WHAT THIS MEANS FOR YOU: A new methodology was developed for identifying Medicare beneficiaries residing in licensed AL communities in the US using zip code data, Medicare enrollment data, and claims data, and exclusion based on AL capacity (licensing information). Results suggested that using licensing information makes identifying AL residents receiving Medicare more accurate, which could inform research and policy by providing new insights into the health of AL residents.
WHAT THIS MEANS FOR YOU: In this study, undergraduate nursing students implemented a 6-week Fall Prevention Care Management intervention for 25 residents in two AL communities. The intervention included individualized care using motivational interviewing and behavioral change related to fall prevention, as well as helping residents reflect on their perceptions of fall prevention. Qualitative analysis suggested that individualized support improved residents’ opinions of the intervention and facilitated participation for residents at high risk of falls.
WHAT THIS MEANS FOR YOU: Face-to-face interviews with healthcare professionals, group meetings, and participant observation were used to examine interprofessional care teamwork in one community that combines independent living, AL, and skilled nursing. Organizational context, care setting factors, and reimbursement programs like Medicare and Medicaid affected teamwork in different ways; for example, co-location of services in a building did not necessarily ensure teamwork among care providers. Additionally, mission-driven investment in care was not sufficient to ensure teamwork. Thus, teamwork in communities that have different levels of care must be specifically considered when creating organizational policies and procedures.
WHAT THIS MEANS FOR YOU: There is a persisting staffing shortage in long-term care, and the use of robots in AL shows promise in relieving some staffing pressures. This systematic review found benefits of using robots to improve social interaction, emotional regulation, and fall prevention; however, some studies found barriers to robot use and inconclusive results. Overall, the quality of many of the studies was questionable, and more rigorous studies are needed to understand the impact of robots on AL staff and residents.
WHAT THIS MEANS FOR YOU: A study in AL and other long-term care communities in Alberta assessed nurses’ and professional care aides’ physical, mental, and emotional health, behavior, stress, quality of life, turnover, and absenteeism. Mental and emotional health, quality of life, and stress related to turnover and absenteeism. Although 68% of caregivers reported being satisfied with their general health, they experienced heavy workloads and high stress. These issues may result in decreased job satisfaction, absenteeism, and higher turnover.
WHAT THIS MEANS FOR YOU: Vaccines are a part of the solution to infectious disease outbreaks like COVID-19, but not everyone is getting them, especially older adults. In a Canadian study, pneumonia vaccine uptake was improved by providing assisted living and long-term care communities with vaccine coverage data and providing automatic reminders for subsequent doses. Therefore, a cloud-based digital vaccination record is one solution to promote the uptake of adult vaccines for older adults, as well as tracking immunization records and sharing them with policymaking organizations. This can improve communication and inform policymakers to reduce the risk of infection in AL communities.
WHAT THIS MEANS FOR YOU: Nonprofit AL communities in Florida lost their tax-exempt status in 2006 and regained it in 2017. Even when nonprofit AL communities had to pay property taxes, they provided higher-quality services than for-profit communities: more nursing staff, residents, and variety in care. In contrast, for-profit AL communities had more substantiated complaints and deficiencies, faced more sanctions after inspections, and incurred higher fines on average.
WHAT THIS MEANS FOR YOU: In two AL communities, twenty-five adults over the age of 65 or who fell in the previous year evaluated a student-led Fall Prevention Care Management (FPCM) program. Despite some positive outcomes (improved fall prevention behaviors and reduced fear of falling), there were some limitations, including disinterest in fall prevention from some participants. However, participants rated the program highly, meaning student-run fall prevention programs may be effective for some AL residents.
ObjectivesTo examine perceptions of patient safety culture (PSC) among assisted living (AL) administrators and direct care workers (DCWs), and their associations with state regulations. DesignWe conducted a survey using the PSC instrument developed by the Agency for Healthcare Research & Quality. Secondary data on ALs and residents were derived from the Medicare Master Beneficiary Summary […]
WHAT THIS MEANS FOR YOU: Findings from this study suggest that AL’s online reviews may signal quality of care issues, offering consumers information to make more informed decisions in their AL selection, and that reviews may offer insight into residents’ perspectives. However, ratings should not replace, but rather complement, other traditional ways of assessing resident experiences because of rating system limitations. Additionally, ratings may assist providers in making improvements to their ALs based on resident feedback, and function as a data source for policymakers about AL quality of care.
