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  • 1
    Online Resource
    Online Resource
    Characteristics of Community Nursing Homes Serving Per Diem Veterans, 1999 to 2002
    SAGE Publications ; 2007
    In:  Medical Care Research and Review Vol. 64, No. 6 ( 2007-12), p. 673-690
    Details
    In: Medical Care Research and Review, SAGE Publications, Vol. 64, No. 6 ( 2007-12), p. 673-690
    Abstract: This study compared the characteristics of community nursing homes where veterans received their care with those of facilities that did not treat veterans from 1999 to 2002 using the Centers for Medicare and Medicaid Services (CMS) Online Survey Certification and Reporting system data merged with the CMS Minimum Data Set. A structure, process, and outcome model was used to examine whether the presence of per diem veterans had any impact on multidimensional quality measures. Facilities with any veterans were less likely to meet recommended nurse staffing standards; more likely to have patients with tube feeding, new catheterizations, and mobility restraints; and more likely to have actual harm citations and new pressure sores, plus quality-of-care, quality-of-life, and total deficiencies, than facilities without veterans. The implications of this study are that the U.S. Department of Veterans Affairs may need to examine its contracting policies with community facilities to understand both quality and selection effects that may be occurring.
    Type of Medium: Online Resource
    ISSN: 1077-5587 , 1552-6801
    URL: Article
    DOI: 10.1177/1077558707304740
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2070248-6
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  • 2
    Online Resource
    Online Resource
    The Performance Impact of Context in TQM Implementation: The Nursing Facility Industry
    SAGE Publications ; 2001
    In:  Health Services Management Research Vol. 14, No. 3 ( 2001-08), p. 147-158
    Details
    In: Health Services Management Research, SAGE Publications, Vol. 14, No. 3 ( 2001-08), p. 147-158
    Abstract: This study develops a model and empirically assesses how# organizational context mediates the impact of total quality management (TQM) implementation on perceived performance in the nursing facility industry. Outcomes are analysed for financial, human resources and resident-care performance. Contextual factors related to TQM implementation include managerial control, reward systems, organizational structure and the extent of implementation. Duration of TQM implementation is included as a control variable. Benchmarking has a positive impact on financial outcomes, and the extent of TQM implementation and required reporting of quality improvement activity results have a positive impact on both financial and human resources performance. The presence of a Quality Steering Council has a positive impact on financial performance, but only among larger facilities.
    Type of Medium: Online Resource
    ISSN: 0951-4848 , 1758-1044
    URL: Article
    DOI: 10.1177/095148480101400302
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2001
    detail.hit.zdb_id: 2035604-3
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  • 3
    Online Resource
    Online Resource
    The performance impact of context in TQM implementation: the nursing facility industry
    SAGE Publications ; 2001
    In:  Health Services Management Research Vol. 14, No. 3 ( 2001-08-01), p. 147-158
    Details
    In: Health Services Management Research, SAGE Publications, Vol. 14, No. 3 ( 2001-08-01), p. 147-158
    Abstract: This study develops a model and empirically assesses how# organizational context mediates the impact of total quality management (TQM) implementation on perceived performance in the nursing facility industry. Outcomes are analysed for financial, human resources and resident-care performance. Contextual factors related to TQM implementation include managerial control, reward systems, organizational structure and the extent of implementation. Duration of TQM implementation is included as a control variable. Benchmarking has a positive impact on financial outcomes, and the extent of TQM implementation and required reporting of quality improvement activity results have a positive impact on both financial and human resources performance. The presence of a Quality Steering Council has a positive impact on financial performance, but only among larger facilities.
    Type of Medium: Online Resource
    ISSN: 0951-4848 , 1758-1044
    URL: Article
    DOI: 10.1258/0951484011912654
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2001
    detail.hit.zdb_id: 2035604-3
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  • 4
    Online Resource
    Online Resource
    Clinician advice to quit smoking among seniors
    Elsevier BV ; 2015
    In:  Preventive Medicine Vol. 70 ( 2015-01), p. 83-89
    Details
    In: Preventive Medicine, Elsevier BV, Vol. 70 ( 2015-01), p. 83-89
    Type of Medium: Online Resource
    ISSN: 0091-7435
    URL: Article
    DOI: 10.1016/j.ypmed.2014.11.020
    RVK:
    XF 1500
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
    detail.hit.zdb_id: 1471564-8
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  • 5
    Online Resource
    Online Resource
    Do Medicaid Incentive Payments Boost Quality? Florida's Direct Care Staffing Adjustment Program
    Informa UK Limited ; 2013
    In:  Journal of Aging & Social Policy Vol. 25, No. 1 ( 2013-01), p. 65-82
    Details
    In: Journal of Aging & Social Policy, Informa UK Limited, Vol. 25, No. 1 ( 2013-01), p. 65-82
    Type of Medium: Online Resource
    ISSN: 0895-9420 , 1545-0821
    URL: Article
    DOI: 10.1080/08959420.2012.705629
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2013
    detail.hit.zdb_id: 2069274-2
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  • 6
    Online Resource
    Online Resource
    Do Medicare and Medicaid Payer-Mix Change After the Privatization of Public Hospitals?
