Nursing Home Residents Covered by Medicare Risk Contracts: Early Findings from the EverCare Evaluation Project

Abstract

EverCare appears to be a model of managed care worth tracking. It is producing care that is at least comparable with what is available in the fee-for-service environment, with evidence that families seem to appreciate the added attention. There is some suggestion that it has enrolled a less disabled but more demented population. Pending results on the effects of this care on hospitalization and emergency care should shed useful light.

Expanding the Knowledge Base of Resident and Facility Outcomes of Care Delivered by Advanced Practice Nurses in Long-Term Care

“…Much of the empiric evidence regarding the link between APN nursing home practice and positive resident outcomes relies on multiple reports of a single study of the EverCare demonstration project in five geographic locations, using administrative data in large part (Kane et al, 2001;Kane et al, 2002;Kane et al, 2004). Some studies were limited by the use of retrospective chart review (Burl, Bonner, Rao, & Khan, 1998) or by a survey that failed to report reliability or validity of the survey instrument (Abdallah, 2005).…”

“…EverCare APNs practicing in nursing homes reduced pneumonia-related hospitalizations through the use of "intensive service days," an incentive payment designed to reimburse the nursing home for the additional care required by treating an acute illness in the nursing home rather than through hospitalization (Rector, Spector, Shaffer, & Finch, 2005). EverCare APNs reduced other preventable hospitalizations, such as for dehydration, hypertension, and urinary tract infections (Kane, Flood, Bershadsky, & Keckhafer, 2004), and improved family satisfaction with care (Kane, Flood, Keckhafer, Bershadsky, & Lum, 2002). Regrettably, none of these studies report details about the specific activities performed by APNs that produced these positive outcomes.…”

The Future History of Gerontological Nursing

“…Evidence is strong that advanced practice geriatric nurses, often as part of geriatric teams, ensure quality care to older people and significantly improve health outcomes in ambulatory (6), acute (7), (8), and institutional long-term care (9)(10)(11)(12).…”

Potenzialanalyse zu „Advanced Practice Nursing (APN)“ für Bewohner mit dementiellen Erkrankungen in deutschen Einrichtungen der stationären Langzeitpflege

“…Positive Effekte lassen sich auch bei der Einschätzung der Pflegesituation seitens der Angehörigen erkennen. So bewerten diese den Versorgungsprozess und die -qualität deutlich positiver, sie nehmen die personelle Präsenz deutlicher wahr und sind in der Folge zufriedener mit der Pflegesituation als die Angehörigen in der Kontrollgruppe ohne GAPN-Intervention [39].…”

“…Im Ergebnis konnte ein aktuelles Review zur Effektivität von APN in Langzeitpflegeeinrichtungen identifiziert werden [35]. Zusätzlich ergab die Suche 4 relevante Publikationen [36][37][38][39], welche allerdings ebenso die Datengrundlage des vorliegenden Reviews bilden. Anschließend wurden zur Aktualisierung der Literaturrecherche des Reviews nach weiteren relevanten Artikeln nach 2010 gesucht.…”