournal Article
dc.source.journaltitleMedical care
dc.source.volume56
dc.source.issue12
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1227
dc.identifier.contextkey13269250
html.description.abstract<p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathqhs_pp/1227
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages985-993


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