Charlene Harrington
Dados Biográficos
| ID | 3761444 |
|---|---|
| NOME | Charlene Harrington |
| PRENOMES | Charlene |
| SOBRENOME | Harrington |
| ASSINATURA | HARRINGTON C |
| AFILIAÇÕES | University of California, San Francisco |
| ORCID | 0000-0001-5716-4362 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 35 |
| TOTAL DE CITAÇÕES | 135 |
| TOTAL COMO AUTOR | 35 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1975 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2018 |
| ÍNDICE H | 6 |
Failure to Meet Nurse Staffing Standards
Large for-profit nursing home chains in the United States have generally reported low nurse staffing levels. This historical case study examined a class action litigation case regarding staffing levels, resident rights, and quality outcomes in 12 Arkansas nursing homes owned by a large for-profit chain. The questions were as follows: (1) How did the residents' care needs compare with actual nurse staffing levels? (2) How did the staffing levels c…
Predictors of Nursing Facility Entry by Medicaid-Only Older Adults and Persons With Disabilities in California
Nearly one-third of adult Medicaid beneficiaries who receive long-term services and supports (LTSS) consist of older adults and persons with disabilities who are not eligible for Medicare. Beneficiaries, advocates, and policymakers have all sought to shift LTSS to home and community settings as an alternative to institutional care. We conducted a retrospective cohort study of Medicaid-only adults in California with new use of LTSS in 2006-2007 (N…
Assessing the Quality of Nursing Homes in Managed Care Organizations
Little is known about the quality of nursing homes in managed care organizations (MCOs) networks. This study (1) described decision-making criteria for selecting nursing home networks and (2) compared selected quality indicators of network and nonnetwork nursing homes. The sample was 17 MCOs participating in a California demonstration that provided integrated long-term services and supports to dually eligible enrollees in 2017. The findings showe…
What Happens to a Nursing Home Chain When Private Equity Takes Over? A Longitudinal Case Study
We analyzed what happens to a nursing home chain when private equity takes over, with regard to strategy, financial performance, and resident well-being. We conducted a longitudinal (2000-2012) case study of a large nursing home chain that triangulated qualitative and quantitative data from 5 different data sources. Results show that private equity owners continued and reinforced several strategies that were already put in place before the takeov…
Health Care Expenditures After Initiating Long-term Services and Supports in the Community Versus in a Nursing Facility
BACKGROUND: Individuals who receive long-term services and supports (LTSS) are among the most costly participants in the Medicare and Medicaid programs. OBJECTIVES: To compare health care expenditures among users of Medicaid home and community-based services (HCBS) versus those using extended nursing facility care. RESEARCH DESIGN: Retrospective cohort analysis of California dually eligible adult Medicaid and Medicare beneficiaries who initiated …
Scandals of abuse
Purpose – The purpose of this paper is to compare two scandals related to the care of individuals with intellectual and developmental disabilities (I/DD) in the USA and the UK. Design/methodology/approach – A descriptive case study methodology was used to conduct an in-depth qualitative analysis of the two scandals to examine the process of scandal development, and to survey the policy response against policy trends and theories of abuse in each …
It is a scandal
Purpose – This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA. Design/methodology/approach – This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially…
Barriers to Use of Workplace Personal Assistance Services to Support Employment in California
Providing personal assistance services (PAS) in the workplace (WPAS) is one approach to support the employment of individuals with disabilities. This descriptive study examined the implementation of Medicaid WPAS by collecting and analyzing telephone interview data from key informants selected from county and public authority officials in California in 2010. The results showed that less than a fraction of 1% of individuals with disabilities who u…
The Relationship of California’s Medicaid Reimbursement System to Nurse Staffing Levels
BACKGROUND: Policy initiatives at the Federal and state level are aimed at increasing staffing in nursing homes. These include direct staffing standards, public reporting, and financial incentives. OBJECTIVE: To examine the impact of California's Medicaid reimbursement for nursing homes which includes incentives directed at staffing. RESEARCH DESIGN: Two-stage limited-information maximum-likelihood regressions were used to model the relationship …
Does State Regulation of Quality Impose Costs on Nursing Homes
BACKGROUND: Government regulation is intended to enhance quality, safety, fairness, or competition in the regulated industry. Such regulation entails both direct and indirect costs. OBJECTIVES: To estimate the costs associated with the regulation of quality of the nursing home industry. SAMPLE: This study includes 11,168 free-standing nursing homes nationally, between 2004 and 2006. RESEARCH DESIGN: Data included information from the Medicare cos…
A Panel Data Analysis of the Relationships of Nursing Home Staffing Levels and Standards to Regulatory Deficiencies
Total nursing staffing and RN staffing levels were predictors of nursing home quality. Further research is needed on the effectiveness of state minimum staffing standards
