Brant E Fries
Biographic Data
| ID | 5410496 |
|---|---|
| NAME | Brant E Fries |
| GIVEN NAMES | Brant E |
| FAMILY NAME | Fries |
| SIGNATURE | FRIES B E |
| AFFILIATIONS | University of Michigan |
| ORCID | 0000-0002-1592-2433 |
| VERIFIED | Yes |
| TOTAL WORKS | 23 |
| TOTAL CITATIONS | 50 |
| WORKS AS AUTHOR | 23 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 1979 |
| LATEST PUBLICATION YEAR | 2021 |
| H-INDEX | 4 |
The Forensic Supplement to the interRAI Mental Health Assessment Instrument
Background: Numerous validation studies support the use of the interRAI Mental Health (MH) assessment system for inpatient mental health assessment, triage, treatment planning, and outcome measurement. However, there have been suggestions that the interRAI MH does not include sufficient content relevant to forensic mental health. We address this potential deficiency through the development of a Forensic Supplement (FS) to the interRAI MH system. …
Validation of Resource Utilization Groups Version III for Home Care (RUG-III/HC)
BACKGROUND: The case-mix system Resource Utilization Groups version III for Home Care (RUG-III/HC) was derived using a modest data sample from Michigan, but to date no comprehensive large scale validation has been done. OBJECTIVES: This work examines the performance of the RUG-III/HC classification using a large sample from Ontario, Canada. METHODS: Cost episodes over a 13-week period were aggregated from individual level client billing records a…
Predictors of Influenza Immunization Among Home Care Clients in Ontario
The Effect of Medicare's Prospective Payment System on Discharge Outcomes of Skilled Nursing Facility Residents
In July 1998, the Centers for Medicare and Medicaid Services (CMS) changed the payment method for Medicare (Part A) skilled nursing facility (SNF) care from a cost-based system to a prospective payment system (PPS). Unlike the previous cost-based payment system, PPS restricts skilled nursing facility payment to pre-determined levels. CMS also reduced the total payments to SNFs coincident with PPS implementation. These changes might reduce quality…
Does Quality Influence Consumer Choice of Nursing Homes? Evidence from Nursing Home to Nursing Home Transfers
We estimated Cox proportional hazards models using assessment data from the Minimum Data Set to test whether nursing home residents and their proxies respond to quality of care by changing providers. Various indicators of poor quality increased the likelihood of transfer. Residents of for-profit homes or homes with excess capacity also were more likely to transfer. Inability to participate in care decisions and factors indicating frailty limited …
Scaling ADLs Within the MDS
BACKGROUND: Dependency in activities of daily living (ADLs) is a reality within nursing homes, and we describe ADL measurement strategies based on items in the Minimum Data Set (MDS) and the creation and distributional properties of three ADL self-performance scales and their relationship to other measures. METHODS: Information drawn from four data sets for a multistep analysis was guided by four study objectives: (1) to identify the subcomponent…
Windows to their World
This study examined relationships between three sensory and communication abilities and two areas of nursing home resident behavior. Data from 18,873 nursing home residents include measures of hearing, visual, and communication abilities, and social engagement and time spent in activities. Increasing level of visual impairment is associated with low levels of social engagement and low time in activities. Both moderate and severe hearing impairmen…
Patterns and Determinants of Health Services Use and Mortality after VA Nursing Home Care
Risk factors for institutionalization and death for up to four years for a nationwide cohort (n = 6,488) of males discharged alive from Department of Veterans Affairs (DVA) nursing homes were identified through linked records of the DVA. Two-year cumulative probabilities of nursing home readmission, hospitalization, and death among nursing home dischargees were 0.30, 0.61, and 0.24, respectively. Using multivariate survival analyses, chronic func…
Facility and Area Variation Affecting the Use of Physical Restraints in Nursing Homes
OBJECTIVES: Various individual characteristics increase a nursing home resident's likelihood of being mechanically restrained. However, there is not good information on the role played by facility characteristics and geographic area in determining the likelihood of physical restraint use. This study investigates the importance of individual, facility, and area indicators in determining the likelihood of restraint use. METHODS: This research uses …
The Structure of Social Engagement among Nursing Home Residents
This research tests the reliability and construct validity of social engagement, a new quality of life measure embedded in the federally mandated Resident Assessment Instrument (RAI) for the nursing home population. The sample consisted of 1,848 residents from 268 homes in 10 states with data collected by trained research nurses. Three resident groups were formed based on residents' cognitive and ADL functioning. Social engagement was significant…
MDS Cognitive Performance Scale(C)
