Quality & Clinical Topics

Advanced practice registered nurses help reduce hospitalizations from nursing home residents MU study examines effectiveness of $35 million program designed to improve quality of care in nursing homes. Marilyn Rantz still remembers the day she got the call that...

Medicare should scrap billing restrictions for direct care services provided by advanced practice nurses in nursing homes, say researchers from the University of Missouri’s Sinclair School of Nursing, citing results of a long-term study. Investigators followed a six-year quality...

Advance care planning involves a meaningful conversation about residents’ end of life goals with the health-care team and documenting these wishes in advance directives; however, these conversations are not taking place early enough or with strategies that allow nursing...

Recently, there have been numerous policy and program responses to reducing potentially avoidable hospitalizations from skilled nursing facilities (SNFs). It is estimated that approximately 25% of resident discharges to SNFs are readmitted within 30 days of discharge. Medicare spends...

Objectives: The purpose of this article is to present six-year findings of the Missouri Quality Initiative (MOQI) to reduce unnecessary hospitalizations for long-stay nursing home residents. Design: A CMS funded demonstration project analyzed over 6-years using a single group...

Hospitalization for nursing home residents is a national concern. Studies suggest the majority of hospital transfers are avoidable, often resulting from poor care processes such as lack of early illness detection, adverse event occurrences, and poor communication between nursing...

Across studies, the risk of hospital transfer for nursing home residents is highest for people without documented advance directives and for people with chronic health conditions (eg, diabetes and congestive heart failure), mental health conditions (eg, depression), and limited...

OBJECTIVES: We explored the differences in potentially avoidable/unavoidable hospital transfers in a retrospective analysis of Interventions to Reduce Acute Care Transfers (INTERACT) Acute Transfer Tools (ACTs) completed by advanced practice registered nurses (APRNs) working in the Missouri Quality Improvement...

Studies describing avoidable hospital transfers for nursing home (NH) residents sug-gest rates vary between 30% and 70%, often citing poor communication, limited resources, patient/family preference, and adverse events as underlying causes.1-3Adverse events, defined as harm resulting from the delivery...

In 2011, the Office of Inspector General (OIG) of the Department of Health and Human Services released the report Medicare Atypical Antipsychotics Drug Claims for Elderly Nursing Homes Residents. This report was prompted by a legislator’s concern about the...