Journal of the American Medical Directors Association最新文献

{"title":"CMS Quality Star Ratings for Nursing Homes Change Frequently: A Descriptive Analysis of Trends From 2009 to 2020","authors":"Tory H. Hogan PhD ,&nbsp;Nicholas R. Maurer MD, MPH ,&nbsp;Pejmon Noghrehchi MHM ,&nbsp;Larry R. Hearld PhD, MSA, MBA","doi":"10.1016/j.jamda.2025.105631","DOIUrl":"10.1016/j.jamda.2025.105631","url":null,"abstract":"<div><h3>Objectives</h3><div>Nursing Home Compare star ratings are closely watched by hospital delivery systems, policymakers, and consumers as measures of care quality. However, very little is known about the degree to which nursing homes can or do move between star ratings, what we refer to as performance mobility. This study addresses a gap in the literature by examining mobility trends in overall nursing home star ratings.</div></div><div><h3>Design</h3><div>Descriptive analysis.</div></div><div><h3>Setting and Participants</h3><div>We reviewed 2,016,985 monthly ratings for 16,568 unique US Medicare–certified nursing homes.</div></div><div><h3>Methods</h3><div>Using Centers for Medicare and Medicaid Services (CMS) Nursing Home Compare data, we constructed a database of the overall monthly star ratings for each nursing home in the United States from January 2009 through February 2020. We began by trending the proportion of nursing homes receiving each rating over time before proceeding to 3 focused analyses on mobility, including (1) the frequency of mobility, (2) the median transition time for each mobility combination, and (3) trends in single-unit changes in rating.</div></div><div><h3>Results</h3><div>From 2009 to 2020, we observed a general upward trend in overall ratings despite stricter quality requirements, and frequent mobility—both upward and downward—between ratings: 40.32% of 1-star nursing homes later received a 5-star rating, whereas 27.97% of 5-star nursing homes later received a 1-star rating. When these changes between extremes occurred, they took an average of &lt;5 years.</div></div><div><h3>Conclusions and Implications</h3><div>Our findings suggest that nursing home 5-star ratings change frequently and quickly. Performance plays a key role in nursing home selection among patients, and our results suggest that further studies should examine the antecedents and impacts of such changes.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 7","pages":"Article 105631"},"PeriodicalIF":4.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Care Staffing: Associations with Facility Characteristics, Residents’ Experience, and Quality Measures","authors":"Stephanie L. Harrison PhD ,&nbsp;Dylan Harries PhD ,&nbsp;Hoi Man Fu MPH ,&nbsp;Gillian E. Caughey PhD ,&nbsp;Tracy Comans PhD ,&nbsp;Megan Corlis BAppSc (Nursing) ,&nbsp;Maria C. Inacio PhD","doi":"10.1016/j.jamda.2025.105686","DOIUrl":"10.1016/j.jamda.2025.105686","url":null,"abstract":"<div><h3>Objectives</h3><div>In October 2022, Australia introduced individual targets for total care and registered nurse (RN) minutes for long-term care facilities based on the assessed care needs of their residents. This study examined associations between facility characteristics and the extent to which care minute targets are met, and determined whether care minutes were associated with residents’ experience and quality measures.</div></div><div><h3>Design</h3><div>Ecological cross-sectional study using pooled publicly available data from 5 quarterly reporting periods between January-March 2023 and January-March 2024.</div></div><div><h3>Setting and Participants</h3><div>A total of 2292 long-term care facilities in Australia.</div></div><div><h3>Methods</h3><div>Generalized linear mixed models were used to examine associations between facility characteristics (ownership type, size, location) and target care minutes met (total and RN minutes). Logistic regression and ordered beta regression models were used to investigate associations between care minutes and residents’ experience and quality measures (pressure injuries, restrictive practices, unplanned weight loss, falls, medication management).</div></div><div><h3>Results</h3><div>The proportion of facilities meeting or exceeding their total care minutes target (≥100% of target) increased from 41% (n = 938) in the first reporting period to 53% (n = 1213) in the most recent period. Compared with government ownership, for-profit and not-for-profit ownership were associated with lower percentages of target care minutes met (rate ratio, 0.76; 95% CI, 0.75-0.78; and rate ratio, 0.82; 95% CI, 0.80-0.83, respectively). For-profit and not-for-profit ownership, larger facility size, and rural or socioeconomically disadvantaged location were associated with lower percentages of target RN minutes met. No statistically significant associations were identified between care minutes and residents’ experience or quality measures.</div></div><div><h3>Conclusions and Implications</h3><div>Variation in meeting target care minutes was observed by different facility characteristics. However, no associations between care minutes and residents’ experience or quality measures were observed. Further research should examine care minutes in addition to other factors impacting care quality including staff training, turnover, skills mix, and models of care.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 7","pages":"Article 105686"},"PeriodicalIF":4.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the Digital Divide- Broadband Access for Congregate Care Communities","authors":"","doi":"10.1016/j.jamda.2025.105672","DOIUrl":"10.1016/j.jamda.2025.105672","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 6","pages":"Article 105672"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Male Gynecomastia in a Geriatric Patient","authors":"","doi":"10.1016/j.jamda.2025.105644","DOIUrl":"10.1016/j.jamda.2025.105644","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 6","pages":"Article 105644"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post Acute Care Transitions: Lessons from a Patient with Sepsis","authors":"","doi":"10.1016/j.jamda.2025.105650","DOIUrl":"10.1016/j.jamda.2025.105650","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 6","pages":"Article 105650"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Intervention to Reduce Antipsychotic Prescriptions at Skilled Nursing Facility","authors":"","doi":"10.1016/j.jamda.2025.105662","DOIUrl":"10.1016/j.jamda.2025.105662","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 6","pages":"Article 105662"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Dementia Care: Palliative Care Performance Improvement to Enhance Quality-of-Life","authors":"","doi":"10.1016/j.jamda.2025.105656","DOIUrl":"10.1016/j.jamda.2025.105656","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 6","pages":"Article 105656"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity and Malnutrition: A Recipe for Disaster","authors":"","doi":"10.1016/j.jamda.2025.105675","DOIUrl":"10.1016/j.jamda.2025.105675","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 6","pages":"Article 105675"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Palliative Care Consult Rates Acute at Post Acute Rehab Facility by Implementing Palliative Care Consult Screening Tools","authors":"","doi":"10.1016/j.jamda.2025.105661","DOIUrl":"10.1016/j.jamda.2025.105661","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 6","pages":"Article 105661"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting Paradigms in Fall Management for Long-Term Care: From Prevention to Injury Mitigation","authors":"Richard G. Stefanacci DO, MGH, MBA, AGSF, CMD ,&nbsp;Cheryl Phillips MD, AGSF","doi":"10.1016/j.jamda.2025.105582","DOIUrl":"10.1016/j.jamda.2025.105582","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 6","pages":"Article 105582"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}