The obra-87 nursing home regulations and implementation of the resident assessment instrument: Effects on process quality

Journal of the American Geriatrics Society

Volumn 45, Issue 8, 1997, Pages 977-985

  Hawes, Catherine ^a   Mor, Vincent ^b   Phillips, Charles D ^c   Fries, Brant E ^d,e   Morris, John N ^g   Steele Friedlob, Eliana ^f   Greene, Angela M ^a   Nennstiel, Marianne ^a  

^a RTI INTERNATIONAL   (United States)

^b BROWN UNIVERSITY   (United States)

^c Menorah Park Center for Senior Living   (United States)

^d UNIVERSITY OF MICHIGAN HEALTH SYSTEM   (United States)

^e RESEARCH AND TRAINING INSTITUTE   (United States)

^f MEDSTAT Group   (United States)

^g NONE

Author keywords

[No Author keywords available]

Indexed keywords

PSYCHOTROPIC AGENT;

ACCURACY; AGED; ARTICLE; ELDERLY CARE; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH CARE QUALITY; HUMAN; MAJOR CLINICAL STUDY; MEDICAL INFORMATION; NURSING HOME;

EID: 0030820554     PISSN: 00028614     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1532-5415.1997.tb02970.x     Document Type: Article

References (54)

1. Smith v. O'Halloran, 557 F Supp. 289 (D Colo. 1983), rev'd sub nom Smith versus Heckler, 747 F.2d 583 (10th Cir. 1984).
2. Institute of Medicine Improving the Quality of Care in Nursing Homes Washington, DC. National Academy of Sciences Press, 1986.
3. Hawes C. The Institute of Medicine study: Improving the quality of nursing home care. In: Katz PR, Kane RL, Mezey MD, eds. Advances in Long-Term Care. New York: Springer, 1991, pp 147-168.
4. Contract DHHS 500-88-0055 was with the Health Standards and Quality Bureau of the Health Care Financing Administration. The project team was led by Research Triangle Institute in North Carolina, with its subcontractors, the Social Gerontological Research Center, Hebrew Rehabilitation Center for Aged, in Boston, MA; the Center for Gerontology and Health Care Research, Brown University, Providence, RI, and the Institute of Gerontology, University of Michigan, Ann Arbor, MI.
5. Morris JN, Hawes C, Fries BE et al. Designing the national resident assessment instrument for nursing homes. Gerontologist 1990;30:293-307.
6. Hawes C, Morris JN, Phillips C et al. Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). Gerontologist 1995;35:172-178.
7. Morris JN, Hawes C, Murphy K et al. Resident Assessment Instrument Training Manual and Resource Guide. Natick, MA: Eliot Press, 1991.
8. Hawes C, Phillips CD, Morris JN, Mor V, Fries BE. Reliability and Validity of the Nursing Home Resident Assessment Instrument (RAI): Report on the Field Testing of the RAI. Research Triangle Park, NC: Research Triangle Institute, 1991.
9. Mor V, Laliberte L, Drugovich M. Review of Standardized Assessments Used in U.S. Nursing Homes. Providence, RI: Center for Gerontology and Health Care Research, Brown University, 1989.
10. Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q 1966;4:166-206.
11. Donabedian A. Quality assessment and assurance: Unity of purpose, diversity of means. Inquiry 1988;25:6-12.
12. Wyszewianski L. Quality of care: Past achievements and future challenges. Inquiry 1988;25:13-22.
13. Kane RA, Kane RL. Long-term care: Variations on a quality assurance theme. Inquiry 1988;25:132-146.
14. Sloane PC, Pickard CG. Custodial nursing home care: Setting realistic goals. J Am Geriatr Soc 1985;33:864-868.
15. Rovner BW, German PS, Brant LJ et al. Depression and mortality in nursing homes. JAMA 1991;265:993-996.
16. Liston EH. Delirium in the aged. Psychiatr Clin North Am 1982;5:49-66.
17. Evans LK, Strumpf NE. Tying down the elderly: A review of the literature on physical restraints. J Am Geriatr Soc 1989;37:65-74.
18. Kane RL, Williams CC, Williams TF et al. Restraining restraints: Changes in a standard of care. Annu Rev Public Health 1993;14:545-584.
