Variation in Licensed Nurse Staffing Characteristics by State Requirements in Residential Care

Rome, Vincent; Harris-Kojetin, Lauren; Carder, Paula

doi:10.3928/19404921-20181212-03

Cited by 12 publications

(11 citation statements)

References 28 publications

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“…Staff mix within AL/RC settings can include registered nurses (RNs), licensed professional/vocational nurses (LPN/LVNs), certified nursing assistants (CNAs), certified medication aides (CMAs), unlicensed direct care workers, and administrators. Thirty-eight states require RNs or LPN/LVNs to provide or supervise care ( Beeber et al, 2018 ; Rome et al, 2019 ). Administrators are responsible for all AL/RC operations, such as staffing, resident care provision, and regulatory compliance.…”

Section: Al/rc Settings Their Residents and Staffmentioning

confidence: 99%

Revisiting the Role of Physicians in Assisted Living and Residential Care Settings

Dys

Smith

Tunalilar

et al. 2020

Gerontology and Geriatric Medicine

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As the United States population ages, a higher share of adults is likely to use long-term services and supports. This change increases physicians’ need for information about assisted living and residential care (AL/RC) settings, which provide supportive care and housing to older adults. Unlike skilled nursing facilities, states regulate AL/RC settings through varying licensure requirements enforced by state agencies, resulting in differences in the availability of medical and nursing services. Where some settings provide limited skilled nursing care, in others, residents rely on resident care coordinators, or their own physicians to oversee chronic conditions, medications, and treatments. The following narrative review describes key processes of care where physicians may interact with AL/RC operators, staff, and residents, including care planning, managing Alzheimer’s disease and related conditions, medication management, and end-of-life planning. Communication and collaboration between physicians and AL/RC operators are a crucial component of care management.

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Section: Al/rc Settings Their Residents and Staffmentioning

confidence: 99%

Revisiting the Role of Physicians in Assisted Living and Residential Care Settings

Dys

Smith

Tunalilar

et al. 2020

Gerontology and Geriatric Medicine

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“…In 2020, there were 18,075 care homes across the UK, with over half a million adult care home residents [7]. In 2016, there were over 15,600 Medicare-or Medicare-certified nursing homes in the United States [8]. In 2012, 143,000 Canadian lived in approximately 1,360 LTCHs across the country [9].…”

Section: Introductionmentioning

confidence: 99%

Models of provider care in long-term care: A rapid scoping review

et al. 2021

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Introduction One of the current challenges in long-term care homes (LTCH) is to identify the optimal model of care, which may include specialty physicians, nursing staff, person support workers, among others. There is currently no consensus on the complement or scope of care delivered by these providers, nor is there a repository of studies that evaluate the various models of care. We conducted a rapid scoping review to identify and map what care provider models and interventions in LTCH have been evaluated to improve quality of life, quality of care, and health outcomes of residents. Methods We conducted this review over 10-weeks of English language, peer-reviewed studies published from 2010 onward. Search strategies for databases (e.g., MEDLINE) were run on July 9, 2020. Studies that evaluated models of provider care (e.g., direct patient care), or interventions delivered to facility, staff, and residents of LTCH were included. Study selection was performed independently, in duplicate. Mapping was performed by two reviewers, and data were extracted by one reviewer, with partial verification by a second reviewer. Results A total of 7,574 citations were screened based on the title/abstract, 836 were reviewed at full text, and 366 studies were included. Studies were classified according to two main categories: healthcare service delivery (n = 92) and implementation strategies (n = 274). The condition/ focus of the intervention was used to further classify the interventions into subcategories. The complex nature of the interventions may have led to a study being classified in more than one category/subcategory. Conclusion Many healthcare service interventions have been evaluated in the literature in the last decade. Well represented interventions (e.g., dementia care, exercise/mobility, optimal/appropriate medication) may present opportunities for future systematic reviews. Areas with less research (e.g., hearing care, vision care, foot care) have the potential to have an impact on balance, falls, subsequent acute care hospitalization.

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“…Related to Infection Control AL communities are regulated by the states, which leads to wide variability across the country. Variability in regulation extends to staffing, 15 nursing services, 16 and most importantly for COVID-19, infection control practices. Furthermore, recent federal enhancements in infection control practices targeted at nursing homes have not affected AL.…”

Section: Lack Of National Regulations and State Variability Especiallymentioning

confidence: 99%

The Need to Include Assisted Living in Responding to the COVID-19 Pandemic

Zimmerman

Sloane

Katz

et al. 2020

Journal of the American Medical Directors Association

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The risk of complications and death from COVID-19 is markedly skewed toward older adults. The US Centers for Disease Control and Prevention (CDC) recently wrote, "Given their congregate nature and residents served (eg, older adults often with underlying chronic medical conditions), nursing home populations are at the highest risk of being affected by COVID-19. If infected with SARS-CoV-2, the virus that causes COVID-19, residents are at increased risk of serious illness." 1 However, in the United States and many other countries, nursing homes are not the only congregate setting that serves older adults with underlying chronic medical conditions. More so, they have been a shrinking component of the residential long-term care system, with some of the largest growth having been in assisted living (AL). AL communities provide supportive care, at least 2 meals a day, and 24hour supervision to individuals who need daily supportive care, but not daily nursing care. 2,3 Recent estimates are that there are 30,200 licensed AL communities across the United States, providing care to more than 835,000 residents 4 dwhich constitutes almost 40% of persons who receive residential long-term care in this country. More than half of the AL residents are "old-old" or "oldest-old": 53% are aged 85 or older, compared with 42% in nursing homes and 47% receiving hospice. 4 More so, many have the chronic underlying conditions implicated in COVID-19: 34% have heart disease, 17% have diabetes, and 15% have lung disease (chronic obstructive pulmonary disease and allied conditions), and more than a quarter have between 4 and 10 chronic health conditions. 5 Thus, the AL population is at high risk for being affected by COVID-19 and suffering serious outcomes.Importantly, AL communities are not the same as nursing homes. In fact, there are several distinct components of AL that make this a unique setting and one not to be ignored in relation to planning and response. This editorial summarizes key differences and their related implications for care.

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Variation in Licensed Nurse Staffing Characteristics by State Requirements in Residential Care

Cited by 12 publications

References 28 publications

Revisiting the Role of Physicians in Assisted Living and Residential Care Settings

Revisiting the Role of Physicians in Assisted Living and Residential Care Settings

Models of provider care in long-term care: A rapid scoping review

The Need to Include Assisted Living in Responding to the COVID-19 Pandemic

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