Abstract
While the delivery of long-term care (LTC) continues to become more community-based, the traditional model of LTC remains the skilled nursing facility (SNF) with over 16,000 Medicare and Medicaid certified nursing facilities in the USA and almost 1.5 million residents. State Medicaid programs pay for the majority of the frail elderly care. Typically, residents of SNFs require skilled nursing care for the management of multiple chronic conditions, taking on average 8–10 medications per day. The care in nursing facilities is highly regulated through both state and federal regulations developed to ensure appropriate resident care. This care is provided through an interdisciplinary team that strives to have each resident attain the highest practicable level of well-being.
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Payment/AcuteInpatientPPS/Readmissions-Reduction-Program.html. https://www.nhqualitycampaign.org/files/Transition_of_Care_Reference.pdf.
Bureau of Labor Statistics. May, 2013. http://www.bls.gov/oes/current/oes291141.htm.
http://www.iom.edu/Reports/1986/Improving-the-Quality-of-Care-in-Nursing-Homes.aspx.
Nursing home reform: continued attention is needed to improve quality of care in small but significant share of facilities. Testimony before the Special Committee on Aging, US Senate. Washington, DC: General Accounting Office, 2007.
Morley JD. Rapid cycles, an essential part of the medical director’s role. J Am Med Dir Assoc. 2008;8(1):535–8.
Stefanacci RG. Determining the future of long-term care. Ann LTC. 2014;22:5.
Commission on Long-Term Care. Report to Congress. www.gpo.gov/fdsys/pkg/GPO-LTCCOMMISSION/pdf/GPO-LTCCOMMISSION.pdf. Published September 30, 2013. Accessed 28 Apr 2014.
Feinberg L, Reinhard SC, Houser A, Choula R. Valuing the invaluable: 2011 update the growing contributions and costs of family caregiving. http://assets.aarp.org/rgcenter/ppi/ltc/i51-caregiving.pdf. Accessed 16 Apr 2014.
O’Shaughnessy CV, National Health Policy Forum. National Spending for Long-Term Services and Supports (LTSS), 2012. www.nhpf.org/library/the-basics/ Basics_LTSS_03-27-14.pdf. Accessed 1 Feb 2013.
Skilled nursing facility services paymentbasics payment system. Revised, October, 2014. www.MEDPAC.gov.
Kripalani S, LeFevre F, Phillips CO, et al. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007;297(8):831–41. https://www.nhqualitycampaign.org/files/Transition_of_Care_Reference.pdf.
Lester P, Stefanacci RG, Chen DG. Nursing home procedures on transitions of care. J Am Med Dir Assoc. 2009;10(9):634–8.
Louden K. Creating a better discharge summary: is standardization the answer? ACP Hospitalist. 2009. http://www.acphospitalist.org/archives/2009/03/discharge.htm. Accessed 23 Feb 2010.
Snow V, Beck D, Budnitz T, et al. Transitions of care consensus policy statement: American College of Physicians, Society of General Internal Medicine, Society of Hospital Medicine, American Geriatrics Society, American College of Emergency Physicians, and Society for Academic Emergency Medicine. J Hosp Med. 2009;4:364–70.
Stefanacci RG. Long-term care regulatory and practice changes: impact on care, quality, and access. Ann LTC. 2014;22:11.
Bundled payments for care improvement initiative: general information. Centers for Medicare and Medicaid Services website. http://innovation.cms.gov/initiatives/bundled-payments. Accessed 8 Oct 2014.
Changes in ACO participants and ACO providers/suppliers during the agreement period. Centers for Medicare & Medicaid website. www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogr. Updated 27 Aug 2014. Accessed 8 Oct 8 2014.
Delisle DR. Big things come in bundled packages: implications of bundled payment systems in health care reimbursement reform. Am J Med Qual. 2013;28(4):339–44.
O’Byrne TJ, Shah ND, Wood D, et al. Episode-based payment: evaluating the impact on chronic conditions. Medicare Medicaid Res Rev. 2013;3(3).
Chandra A, Dalton MA, Holmes J. Large increases in spending on postacute care in Medicare point to the potential for cost savings in these settings. Health Aff (Millwood). 2013;32(5):864–72.
Bilimoria NM. ACOs and long-term care: it’s all about readmissions. Readmissions News. 2013;2(2):1,5,6. www.setma.com/In-The-News/pdfs/Readmissions-News-Feb-2013.pdf. Accessed 8 Oct 2014.
Centers for Medicare & Medicaid Services. Medicaid managed care enrollment report: summary statistics as of July 1, 2011. www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Data-and-Systems/Medicaid-Managed-Care/Medicaid-Managed-Care-Enrollment-Report.html. Accessed 15 Oct 2014. See more at: http://www.annalsoflongtermcare.com/article/long-term-care-regulatory-and-practice-changes-impact-care-quality-and-access#sthash.E7AAhu72.dpuf.
Federal coordinated health care office. Centers for Medicare & Medicaid website. www.cms.gov/About-CMS/Agency-Information/CMSLeadership/Office_FCHCO.html. Updated 1 Aug 2014. Accessed 15 Oct 2014.
Nursing home value-based purchasing demonstration. Centers for Medicare & Medicaid Services website. www.cms.gov/Medicare/demonstration-Projects/demoProjectsEvalRpts/downdload. Accessed 15 Oct 2014.
Evaluation of the nursing home value-based purchasing demonstration: Year 3 and final evaluation report. Washington, DC: L&M Policy Research LLC, 2013. http://innovation.cms.gov/Files/reports/NursingHomeVBP_EvalReport.pdf. Accessed October 15, 2014. - See more at: http://www.annalsoflongtermcare.com/article/long-term-care-regulatory-and-practice-changes-impact-care-quality-and-access#sthash.E7AAhu72.dpuf.
Are there penalties to providers who don’t switch to electronic health records? HealthIT.gov. www.healthit.gov/providers-professionals/faqs/are-there-penalties-providers-who-don%E2%80%99t-switch-electronic-health-record. Updated 15 Jan 2013. Accessed 15 Oct 2014. See more at: http://www.annalsoflongtermcare.com/article/long-term-care-regulatory-and-practice-changes-impact-care-quality-and-access#sthash.E7AAhu72.dpuf.
Eligibility. Centers for Medicare & Medicaid website. www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/el.Updated May 2012. Accessed 15 Oct 2014.
Physician quality reporting system. Centers for Medicare & Medicaid Services website. www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html. Updated Jun 2014. Accessed 15 Oct 2014. See more at: http://www.annalsoflongtermcare.com/article/long-term-care-regulatory-and-practice-changes-impact-care-quality-and-access#sthash.E7AAhu72.dpuf.
Payment adjustment information. Centers for Medicare & Medicaid Services website. www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Payment-Adjustment-Information.html. Updated Sept 2014. Accessed 15 Oct 2014. See more at: http://www.annalsoflongtermcare.com/article/long-term-care-regulatory-and-practice-changes-impact-care-quality-and-access#sthash.E7AAhu72.dpuf.
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Stefanacci, R.G., Brown, G., Reich, S. (2016). Behind the Scenes at Nursing Facilities. In: Fenstemacher, P., Winn, P. (eds) Post-Acute and Long-Term Medicine. Current Clinical Practice. Humana Press, Cham. https://doi.org/10.1007/978-3-319-16979-8_5
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