19. Ray WA, Federspiel CF, Schaffner W. A study of anti-psychotic drug use in nursing homes: Epidemiological evidence suggesting misuse. Am J Public Health 1980;70:485-491.
20. Howard J. Medication procedure in a nursing home: Abuse of PRN orders. J Am Geriatr Soc 1977;25:83-84.
21. Harrington C, Tompkins C, Curtis M et al. Psychotropic drug use in long-term care facilities: A review of the literature. Gerontologist 1992;32:822-833.
22. Ouslander JG, Kane RL. The cost of urinary incontinence in nursing homes. Med Care 1984;22:69-79.
23. Ouslander JG, Fowler E. Incontinence in VA nursing home care units. J Am Geriatr Soc 1985;33:33-40.
24. Marron KR, Fillit H, Peskowitz M et al. The nonuse of urethral catheterization in management of urinary incontinence in the teaching nursing home. J Am Geriatr Soc 1983;31:278-281.
25. Starer P, Libow LS. Obscuring urinary incontinence: Diapering the elderly. J Am Geriatr Soc 1985;12:842-846.
26. Schnelle JF, Sowell VA, Traugher B. Reduction of urinary incontinence in nursing homes: Does it reduce or increase costs? J Am Geriatr Soc 1988;36:34-39.
27. Ouslander JG, Kane RL, Abrass IB. Urinary Incontinence in elderly nursing home residents. JAMA 1982;248:1194-1197.
28. Michoki RJ, Lamy PP. The problem of pressure sores in a nursing home population: Statistical data. J Am Geriatr Soc 1976;24:323-328.
29. Himmelstein DU, Jones AA, Woolhandler S. Hypernatremic dehydration in nursing home patients: An indicator of neglect. J Am Geriatr Soc 1983.
30. Gugel RN. Psychosocial interventions in the nursing home. In: Katz PR, Calkins E, eds. Principles and Practice of Nursing Home Care. New York: Springer, 1989.
31. Shah BV, Barnwell GB, Beiler GS. SUDAAN: User's Manual, Release 6.40. Research Triangle Park, NC: Research Triangle Institute, 1995.
32. Phillips CD, Hawes C, Iannacchionne V et al. Evaluating the Effects of the Resident Assessment Instrument: Methodological Issues and Approaches. Research Triangle Park, NC: Research Triangle Institute, 1995.
33. Phillips CD, Morris JN, Hawes C et al. Association of the resident assessment instrument (RAI) with changes in function, cognition, and psychosocial status. J Am Geriatr Soc, 1997;45:986-993.
34. Morris JN, Nonemaker S., Murphy K et al. A commitment to change: Revision of HCFA's RAI. J Am Geriatr Soc, 1997;45:101-1016.
35. Sgadari A., Morris JN, Fries BE et al. Efforts to establish reliability of the RAI. Age Aging, in press.
36. Phillips CD, Hawes C, Mor V et al. Facility area variation in physical restraint use in nursing homes. Med Care, 1996,34:1149-1162.
37. Morris JN, Fries BE, Mehr D et al. MDS cognitive performance scale. J Gerontol Med Sci 1994;49:M174-182.
38. Fries BE, Schneider D, Foley WJ et al. Refining a case mix measure for nursing homes: Resource utilization groups (RUG III). Med Care 1994;32:668-685.
39. Analysis of the On-line Survey and Certification Automated Reports (OSCAR) by Vincent Mor and Jeffrey Hiris, Center for Gerontology and Health Care Research, Brown University, Providence, RI, 1995.
40. Fries BE, Hawes C, Morris JN et al. Effect of the national resident assessment instrument on selected health conditions and problems. J Am Geriatr Soc, 1997;45:994-1001.
41. Mor V, Intrator O, Hiris J et al. Impact of the MDS on changes in nursing home discharge rates and destinations. J Am Geriatr Soc, 1997;45:1002-1010.
42. Buck JA. Psychotropic drug practice in nursing homes. J Am Geriatr Soc 1988;36:409-418.
43. Sternberg J, Spector W, Drugovich M et al. Use of psychoactive drugs in nursing homes: Prevalence and residents' characteristics. J Geriatr Drug Ther 1990;4:47-60.
44. Hines M, Mor V, Hawes C et al. Development of Resident Assessment System and bata Base for Nursing Home Residents: Post-Implementation Telephone Survey Report. Providence, RI: Center for Gerontology and Health Care Research, Brown University, 1994.