Developing Personal Care Programs
This paper examines the development of programs delivering personal care to the elderly and disabled. First, we report the latest national participant and expenditure trend data for the three main personal care programs: the Medicaid Personal Care Services (PCS) benefit, Medicaid 1915(c) waivers, and the Older Americans Act Title III. Second, to examine interstate variation revealed in the trend analysis, we present three time-series regression m…
California Nursing Facility Quality and Union Environments
These findings suggest that unionization enhances problem reporting while, especially in stronger union environments, reducing the incidence of serious quality violations
Smoke without Fire
This paper draws from a rich longitudinal California data set to analyze the scope and nature of nursing home closures between 1997 and 2001, and to present a Cox proportionate hazards model of the risks of closure that arise from a range of facility and market characteristics. When compared with the sample total of 1,482 facilities operating in the baseline year of 1997, only 56 facilities closed through 2001, involving the loss of 3.8% of facil…
Unmet Need for Personal Assistance Services
Overall, just 6.6% of needed hours are unmet among the 3.3 million people needing help in two or more ADLs. We estimate the annual cost of eliminating unmet need among persons with incomes under 300% of the Supplemental Security Income level between 1.2 and 2.7 billion dollars for those living alone and from 2.2 to 7.1 billion dollars for those living with others
Medicaid Community-Based Programs
As states face challenges posed by budget crises and pressures to develop Medicaid home and community-based services (HCBS), this paper provides a longitudinal analysis of state variation in expenditures and utilization for three HCBS programs (waivers, home health and personal care), and for total Medicaid HCBS. The first part of the analysis describes the nature and scope of state variation for each program in 1999, using such measures as parti…
Quality of Care in Nursing Homes
BACKGROUND: Recent work has highlighted a negative correlation between proprietary status and nursing home quality of care. This relationship might be explained by the context in which proprietary homes operate. However, another possible explanation is that some proprietary homes take excessive profit to the detriment of care quality. OBJECTIVE: To examine the relationship between profit levels and quality in proprietary and nonproprietary nursin…
Access to Community-Based Long-Term Care
Recent legal rulings, combined with the demonstrated preferences of most individuals to receive care in the community, require policies to foster the expansion of Medicaid community-based care. The most consistent relationships that are amenable to policy intervention relate to state fiscal resources and long-term care supply regulation
Residential Care Supply and Cognitive and Physical Problem Case Mix in Nursing Homes
The findings raise caution about the optimistic assumptions of the interplay between residential care/assisted living policy and nursing-home use
Does Investor Ownership of Nursing Homes Compromise the Quality of Care
Objectives. Two thirds of nursing homes are investor owned. This study examined whether investor ownership affects quality. Methods. We analyzed 1998 data from state inspections of 13 693 nursing facilities. We used a multivariate model and controlled for case mix, facility characteristics, and location. Results. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit facilities and 43.0% higher than public faci…
Nursing Home Staffing and Its Relationship to Deficiencies
Facility characteristics and states were stronger predictors of deficiencies than were staffing hours and resident characteristics. Because only a small portion of the total variance in deficiencies could be explained, much work remains to explore factors that influence deficiencies
Readings in the Sociology of Aids
What Is Sociological about AIDS? *Social Epidemiology and Demography *Identity and Behavior *The Life Course *Caregiving *Knowledge, Attitudes, and Collective Behavior *Social Stratification *Organizations and Services *Health Professions and Occupations *Economics *Public Policy Index
Community-based service use by people with Aids
This paper reports on community-based service use by persons with AIDS or disabling HIV (PWAs) who have an informal caregiver, with specific focus on four categories of service: nursing care; practical help; psychological services; and help with the management of personal affairs. Data are drawn from a large-scale community-based survey of caregivers in San Francisco and Los Angeles (n = 642). Caregivers report that PWAs make substantial use of c…
State-imposed limits on Medicaid reimbursement for nursing facility care
OBJECTIVES: Nursing cost-center limits were examined, along with their effects on Medicaid. METHODS: A national survey of Medicaid nursing facility reimbursement provided data on cost centers for nursing, administration, and capital, whether in specific, larger, or multiple cost centers. RESULTS: Most states impose nursing and administration limits. Far fewer states impose capital limits, but only capital limits may be related to constraint of re…
The Effect of Certificate of Need and Moratoria Policy on Change in Nursing Home Beds in the United States
OBJECTIVES: This study examined the effects of state certificate of need and/or moratorium requirements on the change in nursing home bed growth in states over a 13-year period. METHODS: Data were collected from five telephone surveys of state officials about state certificate of need and moratorium policies, state Medicaid nursing home reimbursement rates, and the licensed nursing home beds in each state for the 1979 through 1993 period. Two-sta…