    SAGE Publications ; 2021
    In:  Medical Care Research and Review Vol. 78, No. 4 ( 2021-08), p. 361-370
    Details
    In: Medical Care Research and Review, SAGE Publications, Vol. 78, No. 4 ( 2021-08), p. 361-370
    Abstract: This study assessed the impact of public hospitals’ privatization on payer-mix. We used a national sample of nonfederal, acute care, public hospitals in 1997 and followed them through 2013, resulting in a cohort of 492 hospitals (8,335 hospital-year observations). Privatization to for-profit (FP) status was associated with a greater increase in Medicare payer-mix (β = 0.13; p ≤ .001), compared with a smaller increase for privatization to not-for-profit (NFP) status (β = 0.02; p ≤ .05). FP privatization was associated with a greater decrease in Medicaid payer-mix (β = −0.09; p ≤ .001), compared with NFP privatization (nonsignificant). There is a larger change in payer-mix after FP privatization than after NFP privatization.
    Type of Medium: Online Resource
    ISSN: 1077-5587 , 1552-6801
    URL: Article
    DOI: 10.1177/1077558719894495
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2070248-6
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  • 7
    Online Resource
    Online Resource
    Nursing Home Quality and Financial Performance: Is There a Business Case for Quality?
    SAGE Publications ; 2019
    In:  INQUIRY: The Journal of Health Care Organization, Provision, and Financing Vol. 56 ( 2019-01), p. 004695801882519-
    Details
    In: INQUIRY: The Journal of Health Care Organization, Provision, and Financing, SAGE Publications, Vol. 56 ( 2019-01), p. 004695801882519-
    Abstract: This study examines the relationship between nursing home quality and financial performance to assess whether there is a business case for quality. Secondary data sources included the Online Survey Certification and Reporting (OSCAR), Certification and Survey Provider Enhanced Reporting (CASPER), Medicare Cost Reports, Minimum Data Set (MDS 2.0), Area Resource File (ARF), and LTCFocus for all free-standing, nongovernment nursing homes for 2000 to 2014. Data were analyzed using panel data linear regression with facility and year fixed effects. The dependent variable, financial performance, consisted of the operating margin. The independent variables comprised nursing home quality measures that capture the three dimensions of Donabedian’s structure-process-outcomes framework: structure Registered Nurse (RN) hours per resident day, Licensed Practical Nurse (LPN) hours per resident day, Certified Nursing Assistant (CNA) hours per resident day, RN skill mix), process (facility-acquired restraints, facility-acquired catheters, pressure ulcer prevention, and restorative ambulation), and outcomes (facility-acquired contractures, facility-acquired pressure ulcers, hospitalizations per resident, rehospitalizations, and health deficiencies). Control variables included size, average acuity index, market competition, per capita income, and Medicare Advantage penetration rate. This study found that the operating margin was lower in nursing homes that reported higher LPN hours per resident day and higher RN skill mix (structure); higher use of catheters, lower pressure ulcer prevention, and lower restorative ambulation (process); and more residents with contractures, pressure ulcers, hospitalizations and health deficiencies (outcomes). The results suggest that there is a business case for quality, whereas nursing homes that have better processes and outcomes of care perform better financially.
    Type of Medium: Online Resource
    ISSN: 0046-9580 , 1945-7243
    URL: Article
    DOI: 10.1177/0046958018825191
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2147137-X
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  • 8
    Online Resource
    Online Resource
    Predicting Nursing Home Financial Distress Using the Altman Z-Score
    SAGE Publications ; 2020
    In:  INQUIRY: The Journal of Health Care Organization, Provision, and Financing Vol. 57 ( 2020-01), p. 004695802093494-
    Details
    In: INQUIRY: The Journal of Health Care Organization, Provision, and Financing, SAGE Publications, Vol. 57 ( 2020-01), p. 004695802093494-
    Abstract: This article uses a modified Altman Z-score to predict financial distress within the nursing home industry. The modified Altman Z-score model uses multiple discriminant analysis (MDA) to examine multiple financial ratios simultaneously to assess a firm’s financial distress. This study utilized data from Medicare Cost Reports, LTCFocus, and the Area Resource File. Our sample consisted of 167 268 nursing home-year observations, or an average of 10 454 facilities per year, in the United States from 2000 through 2015. The independent financial variables, liquidity, profitability, efficiency, and net worth were entered stepwise into the MDA model. All of the financial variables, with the exception of net worth, significantly contributed to the discriminating power of the model. K-means clustering was used to classify the latent variable into 3 categorical groups: distressed, risk-of-financial distress, and healthy. These findings will provide policy makers and practitioners another tool to identify nursing homes that are at risk of financial distress.
