Purpose: This study aims to examine culture change in nursing homes in South Korea and to identify the outcomes of culture change implementation. Design and Methods: Data were taken from survey responses from 223 top- or mid-level staff among nursing homes in South Korea that were selected through a proportionate random-stratified sampling method…

Purpose: Individuals receiving postacute care in skilled nursing facilities often require complex, skilled care provided by licensed nurses. It is believed that a stable set of nursing personnel is more likely to deliver better care. The purpose of this study was to determine the relationships among licensed nurse retention, turnover, and a 30-day…

Purpose: Theories of the policy process recognize that policy proposals are typically generated, debated, redrafted, and accepted for consideration through the gradual accumulation of knowledge within communities of specialists. Thus, to inform long-term care (LTC) reform efforts, we conducted a Web-based survey of 1,147 LTC specialists…

Purpose: Although the nursing facility transition literature is growing, little research has analyzed the characteristics of individuals so assisted or compared participants to those who remain institutionalized. This article describes an analytic method that researchers can apply to address these knowledge gaps, using the Arkansas Passages…

Purpose: The purpose of this study was to quantify the effect of specific nursing home features and state Medicaid policies on the risk of hospitalization among cognitively impaired nursing home residents. Design and Methods: We used multilevel logistic regression to estimate the odds of hospitalization among long-stay (greater than 90 days)…

Purpose: We examined the relationship between the quality indicator for decline in activities of daily living (ADL) and the use of the Minimum Data Set (MDS) for determining Medicaid skilled nursing facility reimbursement. Design and Methods: We conducted a cross-sectional analysis using the 2004 National MDS Facility Quality Indicator reports as…

Background: One hundred and forty-two children and adults with profound intellectual and multiple disabilities were identified in 1993 in a single Scottish region on whom detailed information was collected via a postal questionnaire survey. Methods: They were followed up in 2003. The time spanned represented a period of significant policy change…

Purpose: Previous research in specific locales indicates that individuals admitted to rural nursing homes have lower care needs than individuals admitted to nursing homes in urban areas, and that rural nursing homes differ in their mix of short-stay and chronic-care residents. This research investigates whether differences in acuity are a function…

Purpose: We compared inpatient days, nursing home days, and total Medicaid claims for five Medicaid-funded home- and community-based services (HCBS) programs for in-home and assisted living services in Florida. Design and Methods: We studied a single cohort of Medicaid enrollees in Florida aged 60 and older, who were enrolled for the first time in…

Statistical and legal analysis of California nursing home admission agreements indicated that agreements limited autonomy of nursing home residents in important ways, including constraints on resident's right to make health care decisions and other basic personal choices, entitlement to due process or grievance procedures, and right to informed…

The survey of state Medicaid programs concerning reimbursement policies and per diem rates for private Intermediate Care Facilities for the Mentally Retarded for 1978-86 focused on: reimbursement methods; trends in reimbursement rates; and factors affecting reimbursement, including economic factors, reimbursement policies, eligibility policy, bed…

Purpose: While state policy and market factors are known to have contributed to the increased supply of residential care, little is known about efforts to accommodate demand from lower-income consumers. This study describes participation and expenditure trends for residential care services funded by Medicaid waivers and examines variation across…

This report examines policy-related trends and projections in the use of various Medicaid-funded care services for persons with mental retardation and related conditions, and identifies factors influencing these trends nationally and in the various states. The examination is based on three sets of research activities: analyses of databases on…

A shortage of home care paraprofessionals in Ohio is causing concern about the quality and continuity of care. Worker turnover is high, ranging from 30-70 percent. Most paraprofessionals share several traits: middle-aged women; single, with dependents; sole breadwinners in their households; wage earners of less than $11,000 per year; part-time…