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Facility and Market Factors Affecting Transitions From Nursing Home to Community

Bibliographic Data

ID9097650
AuthorsGreg Arling (0000-0001-8563-9433, Indiana University School of Medicine, corresponding author), Kathleen A Abrahamson, Kathleen Abrahamson (0000-0003-0132-7673, Western Kentucky University), Valerie Cooke (Minnesota Department of Human Services), Robert L Kane (0009-0005-8505-6218, University of Minnesota), Teresa Lewis (Minnesota Department of Human Services)
Year2011
Volume49
Issue9
Pages790-796
Publication date2011-09-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31821b3548
PMID21577163
OpenAlexW2124936225
LanguageEN
Citations received1

BACKGROUND: Research into nursing home transitions has given limited attention to the facility or community contexts. OBJECTIVE: To identify facility and market factors affecting transitions of nursing home residents back to the community. RESEARCH DESIGN: Multilevel models were used to estimate effects of facility and market factors on facility-level community discharge rates after controlling for resident demographic, health, and functional conditions. Facility discharge rates were adjusted using Empirical Bayes estimation. SUBJECTS: Annual cohort of first-time admissions (N=24,648) to 378 Minnesota nursing facilities in 75 nursing home markets from July 2005 to June 2006. MEASURES: Community discharge within 90 days of admission; facility occupancy, payer mix, ownership, case-mix acuity, size, admissions from hospitals, nurse staffing level, and proportion of admissions preferring or having support to return to the community; and nursing market population size, average occupancy, market concentration, and availability of home and community-based services. RESULTS: Rates of community discharge (Empirical Bayes residual) were highest in facilities with more residents preferring community discharge, more Medicare days, higher nurse staffing levels, and higher occupancy. In addition, facilities had higher community discharge rates if they were located in markets with a greater ratio of home and community-based services recipients to nursing home residents and with larger populations. CONCLUSIONS: State Medicaid programs should undertake system-level interventions that encourage nursing facilities to reduce unused bed capacity, balance the mix of payers, invest in nurse staffing, and take other steps to promote community discharges. In addition, states should increase home and community-based services, particularly in markets with low community discharge rates

Business · Nursing homes · Skilled Nursing Facility · Geriatric Care and Nursing Homes · Heart Failure Treatment and Management · Medicine · Nursing · Gerontology

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Citations per year0.11
Citation span2017 - 2017 (1)
Highly citedNo

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