    Type of Medium: Online Resource
    ISSN: 0046-9580 , 1945-7243
    URL: Article
    DOI: 10.1177/0046958020934946
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2147137-X
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  • 9
    Online Resource
    Online Resource
    Psychometric Properties of the Spanish Consumer Assessment of Health Plans Survey (CAHPS)
    SAGE Publications ; 2003
    In:  Hispanic Journal of Behavioral Sciences Vol. 25, No. 3 ( 2003-08), p. 386-409
    Details
    In: Hispanic Journal of Behavioral Sciences, SAGE Publications, Vol. 25, No. 3 ( 2003-08), p. 386-409
    Abstract: This study describes the psychometric properties of the Consumer Assessments of Health Plans Survey (CAHPS) in 279 persons who completed it in Spanish and 439 persons who completed it in English. We found negatively skewed distributions of responses and significant ceiling effects in both English and Spanish surveys. Cronbach’s alphas for English and Spanish multiple-item composites were 0.69 or higher. Correlations between the CAHPS measures and willingness of individuals to recommend their doctor and health plan to family and friends were all moderately strong and statistically significant except for one global rating. There were significant differences in the patterns of correlations between global ratings and composites for English and Spanish surveys. This study suggests that the Spanish CAHPS 2.0 core survey has acceptable psychometric properties.
    Type of Medium: Online Resource
    ISSN: 0739-9863 , 1552-6364
    URL: Article
    DOI: 10.1177/0739986303256916
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2003
    detail.hit.zdb_id: 2067258-5
    SSG: 5,2
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  • 10
    Online Resource
    Online Resource
    Language and Regional Differences in Evaluations of Medicare Managed Care by Hispanics
    Wiley ; 2008
    In:  Health Services Research Vol. 43, No. 2 ( 2008-04), p. 552-568
    Details
    In: Health Services Research, Wiley, Vol. 43, No. 2 ( 2008-04), p. 552-568
    Abstract: Objectives. This study uses the Consumer Assessments of Healthcare Providers and Systems (CAHPS ® ) survey to examine the experiences of Hispanics enrolled in Medicare managed care. Evaluations of care are examined in relationship to primary language (English or Spanish) and region of the country. Data Sources. CAHPS 3.0 Medicare managed care survey data collected in 2002. Study Design. The dependent variables consist of five CAHPS multi‐item scales measuring timeliness of care, provider communication, office staff helpfulness, getting needed care, and health plan customer service. The main independent variables are Hispanic primary language (English or Spanish) and region (California, Florida, New York/New Jersey, and other states). Ordinary least squares regression is used to model the effect of Hispanic primary language and region on CAHPS scales, controlling for age, gender, education, and self‐rated health. Data Collection/Extraction Methods. The analytic sample consists of 125,369 respondents (82 percent response rate) enrolled in 181 Medicare managed care plans across the U.S. Of the 125,369 respondents, 8,463 (7 percent) were self‐identified as Hispanic. The survey was made available in English and Spanish, and 1,353 Hispanics completed one in Spanish. Principal Findings. Hispanic English speakers had less favorable reports of care than whites for all dimensions of care except provider communication. Hispanic Spanish speakers reported more negative experiences than whites with timeliness of care, provider communication, and office staff helpfulness, but better reports of care for getting needed care. Spanish speakers in all regions except Florida had less favorable scores than English‐speaking Hispanics for provider communication and office staff helpfulness, but more positive assessments for getting needed care. There were greater regional variations in CAHPS scores among Hispanic Spanish speakers than among Hispanic English speakers. Spanish speakers in Florida had more positive experiences than Spanish speakers in other regions for most dimensions of care. Conclusions. Hispanics in Medicare managed care face barriers to care; however, their experiences with care vary by language and region. Spanish speakers (except FL) have less favorable experiences with provider communication and office staff helpfulness than their English‐speaking counterparts, suggesting language barriers in the clinical encounter. On the other hand, Spanish speakers reported more favorable experiences than their English‐speaking counterparts with the managed care aspects of their care (getting needed care and plan customer service). Medicare managed care plans need to address the observed disparities in patient experiences among Hispanics as part of their quality improvement efforts. Plans can work with their network providers to address issues related to timeliness of care and office staff helpfulness. In addition, plans can provide incentives for language services, which have the potential to improve communication with providers and staff among Spanish speakers. Finally, health plans can reduce the access barriers faced by Hispanics, especially among English speakers.
    Type of Medium: Online Resource
    ISSN: 0017-9124 , 1475-6773
    URL: Issue
    URL: Article
    DOI: 10.1111/hesr.2008.43.issue-2
    DOI: 10.1111/j.1475-6773.2007.00796.x
    Language: English
    Publisher: Wiley
    Publication Date: 2008
    detail.hit.zdb_id: 2078493-4
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