Impact of Implementing the Preferences for Everyday Living Inventory on Nursing Home Survey Deficiencies

Kunkel, Miranda; Bowblis, John R.; Straker, Jane; Haitsma, Kimberly Van; Abbott, Katherine

doi:10.1016/j.jamda.2022.10.021

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…Additionally, our findings align with previous research on the relationship between PCC implementation and NH quality. (Kunkel et al, 2022b) found NHs who completely implemented the PELI (i.e., integrated information from the PELI interview into care delivery and/or quality improvement) had fewer deficiencies than NHs who only partially implemented the PELI. As staffing levels are associated with NH quality (Schnelle et al, 2004), this may indicate that complete PELI implementers have higher quality.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have explored PELI implementation as a predictor of NH quality using other outcome measures. A recent study by Kunkel and colleagues (2022b) found that NHs who completely implemented the PELI were more likely to have a 4 or 5 deficiency star rating and be deficiency free, as compared to NHs who only partially implemented the PELI. In this paper, the outcome measure is an input in the production of quality—staffing levels.…”

Section: Introductionmentioning

confidence: 98%

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Exploring the Relationship Between Extent of Person-Centered Care Implementation and Staffing Levels in Ohio Nursing Homes

et al. 2023

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Background: The Preferences for Everyday Living Inventory (PELI) is a person-centered care (PCC) tool that uncovers/honors older adults’ important preferences. PCC implementation in nursing homes (NHs) often requires additional resources, such as staff time. We explored if PELI implementation is associated with NH staffing levels. Methods: Using NH-year as the unit of observation ( n = 1307), 2015 and 2017 data from Ohio NHs was used to examine the relationship between complete versus partial PELI implementation and staffing levels, measured in hours per resident day, for various positions and total nursing staff. Results: Complete PELI implementation was associated with higher nursing staff levels in both for-profits and not-for-profits; however, total nursing staff levels in not-for-profits were higher than for-profits (0.16 vs. 0.09 hours per resident day). The specific nursing staff associated with PELI implementation varied by ownership. Discussion: For NHs to fully implement PCC, a multifaceted approach to improve staffing is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Exploring the Relationship Between Extent of Person-Centered Care Implementation and Staffing Levels in Ohio Nursing Homes

et al. 2023

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“…Nursing staff play a vital role in the operation of NHs providing care and services to help residents attain their highest practical well-being (§483.35[a]). Consistently assigning the same nursing staff to residents in a manner that allows them to frequently observe and interact with those residents may make staff more aware of resident’s care plans and needs, identify changes in resident conditions, and provide more person-centered care that enhances the resident’s quality of care and life (Castle, 2011; Kunkel et al, 2023). As such, higher nursing staff levels, lower variability in daily staffing levels, and the same staff providing care to residents (i.e., lower turnover) should be associated with higher quality outcomes.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

Beyond Nursing Staff Levels: The Association of Nursing Home Quality and the Five-Star Quality Rating System’s New Staffing Measures

Brunt

Bowblis

2023

Med Care Res Rev

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Recently, the Centers for Medicare & Medicaid Services (CMS) introduced staffing measures related to staffing variability and turnover in the Nursing Home (NH) Care Compare Five-Star Quality Rating System. While the consensus within the literature is that reduced variability and turnover are associated with higher NH quality of care and life, no existing studies have evaluated the relationship between CMS’s newly introduced staffing measures and quality. This study uses regression analysis to estimate the relationship between 13 quality measures (used in Care Compare) and CMS’s new staffing measures (i.e., weekend nursing staff levels, total nursing and registered nurse staff turnover, and administrator turnover) as well as a measure of daily staffing variation recently introduced in the literature called the coefficient of variation. Regressions analysis finds strong evidence of an association between quality and these staffing measures, though some measures (e.g., nursing staff turnover) are highly correlated and may be duplicative.

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“…NH deficiencies come from two sources. One, state survey agencies conduct routine NH inspections every 9–15 months to assess compliance with federal standards; noncompliance generally results in one or more deficiency citations (Kunkel et al, 2023; Peterson et al, 2022). Two, upon receipt of a complaint and a subsequent investigation, state surveyors determine if the complaint is substantiated and, if so, whether a regulatory violation has occurred warranting a deficiency citation.…”

Section: Introductionmentioning

confidence: 99%

The Importance of Zero-Deficiency Complaints in Nursing Homes: A Mere Consequence or Serious Concern?

Bhattacharyya,

Peterson,

Molinari

et al. 2024

J Appl Gerontol

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Complaints represent an important metric for assessing the quality of nursing home (NH) care. Using the Automated Survey Processing Environment (ASPEN) Complaints/Incidents Tracking System dataset (2017), we examined the relationships between zero-deficiency complaints (ZDCs) and zero-deficiency substantiated complaints (ZDSCs) and the proportion of residents with dementia. NHs ( N = 15,339) were separated into three groups—proportion of residents with dementia in the top, two middle, and the bottom quartiles. Negative binomial regressions assessed zero-deficiency complaint patterns in relation to NHs’ proportion of residents with dementia, controlling for facility characteristics, staffing, and racial pattern. We reported average marginal effects ( AMEs) and 95% confidence intervals ( CIs). NHs in the top quartile yielded higher numbers of both ZDC ( AME = .189, 95% CI: .102−.276, p < .001) and ZDSC ( AME = .236, 95% CI: .094−.378, p = .001), than NHs in the bottom quartile. Results suggest a need for more uniform investigation processes and staff training to promote a more valid complaint process for residents with dementia.

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Impact of Implementing the Preferences for Everyday Living Inventory on Nursing Home Survey Deficiencies

Cited by 6 publications

References 8 publications

Exploring the Relationship Between Extent of Person-Centered Care Implementation and Staffing Levels in Ohio Nursing Homes

Exploring the Relationship Between Extent of Person-Centered Care Implementation and Staffing Levels in Ohio Nursing Homes

Beyond Nursing Staff Levels: The Association of Nursing Home Quality and the Five-Star Quality Rating System’s New Staffing Measures

The Importance of Zero-Deficiency Complaints in Nursing Homes: A Mere Consequence or Serious Concern?

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