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Long term care
Publications
Listed by publication date. You can also view these publications alphabetically.
2006
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Differences Between Newly Admitted Nursing Home Residents in Rural and Nonrural Areas in a National Sample
Author(s): Jane Nelson Bolin, Charles D Phillips, Catherine Hawes
Research center:
Southwest Rural Health Research Center
Topics:
Long term care,
Rural statistics and demographics
Citation: Gerontologist, 46(1), 33-41
Date: 2006
This research investigates whether differences in acuity are a function of differences in resident payer status and occur for both individuals admitted for short stays, with Medicare as payer, and those needing chronic care. Results of the analyses indicated that non-Medicare residents admitted to rural nursing facilities have lower acuity scores than non-Medicare residents admitted to metropolitan nursing homes. Individuals admitted under Medicare were similar in rural and urban areas.
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Rural Hospitals and Long-Term Care: the Challenges of Diversification and Integration Strategies
Author(s): Andrew F. Coburn, Stephanie Loux, E.J. Bolda
Research center:
Maine Rural Health Research Center
Topics:
Hospitals and clinics,
Long term care
Citation: In R. T. Goins, & J. A. Krout (Eds.), Service delivery to rural older adults: Research, policy, and practice. (pp. 103-122). New York, NY: Springer Publishing Co.
Date: 2006
2005 -
Patterns Of Post-Acute Utilization In Rural And Urban Communities: Home Health, Skilled Nursing, and Inpatient Medical Rehabilitation
Author(s): Janet P. Sutton
Research center:
Walsh Center for Rural Health Analysis
Topics:
Home health,
Long term care
Date: 03 / 2005
Describes rural Medicare beneficiaries' patterns of post-acute utilization of home health services, skilled nursing facilities, and inpatient rehabilitation facilities. This study provides baseline data that policymakers, researchers, and others who are interested in rural health care issues may use to monitor how changes in Medicare policies affect access to post-acute care in rural areas.
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National Study Comparing Resident Medication Use in Rural and Non-Rural Assisted Living Facilities
Research center:
Southwest Rural Health Research Center
Topics:
Long term care,
Pharmacy and prescription drugs
Date: 02 / 2005
In addition to comparing rural and non-rural assisted living residents' medication utilization, this study examined the prevalence of inappropriately prescribed medications (IPMs) and drug-to-drug interactions (DDIs) among residents of rural and non-rural assisted living facilities (ALFs). Residents of rural ALFs tended to be somewhat more impaired in physical functioning and cognitive status, and on average, took slightly more medications than their non-rural counterparts. Residents in rural ALFs appeared somewhat more likely to have an IPM and a DDI, a finding that, although not statistically significant, is consistent with their higher likelihood of taking more medications and their slightly lower likelihood of being in a facility with a RN on staff. Report available on request.
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Rural Implications of Medicare's Post-Acute-Care Transfer Payment Policy
Author(s): Julie A. Schoenman, Curt D. Mueller
Research center:
Walsh Center for Rural Health Analysis
Topics:
Health care financing,
Long term care,
Medicare
Citation: Journal of Rural Health, 21(2), 122-130
Date: 2005
Examines how the initial policy change affected rural and urban hospitals and investigates the likely impact of the FY2004 expansion and other possible future expansions. The authors conclude that rural hospitals are not disproportionately harmed by the post-acute-care transfer policy. An expanded policy may even benefit rural hospitals by recognizing their lower use of post-acute-care and readjusting DRG weights so that they are paid more appropriately when providing the full course of inpatient care.
2004 -
Rural Implications of Medicare's Post-Acute Care Transfer Payment Policy
Author(s): Julie A. Schoenman
Research center:
Walsh Center for Rural Health Analysis
Topics:
Health care financing,
Long term care,
Medicare
Date: 06 / 2004
Beginning in October 1998, Medicare began to pay acute-care hospital cases in 10 DRGs as transfers instead of discharges when the patient is discharged to a targeted post-acute care (PAC) provider after a short inpatient stay. This study examines the behavioral and financial impacts of the initial 10-DRG policy, and projects the likely financial impact of extending the policy to cover additional DRGs or discharges to swing beds. Key findings: 1) Hospitals' discharge behavior did not change significantly in ways that would suggest a strategic response to the PAC transfer payment policy; 2) Based on simulation, less than 5 percent of all cases discharged from the additional DRGs would receive the PAC transfer payment instead of the full DRG payment. Medicare revenue earned by rural hospitals would fall by more than $1,100 for each transfer case.; and 3) Expanding the transfer policy to cover swing beds would result in a relatively small financial impact. A policy brief is also available.
