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Clinicians who work at skilled nursing facilities and nursing homes can be crucial to improve the quality of https://www.mcknights.com/news/snfists-found-to-reduce-burdensome-end-of-life-care/ for residents, according to a new study. During the past two [...]

Objective: To evaluate how post-acute care (PAC) transitions affect minority older adults with Alzheimer's disease or related dementia (ADRD), and the extent to which dual Medicare-Medicaid eligibility may attenuate or exacerbate disparities in PAC outcomes. We examined: (1) PAC referrals by race/ethnicity and dual status; (2) individual, hospital, and market-level factors associated with PAC; (3) the association between PAC and outcomes. Data Sources/Study Setting: We used the following secondary data: Master Beneficiary Summary File (MBSF), Medicare Provider Analysis and Review (MedPAR), Minimum Data Set (MDS), Area Health Resource File (AHRF), hospital Provider of Services (POS) file, and the area deprivation index (ADI). Study Design: This observational study consisted of 619,262 community-residing Medicare fee-for-service (FFS) beneficiaries with ADRD who had a hospital stay in 2017. Data Collection/Extraction Methods: PAC discharge was to skilled nursing facilities (SNF), home health care (HHC) agencies or home without services. Outcomes were 30-day readmission and death. Multinomial logistic regressions with hospital random effects (RE), stratified by dual eligibility, were fit. Principal Findings: Dual-related differences were significantly larger than race/ethnicity differences in PAC transitions. For example, the difference in the probability of SNF transitions between White and Black patients was 3.2% and 6.8%-points for non-duals and duals, respectively. The difference between non-dual/dual White patients was 21.6% points, and among Black patients 18.0%-points. The adjusted risk of 30-day readmission was 5.6 percentage point higher among non-duals discharged to SNF, compared to home, but such risk among duals was not statistically significantly different. The adjusted probabilities of 30-day mortality were larger for duals and non-duals who transitioned to SNF, compared to those discharged home. Conclusions: PAC referrals and the resulting outcomes for Medicare beneficiaries with ADRD are associated with multi-level variables that need to be incorporated in discharge decision making. KEYWORDS Alzheimer's disease or dementia, mortality, post-acute care, readmissions What is known on this topic? * Hospitals and insurers have been shifting post-acute care (PAC) from institutional care settings to home. * Overall, for Medicare beneficiaries, studies have indicated that discharge to home health was associated with higher readmission rates. * Little is known about PAC transitions among community-dwelling Medicare beneficiaries with dementia and their impact on outcomes. What does this study add? * We found differences in PAC transitions to be more pronounced by dual status than by race/ethnicity. * PAC outcomes for hospital readmissions were not statistically significant by race/ethnicity but were by dual status. * Interventions to improve PAC transitions and outcomes for Medicare beneficiaries with ADRD should specifically consider differences duals versus non-duals in care needs and access., 1 | INTRODUCTION Post-acute care (PAC) provided in a skilled nursing home (SNF) or at home with services from a home health care (HHC) agency has been common among Medicare [...]

When people with Alzheimer’s disease and related dementias stop taking long-term opioid therapy (LTOT), they have a lower chance for short- and long-term worsening pain and depressive symptoms compared to [...]

Nursing homes that screen residents for excess daytime sleepiness (EDS) may be able to predict mortality risk, a new study finds. The condition is also linked with age-related comorbidities in [...]

A new report gives details about how nursing home administrators handled the challenges that came with supporting residents with https://www.mcknights.com/news/clinical-news/study-excess-deaths-fell-among-facility-residents-with-dementia-in-year-2-of-pandemic/ during the COVID-19 pandemic. The https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.18634 was published Thursday in [...]

A recent study found that using probiotics and antibiotics for Clostridioides difficile is safe and effective. The https://academic.oup.com/jacamr/article/5/5/dlad102/7261100?login=false was published in JAC-Antimicrobial Resistance on Sept. 6. People living in nursing [...]

The use of physical therapy following a fall-related injury significantly reduces the rate of serious new injuries, related opioid use and healthcare costs among falls-prone patients, a new study has [...]

COVID-19 cases fell across 81 nursing homes fitted with new air purification technology, highlighting the part air quality interventions can play in supporting infection control measures, a new study has [...]

Nursing home workers should be trained to provide specific care for dementia patients, whose presence in nursing homes is growing, according to new research. The study, published in Health Affairs [...]

Investigators who tracked the use of COVID-19 medications in nursing homes describe prescribing patterns that “fluctuated dramatically” over time, shedding new light on the ups and downs of clinical care [...]

Most nursing home clinicians do not include sodium/glucose cotransporter-2 inhibitors (SGLT2Is) in their diabetes treatment toolkit, a new study has found. But use of the glucose-lowering drugs is growing in [...]

A new study in more than 17,000 nursing home residents has found that a booster vaccination plus prior COVID-19 infection increased protection against severe COVID-19 outcomes in this population. This [...]

Shifting nursing home culture from “deny and defend” to “disclosure and apology” when medical mistakes are made can improve job satisfaction and help stem burnout among employees, according to new [...]

Cancer patients in nursing homes receive more aggressive end-of-life care than their community-dwelling peers, despite an increased emphasis on reducing treatments that compromise quality of life, a new study has [...]

Nursing home residents who receive a bivalent COVID-19 mRNA vaccine show signs of substantial immune system response to SARS-CoV-2, including omicron variants, federal researchers have found. The findings offer evidence [...]

Nursing home administrators stressed about their industry’s sustainability due to the costs of responding to COVID-19, lost revenue, and the negative portrayal of nursing homes by the media, found a [...]

The oldest nursing home residents derive significant protection against future SARS-CoV-2 infections when they have had a past infection and are vaccinated against COVID-19, a new study finds. These factors [...]

WASHINGTON, DC — US senior living residents average more than a dozen chronic conditions each, and many residents use high-cost healthcare services, suggesting ways that operators can integrate care and [...]

Nursing home residents do not have an increased risk of death after receiving COVID-19 vaccinations, according to a large new study from the Netherlands. In fact, their mortality risk appears [...]

Fully 11% of older patients have pressure injuries when admitted to skilled nursing facilities for post-acute stroke rehabilitation, a new study finds. Certain factors make such a diagnosis more likely, [...]

With the prospect of new strains of the COVID-19 virus looming, researchers are making a case for states to impose vaccination booster shot mandates on nursing home employees. Mandating healthcare [...]

A tool in development called the Avoidable Transfer Scale enables nursing homes to outsource quality improvement work related to potentially avoidable hospitalizations, researchers at the Regenstrief Institute and Indiana University [...]

Hospitals with a greater local supply of skilled nursing facilities and licensed nursing home beds are less likely to readmit patients with key conditions than hospitals in areas that lean [...]

Nursing facility residents who took COVID-19 antivirals pills had a relatively low hospitalization rate, but some experienced changes in mental status while taking Paxlovid, a unique call center study has [...]

Certain surgically implanted, or suprapubic, catheters do not improve outcomes that are important for older adults’ well-being, such as functional ability and cognitive status, a study in nursing homes has [...]

In a finding that may counter popular perceptions, post-acute patients transferred to skilled nursing facilities in 2020 had a relatively low overall risk of COVID-19 infection and death, although mortality [...]

Two common types of antibiotic-resistant bacteria linger in nursing homes, putting vulnerable residents at risk of infection despite cleanings — and even during changes of occupancy, according to a new [...]

With important exceptions, hypertension (high blood pressure) is well-controlled in nursing homes run by the U.S. Veterans Administration, a new study finds. Poor control of hypertension — both under- and [...]