OBJECTIVE: The objective of this study was to document the growth of postacute care and contemporaneous staffing trends in US nursing homes over the decade 2001 to 2010. DESIGN: We integrated data from all US nursing homes longitudinally to track annual changes in the levels of postacute care intensity, therapy staffing and direct-care staffing separately for freestanding and hospital-based facilities. SETTING: All Medicare/Medicaid-certified nursing homes from 2001 to 2010 based on the Online Survey Certification and Reporting System database merged with facility-level case mix measures aggregated from resident-level information from the Minimum Data Set and Medicare Part A claims. MEASUREMENTS: We created a number of aggregate case mix measures to approximate the intensity of postacute care per facility per year, including the proportion of SNF-covered person days, number of admissions per bed, and average RUG-based case mix index. We also created measures of average hours per resident day for physical and occupational therapists, PT/OT assistants, PT/OT aides, and direct-care nursing staff. RESULTS: In freestanding nursing homes, all postacute care intensity measures increased considerably each year throughout the study period. In contrast, in hospital-based facilities, all but one of these measures decreased. Similarly, therapy staffing has risen substantially in freestanding homes but declined in hospital-based facilities. Postacute care case mix acuity appeared to correlate reasonably well with therapy staffing levels in both types of facilities. CONCLUSION: There has been a marked and steady shift toward postacute care in the nursing home industry in the past decade, primarily in freestanding facilities, accompanied by increased therapy staffing.
OBJECTIVE: The objective of this study was to document the growth of postacute care and contemporaneous staffing trends in US nursing homes over the decade 2001 to 2010. DESIGN: We integrated data from all US nursing homes longitudinally to track annual changes in the levels of postacute care intensity, therapy staffing and direct-care staffing separately for freestanding and hospital-based facilities. SETTING: All Medicare/Medicaid-certified nursing homes from 2001 to 2010 based on the Online Survey Certification and Reporting System database merged with facility-level case mix measures aggregated from resident-level information from the Minimum Data Set and Medicare Part A claims. MEASUREMENTS: We created a number of aggregate case mix measures to approximate the intensity of postacute care per facility per year, including the proportion of SNF-covered person days, number of admissions per bed, and average RUG-based case mix index. We also created measures of average hours per resident day for physical and occupational therapists, PT/OT assistants, PT/OT aides, and direct-care nursing staff. RESULTS: In freestanding nursing homes, all postacute care intensity measures increased considerably each year throughout the study period. In contrast, in hospital-based facilities, all but one of these measures decreased. Similarly, therapy staffing has risen substantially in freestanding homes but declined in hospital-based facilities. Postacute care case mix acuity appeared to correlate reasonably well with therapy staffing levels in both types of facilities. CONCLUSION: There has been a marked and steady shift toward postacute care in the nursing home industry in the past decade, primarily in freestanding facilities, accompanied by increased therapy staffing.
Authors: Jacqueline S Zinn; Vincent Mor; Orna Intrator; Zhanlian Feng; Joseph Angelelli; Jullet A Davis Journal: Health Serv Res Date: 2003-12 Impact factor: 3.402
Authors: J Kosecoff; K L Kahn; W H Rogers; E J Reinisch; M J Sherwood; L V Rubenstein; D Draper; C P Roth; C Chew; R H Brook Journal: JAMA Date: 1990-10-17 Impact factor: 56.272
Authors: Binyam K Seblega; Ning Jackie Zhang; Lynn Y Unruh; Gerald-Mark Breen; Thomas T H Wan Journal: Med Care Res Rev Date: 2009-08-11 Impact factor: 3.929
Authors: Lacey Loomer; Ellen McCreedy; Emmanuelle Belanger; Angelo E Volandes; Susan L Mitchell; Jennifer A Palmer; Vincent Mor Journal: J Am Med Dir Assoc Date: 2019-10-03 Impact factor: 4.669