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As the late Robert Kane observed, the term nursing home is often a misnomer. Most U.S. nursing homes lack adequate nursing staff, and they are typically not very homelike in either their physical structure or culture. These problems were magnified during the pandemic. The underlying reasons for these longstanding issues are that most state Medicaid payment systems reimburse nursing homes at a relatively low level and the government does not hold nursing homes accountable for spending dollars on direct resident care. To encourage increased staffing and more homelike models of care, policymakers need to reform how nursing homes are paid and hold facilities accountable for how they spend government dollars. With these reforms, the term nursing home will become more appropriate in the United States.

NURSING HOMES: QUALITY AND CARE ISSUES -- NURSING HOMES: QUALITY AND CARE ISSUES -- CONTENTS -- PREFACE -- Chapter 1 NURSING HOME REFORM: CONTINUED ATTENTION IS NEEDED TO IMPROVE QUALITY OF CARE IN A SMALL BUT SIGNIFICANT SHARE OF HOMES -- Why GAO Did This Study -- What GAO Found -- Background -- Survey Process -- Enforcement -- Oversight -- Quality of Care Remains a Problem for a Small but Significant Proportion of Nursing Homes Nationwide -- CMS Has Strengthened Its Enforcement Capabilities, although Key Initiatives Still Need Refinement

In 'Nursing Homes Explained,' an RN specializing in Gerontology shares her knowledge to help prepare readers for the inevitable decisions that have to be made as we and our loved ones age, and it provides a useful overview of the industry for nursing students and others thinking of entering the field. The book educates readers about the long-term care industry and the field of gerontology, with a discussion on death and dying, Alzheimer units, rehabilitation processes, elder abuse, the physician's role, and how corporations, middle management and direct care providers operate within the elder-

In 'Nursing Homes Explained, ' an RN specializing in Gerontology shares her knowledge to help prepare readers for the inevitable decisions that have to be made as we and our loved ones age, and it provides a useful overview of the industry for nursing students and others thinking of entering the field. The book educates readers about the long-term care industry and the field of gerontology, with a discussion on death and dying, Alzheimer units, rehabilitation processes, elder abuse, the physician's role, and how corporations, middle management and direct care providers operate within the elder-

Cover -- Praise -- Title Page -- Copyright Page -- Acknowledgments -- About the Author -- Table of Contents -- Reviewers -- Foreword -- Introduction -- Chapter 1_Healthcare: Overview of Change and Complexity -- Chapter 2_What Is Home Healthcare and Home Care Comprised of Exactly? -- Chapter 3_What Makes Home Care the Most Unique Practice Setting? -- Chapter 4_Becoming a Home Care Clinician or Manager: Information Needed for Success -- Chapter 5_The Environment of Care: The Home and Community Interface -- Chapter 6_The Fundamentals: The Interface of Law, Regulation, and Quality

Nursing in Care Homes is a practical guide for nurses of all levels working in care homes. It is directly relevant to everyday practice and covers clinical issues such as continence care, wound care, infection control, and nutrition, as well as information on a wide range of issues including legal requirements, care home standards, and liasing with social and health care services. The revised and updated second edition includes new chapters on maximising abilities, risk management, stroke, and diabetes and calls upon the recommendations of the National Service Framework for Older People and th

Nursing Home Compare (NHC) publishes composite quality ratings of nursing homes based on a five-star rating system, a system that has been subject to controversy about its validity. Using in-depth interviews, we assess the views of nursing home administrators and staff on NHC and unearth strategies used to improve ratings. Respondents revealed conflicting goals and strategies. Although nursing home managers monitor the ratings and expend effort to improve scores, competing goals of revenue maximization and avoidance of litigation often overshadow desire to score well on NHC. Some of the improvement strategies simply involve coding changes that have no effect on resident outcomes. Many respondents doubted the validity of the self-reported staffing data and stated that lack of risk adjustment biases ratings. Policy makers should consider nursing home incentives when refining the system, aiming to improve the validity of the self-reported domains to provide incentives for broader quality improvement.