Nationwide improvement in nursing home care not likely, despite some changes

ene Harrington of the University of California at San Francisco and her colleagues presented why and how to create a report card for nursing facilities much like report cards for hospitals and health plans. Older consumers could use such report cards to make informed decisions about long-term care.

Dana B. Mukamel of the University Rochester and William D. Spector of the Agency for Healthcare Research and Quality argued that quality report cards should be viewed as one of several options to ensure higher quality nursing home care.

Many experts contend that the overall quality of nursing home care in America remains poor. There are serious, ongoing nursing home quality problems. What can be done about it? Joseph Angelelli of Brown University and his colleagues in their study found that nursing homes that receive a high number of deficiencies tend to exit the Medicare/Medicaid market. They argued that public reporting may indeed promote overall quality in some facilities, but it also hastens the demise of the most "at-risk" facilities. And the demise of these facilities creates a void with no clear plan as to what will take their place.

The study by Jeanie Kayser-Jones of the University of California at San Francisco and her colleagues investigated the physical environment and organization factors that influenced the process of providing care to terminally ill home residents. They found that the nursing home environment in two facilities studied were inappropriate for end-of-life care. Among other problems, the rooms were crowded, there was little privacy, and the facilities were noisy.

David R. Mehr of the University of Missouri at Columbia, and his colleagues compared treatment and mortality in U.S. and Dutch nursing home residents with lower respiratory infection (LRI). They "found striking differences in management among residents with dementia who had LRI." Hospitalization and antibiotics were very common in the United States, ra

Contact: Melanie Radkiewicz
The Gerontological Society of America

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