BACKGROUND: Chronic cognitive impairment is a major problem in U.S. nursing homes, yet traditional assessment systems in most facilities included only limited information on cognitive status. Following the Congressional mandate in the Omnibus Reconciliation Act of 1987 (OBRA '87), U.S. nursing homes now complete the Minimum Data Set (MDS), a standardized, comprehensive assessment of each resident's functional, medical, psychosocial, and cognitive…
Refining a Case-Mix Measure for Nursing Homes
A case-mix classification system for nursing home residents is developed, based on a sample of 7,658 residents in seven states. Data included a broad assessment of resident characteristics, corresponding to items of the Minimum Data Set, and detailed measurement of nursing staff care time over a 24-hour period and therapy staff time over a 1-week period. The Resource Utilization Groups, Version III (RUG-III) system, with 44 distinct groups, achie…
Length of Stay in VA Nursing Homes
To examine the patterns and determinants of length of stay among residents of nursing homes of the Department of Veterans Affairs (VA), the authors conducted a retrospective follow-up study of all persons (n = 4,918) admitted to VA nursing homes between October 1986, and April 1987, using computerized records of the VA. Brief-stay ( 6 months; n = 1,832) were older and more functionally impaired than other residents. Medium- and long-stay resident…
Reducing the use of physical restraints in nursing homes
OBJECTIVES. Reducing the widespread use of physical restraints in nursing homes is a primary goal of the federal nursing home reforms enacted as part of the Omnibus Budget Reconciliation Act of 1987. However, some nursing home operators assert that reducing restraint use could be prohibitively expensive, costing payors perhaps as much as $1 billion annually. We investigated whether nursing home residents free from physical restraint require more …
Mental Dysfunction and Resource Use in Nursing Homes
The role of dementia and other mental disorders in nursing home case-mix classification systems has been an area of controversy. The role of mental dysfunctions was considered in developing a new case-mix measurement system for facility payment in a national demonstration to understand staff time use in nursing homes. Nursing staff (nurses and aides) time and resident assessment data were collected for 6,663 nursing home residents in 6 states. Me…
The accuracy of the National Death Index when personal identifiers other than Social Security number are used
This study analyzed the accuracy of the National Death Index when personal identifiers were used that included or excluded Social Security number. Computerized records of the Department of Veterans Affairs were used for comparison. Different combinations of identifiers other than Social Security number correctly identified from 83 to 92 percent of dead and 92 to 99 percent of living persons. These results should prove useful in ascertaining the m…
Designing the National Resident Assessment Instrument for Nursing Homes
In response to the Omnibus Reconciliation Act of 1987 mandate for the development of a national resident assessment system for nursing facilities, a consortium of professionals developed the first major component of this system, the Minimum Data Set (MDS) for Resident Assessment and Care Screening. A two-state field trial tested the reliability of individual assessment items, the overall performance of the instrument, and the time involved in its…
A Classification System for Long-Staying Psychiatric Patients
Data on a sample of 890 Veteran's Administration long-staying psychiatric patients were studied to develop a classification system that explains actual daily resource use. Disturbed patients with lengths of stay of less than three years and those with psychotic conditions who are not withdrawn represent the two groups found to use significantly more resources in their daily care. The Long-Stay Psychiatric Patient Classification (LPPC) System, wit…
Case-Mix Classification of Medicare Residents in Skilled Nursing Facilities
Medicare residents in Skilled Nursing Facilities (SNFs) represent a small but unique population about which little is known. Data collected in a national sample of 2,564 Medicare residents in 38 SNFs were used to derive a resident classification system appropriate for use in a payment system. The classification system, Resource Utilization Groups-Medicare (RUG-T18) explains 55.5% of the per-diem resource cost differences of Medicare SNF residents…
A Psychiatric Patient Classification System
It is generally accepted that diagnosis-related groups (DRGs) for alcohol, drug, and mental disorders are inappropriate for inpatient prospective payment. To address this issue, the Veterans Administration (VA) supported a project to construct alternative classes that are more clinically meaningful, more homogeneous in their resource use, and that account for more variation in resource use among psychiatric and substance use cases than existing D…
Resource Utilization Groups
The ability to understand, control, manage, regulate, and reimburse nursing home care has been hampered by the inavailability of a classification system of long-term care patients. A study of 1,469 patients in Connecticut nursing homes has resulted in such a classification system that clusters patients with similar relative needs for resources, in particular, for nursing time. The nine groups formed can be used to develop a case-mix profile of th…