45. Marek KD, Rantz MJ, Fagin C et al. OBRA '87. Has it resulted in better quality of care? J Gerontol Nurs 1996;22:28-36.
46. Testimony before the U.S. Senate Special Committee on Aging, Medicaid Reform: Quality of Care in Nursing Homes At Risk? by Ellen T. Reap, President, Association of Health Facility Survey Agencies; John Willis, Texas State Long-Term Care Ombudsman; Scott Severens, President, National Citizens Coalition for Nursing Home Reform; William M. Russell, M.D., Medical Director, St. Elizabeth Home, Baltimore, MD; Washington DC, October 26, 1995. Testimony before the Democratic Policy Committee Hearing, Forum on Republican Proposals to Repeal Access to Affordable Quality Nuing Home Care, by of Elma Holder, Executive Director, National Citizens Coalition for Nursing Home Reform; Mary Fitzpatrick, family member; Morris J. Kaplan, Owner and Administrator, Gwynedd Square Nursing Center, Lansdale, PA.Washington, DC (October 6, 1995). Testimony at a Congressional Staff and Press Briefing, Sponsored by Senators David Pryor and Jay Rockefeller and the Democratic Members of the U.S. Senate Special Committee on Aging, by Bruce Vladeck, Administrator Health Care financing Administration in Washington, DC (December, 1993).
47. Testimony before the U.S. Senate Special Committee on Aging, Medicaid Reform: Quality of Care in Nursing Homes At Risk? by Ellen T. Reap, President, Association of Health Facility Survey Agencies; John Willis, Texas State Long-Term Care Ombudsman; Scott Severens, President, National Citizens Coalition for Nursing Home Reform; William M. Russell, M.D., Medical Director, St. Elizabeth Home, Baltimore, MD; Washington DC, October 26, 1995. Testimony before the Democratic Policy Committee Hearing, Forum on Republican Proposals to Repeal Access to Affordable Quality Nuing Home Care, by of Elma Holder, Executive Director, National Citizens Coalition for Nursing Home Reform; Mary Fitzpatrick, family member; Morris J. Kaplan, Owner and Administrator, Gwynedd Square Nursing Center, Lansdale, PA.Washington, DC (October 6, 1995). Testimony at a Congressional Staff and Press Briefing, Sponsored by Senators David Pryor and Jay Rockefeller and the Democratic Members of the U.S. Senate Special Committee on Aging, by Bruce Vladeck, Administrator Health Care financing Administration in Washington, DC (December, 1993).
48. Testimony before the U.S. Senate Special Committee on Aging, Medicaid Reform: Quality of Care in Nursing Homes At Risk? by Ellen T. Reap, President, Association of Health Facility Survey Agencies; John Willis, Texas State Long-Term Care Ombudsman; Scott Severens, President, National Citizens Coalition for Nursing Home Reform; William M. Russell, M.D., Medical Director, St. Elizabeth Home, Baltimore, MD; Washington DC, October 26, 1995. Testimony before the Democratic Policy Committee Hearing, Forum on Republican Proposals to Repeal Access to Affordable Quality Nuing Home Care, by of Elma Holder, Executive Director, National Citizens Coalition for Nursing Home Reform; Mary Fitzpatrick, family member; Morris J. Kaplan, Owner and Administrator, Gwynedd Square Nursing Center, Lansdale, PA.Washington, DC (October 6, 1995). Testimony at a Congressional Staff and Press Briefing, Sponsored by Senators David Pryor and Jay Rockefeller and the Democratic Members of the U.S. Senate Special Committee on Aging, by Bruce Vladeck, Administrator Health Care financing Administration in Washington, DC (December, 1993).
49. Phillips CD, Hawes C, Morris JN et al. The nursing home resident assessment instrument (RAI) and the quality of assessments: The impact of the RAI on some measures of process quality. HCFA/RAI Project Working Paper #2, Research Triangle Institute, Research Triangle Park, NC, 1994.
50. Teno J, Branco K, Mor V et al. