Evidence map›Paper›PMID 31451383›Full record

ArticleJournal of the American Medical Directors Association2020

Thirty-Year Trends in Nursing Home Composition and Quality Since the Passage of the Omnibus Reconciliation Act.

Shekinah A Fashaw, Kali S Thomas, Ellen McCreedy, Vincent Mor

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Directors Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 2 pooled it
13.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.

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  15. Falling off a cliff: Psychiatric care of nursing home residents.Journal of the American Geriatrics Society · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Shekinah A FashawCenter for Gerontology and Healthcare Research, School of Public Health, Brown University, Providence, RI; Department of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, RI. Electronic address: shekinah_fashaw@brown.edu.
Kali S ThomasCenter for Gerontology and Healthcare Research, School of Public Health, Brown University, Providence, RI; Department of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, RI; Center of Innovation in Long-Term Services and Supports, US Department of Veterans Affairs Medical Center, Providence, RI.
Ellen McCreedyCenter for Gerontology and Healthcare Research, School of Public Health, Brown University, Providence, RI; Department of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, RI.
Vincent MorCenter for Gerontology and Healthcare Research, School of Public Health, Brown University, Providence, RI; Department of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, RI; Center of Innovation in Long-Term Services and Supports, US Department of Veterans Affairs Medical Center, Providence, RI.
Brown University · USProvidence VA Medical Center · USUnited States Department of Veterans Affairs · US

Funding

VARIATIONS IN LIFE'S FINAL CHAPTERP01AG027296 · NIA · BROWN UNIVERSITY · PI AMAL N. TRIVEDI · 2007 to 2026
$38.9M
National Research Service AwardT32HS000011 · AHRQ · BROWN UNIVERSITY · PI TRIVEDI, AMAL N. · 1986 to 2024
$6.1M
Evaluating Cash Benefit Programs for Veterans' Long Term CareIK2HX001775 · VA · PROVIDENCE VA MEDICAL CENTER · PI THOMAS, KALI ST. MARIE · 2020 to 2021
–
AHRQ HHS T32 HS000011HSRD VA CDA 14-422HSRD VA IK2 HX001775NIA NIH HHS P01 AG027296
6 · The paper itself

Abstract

objectiveIn 1987, the Omnibus Reconciliation Act (OBRA) called for a dramatic overhaul of the nursing home (NH) quality assurance system. This study examines trends in facility, resident, and quality characteristics since passage of that legislation.

methodsWe conducted univariate analyses of national data on US NHs from 3 sources: (1) the 1985 National Nursing Home Survey (NNHS), (2) the 1992-2015 Online Survey Certification and Reporting (OSCAR) Data, and (3) LTCfocUS data for 2000-2015. We examined changes in NH characteristics, resident composition, and quality. SETTING AND

participantsUS NH facilities and residents between 1985 and 2015.

resultsThe proportion of NHs that are Medicare and Medicaid certified, members of chains, and operating not-for-profit has increased over the past 30 years. There have also been reductions in occupancy and increases in the share of residents who are racial or ethnic minorities, admitted for post-acute care, in need of physical assistance with daily activities, primarily supported by Medicare, and diagnosed with a psychiatric condition such as schizophrenia. With regard to NH quality, direct care staffing levels have increased. The proportion of residents physically restrained has decreased dramatically, coupled with changes in inappropriate antipsychotic (chemical restraint) use. CONCLUSIONS AND IMPLICATIONS: Together with changes in the long-term care market, the NHs of today look very different from NHs 30 years ago. The 30th anniversary of OBRA provides a unique opportunity to reflect, consider what we have learned, and think about the future of this and other sectors of long-term care.

Indexed as

MedicareNursing HomesAgedFemaleHumansMedicaidRestraint, PhysicalSkilled Nursing FacilitiesUnited Statesnursing home characteristicsNursing Home Reform ActOBRA 1987Quality

Identifiers

PMID31451383
PMCPMC6986999
OpenAlexW2969371174

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.