Validation and Use of Resource Utilization Groups as a Case-mix Measure for Long-term Care
A companion article describes the development of a patient classification system for long-term care patients, Resource Utilization Groups (RUGs). Three potential limitations of this system and its development are addressed here: the use of a subjectively determined dependent variable, geographic limitation of the data to Connecticut skilled nursing facilities, and limited assessment of the quality of the facilities studied. Additional systems of …
The Effect of Delay Rules in Controlling Unscheduled Visits to Hospitals
The increased demand of unscheduled visits to hospital outpatient facilities, and particularly to walk-in clinics, necessitates the consideration of means to control this flow and to reduce in-hospital waiting times. A model is developed in which a percentage of the unscheduled visits are assumed to be delayable, e.g., patients with non-urgent complaints who call may be asked to delay their arrivals for specified lengths of time. A simple rule fo…
The Structure of Social Engagement among Nursing Home Residents
This research tests the reliability and construct validity of social engagement, a new quality of life measure embedded in the federally mandated Resident Assessment Instrument (RAI) for the nursing home population. The sample consisted of 1,848 residents from 268 homes in 10 states with data collected by trained research nurses. Three resident groups were formed based on residents' cognitive and ADL functioning. Social engagement was significant…
Windows to their World
This study examined relationships between three sensory and communication abilities and two areas of nursing home resident behavior. Data from 18,873 nursing home residents include measures of hearing, visual, and communication abilities, and social engagement and time spent in activities. Increasing level of visual impairment is associated with low levels of social engagement and low time in activities. Both moderate and severe hearing impairmen…
Reducing the use of physical restraints in nursing homes
OBJECTIVES. Reducing the widespread use of physical restraints in nursing homes is a primary goal of the federal nursing home reforms enacted as part of the Omnibus Budget Reconciliation Act of 1987. However, some nursing home operators assert that reducing restraint use could be prohibitively expensive, costing payors perhaps as much as $1 billion annually. We investigated whether nursing home residents free from physical restraint require more …
The accuracy of the National Death Index when personal identifiers other than Social Security number are used
This study analyzed the accuracy of the National Death Index when personal identifiers were used that included or excluded Social Security number. Computerized records of the Department of Veterans Affairs were used for comparison. Different combinations of identifiers other than Social Security number correctly identified from 83 to 92 percent of dead and 92 to 99 percent of living persons. These results should prove useful in ascertaining the m…
Length of Stay in VA Nursing Homes
To examine the patterns and determinants of length of stay among residents of nursing homes of the Department of Veterans Affairs (VA), the authors conducted a retrospective follow-up study of all persons (n = 4,918) admitted to VA nursing homes between October 1986, and April 1987, using computerized records of the VA. Brief-stay ( 6 months; n = 1,832) were older and more functionally impaired than other residents. Medium- and long-stay resident…
Patterns and Determinants of Health Services Use and Mortality after VA Nursing Home Care
Risk factors for institutionalization and death for up to four years for a nationwide cohort (n = 6,488) of males discharged alive from Department of Veterans Affairs (DVA) nursing homes were identified through linked records of the DVA. Two-year cumulative probabilities of nursing home readmission, hospitalization, and death among nursing home dischargees were 0.30, 0.61, and 0.24, respectively. Using multivariate survival analyses, chronic func…
The Effect of Delay Rules in Controlling Unscheduled Visits to Hospitals
The increased demand of unscheduled visits to hospital outpatient facilities, and particularly to walk-in clinics, necessitates the consideration of means to control this flow and to reduce in-hospital waiting times. A model is developed in which a percentage of the unscheduled visits are assumed to be delayable, e.g., patients with non-urgent complaints who call may be asked to delay their arrivals for specified lengths of time. A simple rule fo…
Resource Utilization Groups
The ability to understand, control, manage, regulate, and reimburse nursing home care has been hampered by the inavailability of a classification system of long-term care patients. A study of 1,469 patients in Connecticut nursing homes has resulted in such a classification system that clusters patients with similar relative needs for resources, in particular, for nursing time. The nine groups formed can be used to develop a case-mix profile of th…
Validation and Use of Resource Utilization Groups as a Case-mix Measure for Long-term Care
A companion article describes the development of a patient classification system for long-term care patients, Resource Utilization Groups (RUGs). Three potential limitations of this system and its development are addressed here: the use of a subjectively determined dependent variable, geographic limitation of the data to Connecticut skilled nursing facilities, and limited assessment of the quality of the facilities studied. Additional systems of …
Case-Mix Classification of Medicare Residents in Skilled Nursing Facilities
Medicare residents in Skilled Nursing Facilities (SNFs) represent a small but unique population about which little is known. Data collected in a national sample of 2,564 Medicare residents in 38 SNFs were used to derive a resident classification system appropriate for use in a payment system. The classification system, Resource Utilization Groups-Medicare (RUG-T18) explains 55.5% of the per-diem resource cost differences of Medicare SNF residents…
A Psychiatric Patient Classification System
It is generally accepted that diagnosis-related groups (DRGs) for alcohol, drug, and mental disorders are inappropriate for inpatient prospective payment. To address this issue, the Veterans Administration (VA) supported a project to construct alternative classes that are more clinically meaningful, more homogeneous in their resource use, and that account for more variation in resource use among psychiatric and substance use cases than existing D…
Designing the National Resident Assessment Instrument for Nursing Homes
In response to the Omnibus Reconciliation Act of 1987 mandate for the development of a national resident assessment system for nursing facilities, a consortium of professionals developed the first major component of this system, the Minimum Data Set (MDS) for Resident Assessment and Care Screening. A two-state field trial tested the reliability of individual assessment items, the overall performance of the instrument, and the time involved in its…
A Classification System for Long-Staying Psychiatric Patients
Data on a sample of 890 Veteran's Administration long-staying psychiatric patients were studied to develop a classification system that explains actual daily resource use. Disturbed patients with lengths of stay of less than three years and those with psychotic conditions who are not withdrawn represent the two groups found to use significantly more resources in their daily care. The Long-Stay Psychiatric Patient Classification (LPPC) System, wit…
The accuracy of the National Death Index when personal identifiers other than Social Security number are used
This study analyzed the accuracy of the National Death Index when personal identifiers were used that included or excluded Social Security number. Computerized records of the Department of Veterans Affairs were used for comparison. Different combinations of identifiers other than Social Security number correctly identified from 83 to 92 percent of dead and 92 to 99 percent of living persons. These results should prove useful in ascertaining the m…
Length of Stay in VA Nursing Homes
To examine the patterns and determinants of length of stay among residents of nursing homes of the Department of Veterans Affairs (VA), the authors conducted a retrospective follow-up study of all persons (n = 4,918) admitted to VA nursing homes between October 1986, and April 1987, using computerized records of the VA. Brief-stay ( 6 months; n = 1,832) were older and more functionally impaired than other residents. Medium- and long-stay resident…
Reducing the use of physical restraints in nursing homes
OBJECTIVES. Reducing the widespread use of physical restraints in nursing homes is a primary goal of the federal nursing home reforms enacted as part of the Omnibus Budget Reconciliation Act of 1987. However, some nursing home operators assert that reducing restraint use could be prohibitively expensive, costing payors perhaps as much as $1 billion annually. We investigated whether nursing home residents free from physical restraint require more …
Mental Dysfunction and Resource Use in Nursing Homes
The role of dementia and other mental disorders in nursing home case-mix classification systems has been an area of controversy. The role of mental dysfunctions was considered in developing a new case-mix measurement system for facility payment in a national demonstration to understand staff time use in nursing homes. Nursing staff (nurses and aides) time and resident assessment data were collected for 6,663 nursing home residents in 6 states. Me…
MDS Cognitive Performance Scale(C)
BACKGROUND: Chronic cognitive impairment is a major problem in U.S. nursing homes, yet traditional assessment systems in most facilities included only limited information on cognitive status. Following the Congressional mandate in the Omnibus Reconciliation Act of 1987 (OBRA '87), U.S. nursing homes now complete the Minimum Data Set (MDS), a standardized, comprehensive assessment of each resident's functional, medical, psychosocial, and cognitive…
Refining a Case-Mix Measure for Nursing Homes