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Nursing Homes In Rural And Urban Areas, 2001
Author(s): Charles D. Phillips, Catherine Hawes, Malgorzata Leyk Williams
Research center:
Southwest Rural Health Research Center
Topics:
Long term care,
Quality,
Rural statistics and demographics
Date: 06 / 2004
Chart book providing descriptive data on the entire population of longer-stay nursing home residents in the country in calendar year 2001 and categorizing them according to the rurality of the nursing home in which they receive care in an effort to address questions related to residents' characteristics and quality of care.
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Assisted Living: Is It An Option For Rural Areas?
Research center:
Southwest Rural Health Research Center
Topic:
Long term care
Report Number: Policy Brief
Date: 05 / 2004
Highlights the key findings of the national survey of assisted living regarding supply, services, and affordability of assisted living facilities in rural areas.
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Expanding Residential Care And Assisted Living In Rural America
Research center:
Southwest Rural Health Research Center
Topic:
Long term care
Report Number: Policy Brief
Date: 05 / 2004
There is an undersupply of assisted living facilities (ALFs) in rural areas. This policy brief provides options for state policymakers and advocates to consider in expanding the availability and nature of assisted living and other types of housing with supportive services in rural areas.
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Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 3
Author(s): Larry D. Gamm, Linnae L. Hutchison, eds.
Research center:
Southwest Rural Health Research Center
Topics:
Health promotion and disease prevention,
Health services,
Healthy People 2010 (Rural),
Long term care,
Physical abuse and domestic violence,
Public health
Report Number: Updated February 2005
Date: 04 / 2004
Includes the overview of research and accompanying models for practice on 5 new focus areas in Rural Healthy People 2010, along with the more detailed literature reviews for each. The focus areas are: Access to Quality Health Services in Rural Areas/Access to Long-term Care; Educational and Community-based Programs in Rural Areas; Immunizations and Infectious Diseases in Rural Areas; Injury and Violence Prevention in Rural Areas; and Rural Public Health Infrastructure.
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Rural-Urban Issues In The Wage Index Adjustment For Prospective Payment In Skilled Nursing Facilities (Brief Report)
Author(s): Kathleen Dalton, Rebecca Slifkin
Research center:
North Carolina Rural Health Research and Policy Analysis Center
Topics:
Long term care,
Medicare Prospective Payment System (PPS),
Medicare Wage Index
Report Number: Findings Brief
Date: 01 / 2004
The hourly wage data collected from Medicare-participating nursing homes were used to examine urban and rural patterns in average hourly nursing home wages and patterns of wage variation within the statewide rural labor markets defined by CMS. The data were also used to examine the adequacy of the hospital wage index as an adjuster for skilled nursing facility rates. Working Paper No. 78 also addresses this topic.
2003 -
Rural-Urban Issues In The Wage Index Adjustment For Prospective Payment In Skilled Nursing Facilities (Full Report)
Author(s): Kathleen Dalton, Rebecca Slifkin
Research center:
North Carolina Rural Health Research and Policy Analysis Center
Topics:
Long term care,
Medicare Prospective Payment System (PPS),
Medicare Wage Index
Report Number: Working Paper No. 78
Date: 11 / 2003
The hourly wage data collected from Medicare-participating nursing homes were used to examine urban and rural patterns in average hourly nursing home wages and patterns of wage variation within the statewide rural labor markets defined by CMS. The data were also used to examine the adequacy of the hospital wage index as an adjuster for skilled nursing facility rates. A findings brief on this topic is also available.
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Assisted Living In Rural America: Results from a National Survey
Author(s): Catherine Hawes, Charles D. Phillips, Scott Holan, Michael Sherman
Research center:
Southwest Rural Health Research Center
Topics:
Long term care,
Rural statistics and demographics
Date: 08 / 2003
Provides descriptive information on the assisted living industry in metropolitan and rural areas. Results indicate that assisted living was largely a private-pay form of long-term care and was more common in metropolitan than rural areas. Findings suggest that assisted living, as currently structured, will make only a marginal contribution to meeting the needs of frail elders living in rural areas.
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Nursing Homes in Rural and Urban Areas, 2000
Author(s): Charles D. Phillips, Catherine Hawes, Malgorzata Leyk Williams
Research center:
Southwest Rural Health Research Center
Topic:
Long term care
Date: 02 / 2003
This report focuses on two basic dimensions of nursing homes; Federally-certified nursing homes and the residents in those homes, and homes operating in settings that differ in their degree of rurality and their geographic location.
The study found that there are higher percentages of elderly population in rural areas, and also that the utilization rates of nursing homes is higher in rural areas. Homes in rural areas are more likely to have fewer beds than urban homes and are also more likely to be government-funded and owned than urban nursing homes. Rural nursing homes are more likely to be below the nursing staff and aides' threshold than homes in urban areas. Overall, these problems put rural nursing homes at higher risk for poor outcomes in nursing homes, but it is most apparent in extremely isolated rural areas.
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Rural-Urban Differences in Nursing Home and Skilled Nursing Supply
Author(s): Kathleen Dalton, Courtney Harold VanHoutven, Rebecca Slifkin, Stephanie Poley, Ann Howard
Research center:
North Carolina Rural Health Research and Policy Analysis Center
Topic:
Long term care
Report Number: Working Paper No. 74
Date: 02 / 2003
Examines characteristics of nursing facilities and the supply of certified skilled nursing beds as the new PPS is being phased in, with particular reference to differences between urban and rural settings. Finds that rural-urban differences in the supply of long-term care beds and in the characteristics of long-term facilities are less pronounced, in general, than rural-urban differences in acute care capacity. Among the differences between urban and rural nursing facilities are: the most rural counties are the most likely to have no certified nursing homes; as counties become more rural, swing beds account for an increasing percentage of Medicare SNF discharges; and long-term care facilities in the most rural counties are more likely to be hospital based. Overall, the supply of nursing facilities does not appear to be a problem in rural areas, with the possible exception of the most rural counties.
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Nursing Homes in Rural America
Research center:
Southwest Rural Health Research Center
Topics:
Aging,
Long term care
Date: 2003
Policy brief that discusses the main findings of a 2000 survey of 17,000 nursing homes related to rural elderly.
2001 -
Rural Hospitals' Ability to Finance Inpatient, Skilled Nursing, and Home Health Care
Author(s): Jeffrey Stensland, Ira Moscovice
Research center:
Minnesota Rural Health Research Center
Topics:
Health care financing,
Home health,
Hospitals and clinics,
Long term care,
Medicare
Date: 10 / 2001
Surveys 448 rural hospitals to see how they are restructuring in light of the Balanced Budget Act of 1997. Among its findings: the most popular strategy for small rural hospitals is to convert to Critical Access Hospital status-35 percent of those surveyed have done so; despite the closing of some facilities, the vast majority of rural patients still have access to one or more skilled nursing facilities and one or more home health agencies; and to help preserve access to care, policy makers should consider paying a portion of the bad debt and charity care expenses that Critical Access Hospitals incur when treating non-Medicare patients.
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Admission Severity and Mortality Rates Among Rural and Urban Nursing Facility Residents with Dementia (Research & Policy Brief)
Author(s): Elise J. Bolda, Kimberly Mooney Murray
Research center:
Maine Rural Health Research Center
Topics:
Long term care,
Mental health
Date: 09 / 2001
Assesses whether the potentially higher utilization of nursing facility services in rural communities can be attributed to differences in use patterns by older adults with dementia. Specifically, addresses the question of whether rural nursing facility residents with dementia are less impaired at the time of their admission to a nursing facility than urban residents with dementia.
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Developing Affordable Non-medical Residential Care in Rural Communities: Barriers and Opportunities
Author(s): Elise J. Bolda, John W. Seavey, Kimberly Mooney Murray, Stephanie Flanary
Research center:
Maine Rural Health Research Center
Topic:
Long term care
Report Number: Working Paper No. 18
Date: 05 / 2001
Explores the challenges and opportunities for affordable non-medical residential care (NMRC) development in rural areas.
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Admission Severity and Mortality Rates Among Rural and Urban Nursing Facility Residents with Dementia
Author(s): Elise J. Bolda, Kimberly Mooney Murray
Research center:
Maine Rural Health Research Center
Topic:
Long term care
Report Number: Working Paper No. 25
Date: 03 / 2001
Assesses whether the potentially higher utilization of nursing facility services in rural communities can be attributed to differences in use patterns by older adults with dementia. Specifically, addresses the question of whether rural nursing facility residents with dementia are less impaired at the time of their admission to a nursing facility than urban residents with dementia.
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Financing and Payment Issues in Rural Long Term Care Integration (Brief)
Research center:
Maine Rural Health Research Center
Topics:
Health care financing,
Long term care
Report Number: Research and Policy Brief
Date: 02 / 2001
Reviews current research and experience and identifies key policy and program considerations for integrated acute and long term care financing in rural areas.
2000 -
Financing and Payment Issues in Rural Long Term Care Integration (Full Report)
Author(s): Paul Saucier, Julie Fralich
Research center:
Maine Rural Health Research Center
Topics:
Health care financing,
Long term care
Report Number: Working Paper No. 21
Date: 2000
Reviews current research and experience and identifies key policy and program considerations for integrated acute and long term care financing in rural areas. Finds that full capitation of acute and long term care payments is an urban financial integration model that is often not applicable in rural areas. Many rural areas do not have adequate infrastructure to support full capitation models, nor are such models necessarily consistent with the common rural area goal of preserving and strengthening existing providers. Other incremental payment approaches that support some integration of services are more feasible for rural areas, including the creation of fee-for-service incentives, partial capitation, and other risk limitation strategies.
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