Nursing Home Staffing and Its Relationship to Deficiencies
Facility characteristics and states were stronger predictors of deficiencies than were staffing hours and resident characteristics. Because only a small portion of the total variance in deficiencies could be explained, much work remains to explore factors that influence deficiencies
Does Investor Ownership of Nursing Homes Compromise the Quality of Care
Objectives. Two thirds of nursing homes are investor owned. This study examined whether investor ownership affects quality. Methods. We analyzed 1998 data from state inspections of 13 693 nursing facilities. We used a multivariate model and controlled for case mix, facility characteristics, and location. Results. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit facilities and 43.0% higher than public faci…
Unmet Need for Personal Assistance Services
Overall, just 6.6% of needed hours are unmet among the 3.3 million people needing help in two or more ADLs. We estimate the annual cost of eliminating unmet need among persons with incomes under 300% of the Supplemental Security Income level between 1.2 and 2.7 billion dollars for those living alone and from 2.2 to 7.1 billion dollars for those living with others
It is a scandal
Purpose – This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA. Design/methodology/approach – This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially…
A Panel Data Analysis of the Relationships of Nursing Home Staffing Levels and Standards to Regulatory Deficiencies
Total nursing staffing and RN staffing levels were predictors of nursing home quality. Further research is needed on the effectiveness of state minimum staffing standards
Fiscal Crisis, Deinstitutionalization, and the Elderly
Access to Community-Based Long-Term Care
Recent legal rulings, combined with the demonstrated preferences of most individuals to receive care in the community, require policies to foster the expansion of Medicaid community-based care. The most consistent relationships that are amenable to policy intervention relate to state fiscal resources and long-term care supply regulation
Residential Care Supply and Cognitive and Physical Problem Case Mix in Nursing Homes
The findings raise caution about the optimistic assumptions of the interplay between residential care/assisted living policy and nursing-home use
State-imposed limits on Medicaid reimbursement for nursing facility care
OBJECTIVES: Nursing cost-center limits were examined, along with their effects on Medicaid. METHODS: A national survey of Medicaid nursing facility reimbursement provided data on cost centers for nursing, administration, and capital, whether in specific, larger, or multiple cost centers. RESULTS: Most states impose nursing and administration limits. Far fewer states impose capital limits, but only capital limits may be related to constraint of re…
Medical Ideologies in Conflict
During the 1960s, the growing dissent within the medical profession heightened the ideological differences among physicians. This paper focuses on the ideological differences among three groups within medicine: traditionalists, liberals, and radicals. A content analysis of selected medical editorials and articles during 1972 was used to identify differences in ideological content for the following areas: professional unity; authority; self-regula…
Sociology
The Sex Factor and the Management of Schools. Neal Gross , Anne E. Trask
The meaning of disability
The meaning of disability
Fiscal Crisis, Deinstitutionalization, and the Elderly
Long-Term Care of the Elderly
A Method for Adjusting Capitation Payments to Managed Care Plans Using Multivariate Patterns of Health and Functioning
A multivariate procedure for identifying case-mix dimensions from discrete health variables is presented. Since the dimensions are generated only from health use data and not service use data, they can be used for adjust capitation rates to provide incentives to treat persons not currently well integrated in standard health care system (e.g., very ill persons, the uninsured) or to promote specific health outcomes. The procedure is illustrated wit…
Evaluating Long-Term Care Demonstrations in Real Time with Study Design and Plan Performance Interactions
The evaluation of long-term care demonstrations has to deal with complex organizational entities, with large, heterogeneous client populations that, during the course of study, may have to change features of their organization or operation. The implications of such "real-time" changes are discussed for analyses of the operation and performance of Social/Health Maintenance Organizations over a 5-year period (2 years of start-up and enrollment and …
Market Ideology in Health Care and the Catholic Church
State-imposed limits on Medicaid reimbursement for nursing facility care
OBJECTIVES: Nursing cost-center limits were examined, along with their effects on Medicaid. METHODS: A national survey of Medicaid nursing facility reimbursement provided data on cost centers for nursing, administration, and capital, whether in specific, larger, or multiple cost centers. RESULTS: Most states impose nursing and administration limits. Far fewer states impose capital limits, but only capital limits may be related to constraint of re…
The Effect of Certificate of Need and Moratoria Policy on Change in Nursing Home Beds in the United States