A case-mix classification system for nursing home residents is developed, based on a sample of 7,658 residents in seven states. Data included a broad assessment of resident characteristics, corresponding to items of the Minimum Data Set, and detailed measurement of nursing staff care time over a 24-hour period and therapy staff time over a 1-week period. The Resource Utilization Groups, Version III (RUG-III) system, with 44 distinct groups, achie…
The Structure of Social Engagement among Nursing Home Residents
This research tests the reliability and construct validity of social engagement, a new quality of life measure embedded in the federally mandated Resident Assessment Instrument (RAI) for the nursing home population. The sample consisted of 1,848 residents from 268 homes in 10 states with data collected by trained research nurses. Three resident groups were formed based on residents' cognitive and ADL functioning. Social engagement was significant…
Patterns and Determinants of Health Services Use and Mortality after VA Nursing Home Care
Risk factors for institutionalization and death for up to four years for a nationwide cohort (n = 6,488) of males discharged alive from Department of Veterans Affairs (DVA) nursing homes were identified through linked records of the DVA. Two-year cumulative probabilities of nursing home readmission, hospitalization, and death among nursing home dischargees were 0.30, 0.61, and 0.24, respectively. Using multivariate survival analyses, chronic func…
Facility and Area Variation Affecting the Use of Physical Restraints in Nursing Homes
OBJECTIVES: Various individual characteristics increase a nursing home resident's likelihood of being mechanically restrained. However, there is not good information on the role played by facility characteristics and geographic area in determining the likelihood of physical restraint use. This study investigates the importance of individual, facility, and area indicators in determining the likelihood of restraint use. METHODS: This research uses …
Windows to their World
This study examined relationships between three sensory and communication abilities and two areas of nursing home resident behavior. Data from 18,873 nursing home residents include measures of hearing, visual, and communication abilities, and social engagement and time spent in activities. Increasing level of visual impairment is associated with low levels of social engagement and low time in activities. Both moderate and severe hearing impairmen…
Scaling ADLs Within the MDS
BACKGROUND: Dependency in activities of daily living (ADLs) is a reality within nursing homes, and we describe ADL measurement strategies based on items in the Minimum Data Set (MDS) and the creation and distributional properties of three ADL self-performance scales and their relationship to other measures. METHODS: Information drawn from four data sets for a multistep analysis was guided by four study objectives: (1) to identify the subcomponent…
Does Quality Influence Consumer Choice of Nursing Homes? Evidence from Nursing Home to Nursing Home Transfers
We estimated Cox proportional hazards models using assessment data from the Minimum Data Set to test whether nursing home residents and their proxies respond to quality of care by changing providers. Various indicators of poor quality increased the likelihood of transfer. Residents of for-profit homes or homes with excess capacity also were more likely to transfer. Inability to participate in care decisions and factors indicating frailty limited …
The Effect of Medicare's Prospective Payment System on Discharge Outcomes of Skilled Nursing Facility Residents
In July 1998, the Centers for Medicare and Medicaid Services (CMS) changed the payment method for Medicare (Part A) skilled nursing facility (SNF) care from a cost-based system to a prospective payment system (PPS). Unlike the previous cost-based payment system, PPS restricts skilled nursing facility payment to pre-determined levels. CMS also reduced the total payments to SNFs coincident with PPS implementation. These changes might reduce quality…
Predictors of Influenza Immunization Among Home Care Clients in Ontario
Validation of Resource Utilization Groups Version III for Home Care (RUG-III/HC)
BACKGROUND: The case-mix system Resource Utilization Groups version III for Home Care (RUG-III/HC) was derived using a modest data sample from Michigan, but to date no comprehensive large scale validation has been done. OBJECTIVES: This work examines the performance of the RUG-III/HC classification using a large sample from Ontario, Canada. METHODS: Cost episodes over a 13-week period were aggregated from individual level client billing records a…
The Forensic Supplement to the interRAI Mental Health Assessment Instrument
Background: Numerous validation studies support the use of the interRAI Mental Health (MH) assessment system for inpatient mental health assessment, triage, treatment planning, and outcome measurement. However, there have been suggestions that the interRAI MH does not include sufficient content relevant to forensic mental health. We address this potential deficiency through the development of a Forensic Supplement (FS) to the interRAI MH system. …
Medicine (23 works) · Geriatric Care and Nursing Homes (18 works) · Nursing (16 works) · Nursing homes (12 works) · Psychiatry (8 works) · Computer Science (7 works) · Gerontology (7 works) · Psychology (7 works) · Case mix index (6 works) · Dementia and Cognitive Impairment Research (6 works)