Our goal was to learn about monitoring and enforcement of state assisted living (AL) regulations. Using survey responses provided in 2019 from administrative agents across 48 states, we described state agency structures, accounted for operational processes concerning monitoring and enforcement, and documented data collecting and public reporting efforts. In half of the states, oversight of […]
Background and Objectives License inspection data have commonly been used as a quality measure for nursing homes but have not yet been used to assess the quality of assisted living/residential care (AL/RC) communities. Drawing on resource dependency theory, we test the hypothesis that structural and environmental characteristics influence AL/RC quality as measured by deficiency citations […]
No abstract available.
Importance: Assisted living (AL) is the largest provider of residential long-term care in the US, and the morbidity of AL residents has been rising. However, AL is not a health care setting, and concern has been growing about residents’ medical and mental health needs. No guidance exists to inform this care. Objective: To identify consensus […]
The current study aimed to test the feasibility and preliminary efficacy of the Promoting Positive Care Interactions (PPCI) intervention designed to establish positive care interactions between staff and residents in assisted living (AL) using an online approach. PPCI was implemented in one AL community using a single group pre-/posttest design; 17 care staff were recruited […]
The purpose of this study was to test the preliminary effectiveness and feasibility of implementation of Function Focused Care for Assisted Living Using the Evidence Integration Triangle in Assisted Living Communities with Residents with Dementia (FFC-AL-EIT-D) during the pandemic. This was a single group pre-post study design including 51 communities in a single state. The […]
Assisted living (AL) communities are experiencing rising levels of resident acuity, challenging efforts to balance person-centered care—which prioritizes personhood, autonomy, and relationship-based care practices—with efforts to keep residents safe. Safety is a broad-scale problem in AL that encompasses care concerns (e.g., abuse/neglect, medication errors, inadequate staffing, and infection management) as well as resident issues (e.g., […]
Assisted living (AL) communities are long-term care settings where people live, work, and visit, and where social relationships and care, including end-of-life care, are negotiated. Assisted living is fraught with uncertainty and conflict about values, especially given residents’ cognitive and physical frailty. These value-laden issues have implications for both resident and care partners’ experiences. Yet, […]
No abstract available.
Objectives Develop and evaluate the implementation of a proposed model for large-scale data-driven quality improvement in assisted living. Design We conducted a mixed-methods evaluation of the implementation of a large-scale data-driven quality improvement collaborative of Wisconsin assisted living communities (ALCs). Setting and Participants The model has been voluntarily implemented by 810 Wisconsin-licensed ALCs serving >20,000 […]
WHAT THIS MEANS FOR YOU: Three industry-wide proposals were recommended to enhance medical care quality for AL residents: regular on-site medical visits; employing experienced professionals in long-term and end-of-life care; and the introduction of an AL medical director role to establish rules, staff qualifications, and collaboration. The researchers acknowledge that adaptations may be necessary to adhere to these recommendations due to community size and availability of resources.
WHAT THIS MEANS FOR YOU: This study examined the use of electronic health records (EHRs) and health information exchange (HIE) in AL between 2010 and 2018. Use varied based on AL size and ownership, with larger (26+ beds) and chain-owned communities more likely to use these technologies. Overall, adoption of these technologies increased from 2010 to 2018, but smaller communities had lower adoption rates.
WHAT THIS MEANS FOR YOU: During the COVID-19 pandemic, AL communities faced hurdles obtaining vital supplies including masks and gloves; AL communities were often considered lower priority than other healthcare settings, leading to delays in receipt. When supplies were obtained, the quantity often overwhelmed available storage space, leading to unsafe supply storage. Solutions include improved emergency management, emphasizing proper storage, and optimizing delivery schedules.
Introduction We compare nursing-home and hospital admissions among residents with Alzheimer’s disease and related dementias (ADRD) in memory-care assisted living to those in general assisted living. Methods Retrospective study of Medicare beneficiaries with ADRD in large (>25 bed) assisted-living communities. We compared admission to a hospital, to a nursing home, and long-term (>90 day) admission […]