Publications: Long Term Care Quality

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Nursing Homes as a Clinical Site for Training Geriatric Health Care Professionals

February 1, 2010 - The authors of this Commonwealth Fund–supported study suggest that developing explicit criteria to evaluate nursing home sites as training centers, as well as more clearly defining the roles of clinical staff and faculty, could strengthen nursing homes’ capacity to serve as learning environments.

Literature Abstract

Disparities in Long-Term Care: Building Equity into Market-Based Reforms

February 1, 2010 - Rather than “lifting all boats,” some market-based policies may exacerbate disparities in the quality of long-term care, according to a Commonwealth Fund–supported study published in Medical Care Research and Review.

Literature Abstract

Person-Centered Care for Nursing Home Residents: The Culture-Change Movement

January 7, 2010 - In a Health Affairs "Web First" article published Jan. 7, The Commonwealth Fund's Mary Jane Koren, M.D., takes a look at "culture change" in long-term care—how the growing movement to transform America's nursing homes got started, and where it might be headed.

In the Literature

Role for a Labor–Management Partnership in Nursing Home Person-Centered Care

December 29, 2009 - This Fund-supported study looks at a partnership that was formed between a New York City nursing home union and 40 nursing homes to help implement "person-centered care" at the facilities. Results showed an improvement in quality of life, with residents gaining more autonomy and privacy and many employees experiencing greater job satisfaction.

In the Literature

Considering the Employee Point of View: Perceptions of Job Satisfaction and Stress Among Nursing Staff in Nursing Homes

November 17, 2009 - Understaffing is a major source of stress for nurses and nursing assistants in the long-term care setting, finds this Commonwealth Fund-supported study. The lack of support raises concerns about the quality of care delivered to an estimated 1.6 million nursing home residents.

In the Literature

Nurses Involvement in Nursing Home Culture Change: Overcoming Barriers, Advancing Opportunities

November 3, 2009 - To be successful, "culture change" initiatives—efforts to help nursing homes transform from institutional hospital-like settings to homes that focus on residents' preferences—depend critically on the care provided for and directed by nursing homes' professional nursing staff.

Literature Abstract

Supporting Culture Change: Working Toward Smarter State Nursing Home Regulation

October 9, 2009 - To move toward a new model of nursing home regulation, the states and federal government must strike a balance between the traditional regulatory approach to weed out substandard facilities and a partnership model aimed at promoting high performance. This Commonwealth Fund issue brief highlights the importance of how such a model is structured, as well as the need to adequately train and educate regulatory staff and providers about culture change.

Issue Brief

Reforming Long-Term Care in the United States: Findings from a National Survey of Specialists

September 9, 2009 - Long-term care specialists—including consumer advocates, providers, public officials, and policy experts—who participated in a national survey generally agreed on the need for long-term care reform. Key groups supported the establishment of government-sponsored financing strategies, a shift toward home- and community-based care, offering payment incentives to improve quality, and more effective regulation of nursing homes, home health care agencies, and assisted living facilities.

In the Literature

Increasing Participation in Benefit Programs for Low-Income Seniors

May 4, 2009 - A review of the literature shows that some of the most vulnerable Americans, low-income seniors, do not participate in benefit programs for which they are eligible. The two major obstacles to enrollment are lack of knowledge about public benefit programs and the complexity of application and enrollment processes.

Fund Report

Racial Disparities in Access to Long-Term Care: The Illusive Pursuit of Equity

November 24, 2008 - While African Americans use rates of nursing homes have now surpassed whites' rates, there has been little gain in equity in long-term care.

In the Literature

Variation in the Use of Federal and State Civil Money Penalties for Nursing Homes

November 24, 2008 - In this study, researchers examined federal and state use of civil money penalties (CMPs) against nursing homes and found that CMPs are an underused tool for spurring improvement in the quality of resident care. Moreover, state enforcement varies widely from state to state.

In the Literature

CNA Empowerment: Effects on Job Performance and Work Attitudes

October 29, 2008 - Certified nursing assistants (CNAs) who feel empowered tend to perform their duties better, have a higher morale and job satisfaction rate, and are less likely to consider leaving their jobs, a Commonwealth Fund-supported study finds.

In the Literature

Healthcare Professional Training: A Comparison of Geriatric Competencies

October 29, 2008 - A comparison of geriatric competency domains across five health care disciplines--dentistry, medicine, nursing, pharmacy, and social work--reveals striking similarities. Based on these commonalities, it may be possible to improve interdisciplinary collaboration in the education and clinical training of health care professionals specializing in geriatrics.

In the Literature

Revamping Long-Term Care in Pennsylvania

July 21, 2008 - Pennsylvania is undergoing a demographic change that most other states will not see for another 10 to 15 years. Experts accurately refer to Pennsylvania as an aging commonwealth.


Long-Term Care: Preparing for the Next Generation

July 21, 2008 - If our nation is to secure the health and quality of life of future generations of older Americans, long-term care must become a priority on the national health care agenda, says Carol Raphael of the Visiting Nurse Service of New York.