“It's Not a Sprint, It's a Marathon”: Stages of Managing a Nursing Home Throughout the Pandemic

Meehan, Amy; Gadbois, Emily A; Brazier, Joan F.; Madrigal, Caroline; Grabowski, David C.; Shield, Renée

doi:10.1016/j.jamda.2023.04.024

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…Findings from this qualitative study illustrate how SNF administrators shifted their focus from the implementation and administration of the new payment model just a few months after the PDPM was enacted. This happened when SNFs universally experienced an initial stage of fear and confusion that shifted all focus toward managing the immediate crisis of the pandemic (Meehan et al, 2023). Their actions follow DuBrin’s first proposition that organizational behavior follows the principles of human behavior.…”

Section: Discussionmentioning

confidence: 99%

Administrator Perspectives on the Impact of COVID-19 on the Administration of the Patient Driven Payment Model in U.S. Skilled Nursing Facilities

Meehan,

Brazier,

Grabowski

et al. 2024

Med Care Res Rev

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The Patient Driven Payment Model (PDPM) was implemented in U.S. skilled nursing facilities (SNFs) in October 2019, shortly before COVID-19. This new payment model aimed to reimburse SNFs for patients’ nursing needs rather than the previous model which reimbursed based on the volume of therapy received. Through 156 semi-structured interviews with 40 SNF administrators from July 2020 to December 2021, this qualitative study clarifies the impact of COVID-19 on the administration of PDPM at SNFs. Interview data were analyzed using modified grounded theory and thematic analysis. Our findings show that SNF administrators shifted focus from management of the PDPM to COVID-19-related delivery of care adaptations, staff shortfalls, and decreased admissions. As the pandemic abated, administrators re-focused their attention to PDPM. Policy makers should consider the continued impacts of the pandemic at SNFs, particularly on delivery of care, admissions, and staffing, on the ability of SNF administrators to administer a new payment model.

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Section: Discussionmentioning

confidence: 99%

Administrator Perspectives on the Impact of COVID-19 on the Administration of the Patient Driven Payment Model in U.S. Skilled Nursing Facilities

Meehan,

Brazier,

Grabowski

et al. 2024

Med Care Res Rev

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“…Interviews examined administrator perspectives as they managed nursing homes across the stages of the pandemic. 6,7 This report synthesizes their responses to questions regarding the care of residents with dementia. Participants were recruited by email to participate in 60-min videoconference or telephone interviews every 3 months for a total of four interviews each.…”

Section: Methodsmentioning

confidence: 99%

“…About 156 interviews were conducted July 2020–December 2021 with administrators of 40 nursing homes that varied by healthcare market and organizational characteristics (Supplemental Figure 1 and Table 1). Interviews examined administrator perspectives as they managed nursing homes across the stages of the pandemic 6,7 . This report synthesizes their responses to questions regarding the care of residents with dementia.…”

Section: Methodsmentioning

confidence: 99%

Caring for nursing home residents with dementia during the COVID‐19 pandemic: Perspectives from administrators

Gadbois,

Brazier,

White

et al. 2023

J American Geriatrics Society

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“…Since the emergence of SARS-CoV-2, various types of long-term care facilities (LTCFs) have experienced the majority of the COVID-19 burden. In the United States alone, more than 2 million documented cases have resulted in more than 160,000 deaths among residents and nearly 3,000 deaths among staff in LTCFs ( 1 , 2 ). A similar situation has been observed in other parts of the world ( 3 ), including South America ( 4 ), Canada ( 5 ), the European Union ( 6–9 ), England ( 10 ), China ( 11 ), and Australia ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Sequencing analysis of SARS-CoV-2 cases in Slovenian long-term care facilities to support outbreak control

Kogoj,

Grašek,

Suljič

et al. 2024

Front. Public Health

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IntroductionResidents of long-term care facilities (LTCFs) are at high risk of morbidity and mortality due to COVID-19, especially when new variants of concern (VOC) emerge. To provide intradisciplinary data in order to tailor public health interventions during future epidemics, available epidemiologic and genomic data from Slovenian LTCFs during the initial phases of the COVID-19 pandemic was analyzed.MethodsThe first part of the study included SARS-CoV-2 reverse-transcription Real-Time PCR (rtRT-PCR) positive LTCF residents, from 21 facilities with COVID-19 outbreaks occurring in October 2020. The second part of the study included SARS-CoV-2 rtRT-PCR positive LTCF residents and staff between January and April 2021, when VOC Alpha emerged in Slovenia. Next-generation sequencing (NGS) was used to acquire SARS-CoV-2 genomes, and lineage determination. In-depth phylogenetic and mutational profile analysis were performed and coupled with available field epidemiological data to assess the dynamics of SARS-CoV-2 introduction and transmission.Results370/498 SARS-CoV-2 positive residents as well as 558/699 SARS-CoV-2 positive residents and 301/358 staff were successfully sequenced in the first and second part of the study, respectively. In October 2020, COVID-19 outbreaks in the 21 LTCFs were caused by intra-facility transmission as well as multiple independent SARS-CoV-2 introductions. The Alpha variant was confirmed in the first LTCF resident approximately 1.5 months after the first Alpha case was identified in Slovenia. The data also showed a slower replacement of existing variants by Alpha in residents compared to staff and the general population.DiscussionMultiple SARS CoV-2 introductions as well as intra-facility spreading impacted disease transmission in Slovenian LTCFs. Timely implementation of control measures aimed at limiting new introductions while controlling in-facility transmission are of paramount importance, especially as new VOCs emerge. Sequencing, in conjunction with epidemiological data, can facilitate the determination of the need for future improvements in control measures to protect LTCF residents from COVID-19 or other respiratory infections.

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“It's Not a Sprint, It's a Marathon”: Stages of Managing a Nursing Home Throughout the Pandemic

Cited by 5 publications

References 24 publications

Administrator Perspectives on the Impact of COVID-19 on the Administration of the Patient Driven Payment Model in U.S. Skilled Nursing Facilities

Administrator Perspectives on the Impact of COVID-19 on the Administration of the Patient Driven Payment Model in U.S. Skilled Nursing Facilities

Caring for nursing home residents with dementia during the COVID‐19 pandemic: Perspectives from administrators

Sequencing analysis of SARS-CoV-2 cases in Slovenian long-term care facilities to support outbreak control

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