Improving the quality of care in nursing homes / Committee on Nursing Home Regulation, Institute of Medicine.

Format:

Book

Author/Creator:

Institute of Medicine (U.S.). Committee on Nursing Home Regulation.

Language:

English

Subjects (All):

Old age homes--Standards--United States.

Old age homes.

Nursing homes--Standards--United States.

Nursing homes.

Physical Description:

1 online resource (431 pages)

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1986.

Language Note:

English

Summary:

As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.

Contents:

Improving the Quality of Care in Nursing Homes; Copyright; Preface; Acknowledgments; Contents; 1 Introduction and Summary ; PURPOSE OF THE STUDY; THE PUBLIC POLICY CONTEXT OF THE STUDY; PERSPECTIVE ON THE ISSUES; The Role of Nursing Homes; Quality of Care and Quality of Life; The Regulatory System; Other Factors Affecting Quality of Care in Nursing Homes; Other Regulatory Policies; Consumers, the Community, and Nursing Home Management and Staff; CONCLUSIONS; SUMMARY OF RECOMMENDATIONS; Regulatory Criteria; Monitoring Nursing Home Performance; Enforcing Compliance with Federal Standards

Other Factors Affecting Quality of Care and Quality of Life in Nursing Homes; Issues Requiring Further Study; Information Systems; Medicaid Payment Policies; Nursing Home Bed Supply; Staffing of Nursing Homes; Single- Versus Multiple-Occupancy Rooms; 2 Concepts of Quality, Quality Assessment, and Quality Assurance ; QUALITY OF CARE IN NURSING HOMES; Characteristics of the Residents; Care Needs; The Care Setting; Requirements for High-Quality Care; Planning And Providing Care; QUALITY OF LIFE; QUALITY ASSESSMENT CRITERIA; Structure; Process; Outcomes; ASSESSING QUALITY OF CARE

Functional Competency/Impairment; Intellectual Impairment/Behavioral Problems; PERSPECTIVE ON QUALITY ASSURANCE; INTERPRETING AND USING INFORMATION FOR QUALITY ASSURANCE; Measurement of Care Quality; Standards; Case Mix; Standard Instruments; National, Regional, and Local Uses; QUALITY ASSURANCE AND THE REGULATORY SYSTEM; 3 Regulatory Criteria ; THE ISSUES; CONSOLIDATING THE TWO SETS OF CRITERIA; RESIDENT ASSESSMENT; REVISING AND STRENGTHENING THE CONDITIONS AND STANDARDS; Quality of Life; Quality of Care; Residents' Rights; Administration; Training of Nurse's Aides; Discrimination

Notification; Participation; Access; Physical Environment; NOTE ON STAFFING STANDARDS; General; Social Services; Licensed and Registered Nurses; 4 Monitoring Nursing Home Performance ; THE ISSUES; PROBLEMS WITH THE SURVEY PROCESS; Predictability; Inefficiency; Paper Compliance; Insensitivity to Resident Needs; Inconsistency; Isolation from Related Monitoring Processes; Variable State Regulatory Capacity; REDESIGNING THE SURVEY PROCESS; Consolidation of Medicare and Medicaid Survey Procedures; Timing and Frequency of Surveys; Two-Stage Survey Approach; The Resident Assessment Audit

The Standard Survey; The Extended Survey; Case-Mix Referencing; Key Indicators; Triggering an Extended Survey: Scoring and Decision-Making; Survey Data Sources; Coordination with Complaint Programs; Consumer Involvement; Positive Incentives; Continuing Improvement of the Survey Process; Reliability and Validity of Instruments and Procedures; Consistency of Survey Results; PACS: AN NEW HCFA SURVEY PROTOCOL; INCREASING STATE REGULATORY CAPACITY; Federal Funding of Certification Activities; State Surveyor Qualifications; Federal Training Support; Dissemination of Research and Evaluation Results; Federal Oversight and Sanctioning Responsibilities

Notes:

"Report of a study conducted under contract no. 500-83-0054 with the Health Care Financing Administration"--T.p. verso.

"Publication IOM-85-10"--T.p. verso.

Includes bibliography: p. 213-237 and index.

ISBN:

9786610221691

9781280221699

1280221690

9780309554848

0309554845

9780585144344

0585144346

OCLC:

940510469