OBJECTIVES: This study examined the effects of state certificate of need and/or moratorium requirements on the change in nursing home bed growth in states over a 13-year period. METHODS: Data were collected from five telephone surveys of state officials about state certificate of need and moratorium policies, state Medicaid nursing home reimbursement rates, and the licensed nursing home beds in each state for the 1979 through 1993 period. Two-sta…
Community-based service use by people with Aids
This paper reports on community-based service use by persons with AIDS or disabling HIV (PWAs) who have an informal caregiver, with specific focus on four categories of service: nursing care; practical help; psychological services; and help with the management of personal affairs. Data are drawn from a large-scale community-based survey of caregivers in San Francisco and Los Angeles (n = 642). Caregivers report that PWAs make substantial use of c…
Nursing Home Staffing and Its Relationship to Deficiencies
Facility characteristics and states were stronger predictors of deficiencies than were staffing hours and resident characteristics. Because only a small portion of the total variance in deficiencies could be explained, much work remains to explore factors that influence deficiencies
Readings in the Sociology of Aids
What Is Sociological about AIDS? *Social Epidemiology and Demography *Identity and Behavior *The Life Course *Caregiving *Knowledge, Attitudes, and Collective Behavior *Social Stratification *Organizations and Services *Health Professions and Occupations *Economics *Public Policy Index
Residential Care Supply and Cognitive and Physical Problem Case Mix in Nursing Homes
The findings raise caution about the optimistic assumptions of the interplay between residential care/assisted living policy and nursing-home use
Does Investor Ownership of Nursing Homes Compromise the Quality of Care
Objectives. Two thirds of nursing homes are investor owned. This study examined whether investor ownership affects quality. Methods. We analyzed 1998 data from state inspections of 13 693 nursing facilities. We used a multivariate model and controlled for case mix, facility characteristics, and location. Results. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit facilities and 43.0% higher than public faci…
Access to Community-Based Long-Term Care
Recent legal rulings, combined with the demonstrated preferences of most individuals to receive care in the community, require policies to foster the expansion of Medicaid community-based care. The most consistent relationships that are amenable to policy intervention relate to state fiscal resources and long-term care supply regulation
Medicaid Community-Based Programs
As states face challenges posed by budget crises and pressures to develop Medicaid home and community-based services (HCBS), this paper provides a longitudinal analysis of state variation in expenditures and utilization for three HCBS programs (waivers, home health and personal care), and for total Medicaid HCBS. The first part of the analysis describes the nature and scope of state variation for each program in 1999, using such measures as parti…
Quality of Care in Nursing Homes
BACKGROUND: Recent work has highlighted a negative correlation between proprietary status and nursing home quality of care. This relationship might be explained by the context in which proprietary homes operate. However, another possible explanation is that some proprietary homes take excessive profit to the detriment of care quality. OBJECTIVE: To examine the relationship between profit levels and quality in proprietary and nonproprietary nursin…
Smoke without Fire
This paper draws from a rich longitudinal California data set to analyze the scope and nature of nursing home closures between 1997 and 2001, and to present a Cox proportionate hazards model of the risks of closure that arise from a range of facility and market characteristics. When compared with the sample total of 1,482 facilities operating in the baseline year of 1997, only 56 facilities closed through 2001, involving the loss of 3.8% of facil…
Unmet Need for Personal Assistance Services
Overall, just 6.6% of needed hours are unmet among the 3.3 million people needing help in two or more ADLs. We estimate the annual cost of eliminating unmet need among persons with incomes under 300% of the Supplemental Security Income level between 1.2 and 2.7 billion dollars for those living alone and from 2.2 to 7.1 billion dollars for those living with others
Developing Personal Care Programs
This paper examines the development of programs delivering personal care to the elderly and disabled. First, we report the latest national participant and expenditure trend data for the three main personal care programs: the Medicaid Personal Care Services (PCS) benefit, Medicaid 1915(c) waivers, and the Older Americans Act Title III. Second, to examine interstate variation revealed in the trend analysis, we present three time-series regression m…
California Nursing Facility Quality and Union Environments
These findings suggest that unionization enhances problem reporting while, especially in stronger union environments, reducing the incidence of serious quality violations
A Panel Data Analysis of the Relationships of Nursing Home Staffing Levels and Standards to Regulatory Deficiencies
Total nursing staffing and RN staffing levels were predictors of nursing home quality. Further research is needed on the effectiveness of state minimum staffing standards
Medicine (28 obras) · Geriatric Care and Nursing Homes (22 obras) · Nursing (22 obras) · Business (18 obras) · Health care (13 obras) · Nursing homes (12 obras) · Economics (11 obras) · Gerontology (11 obras) · Medicaid (10 obras) · Sociology (10 obras)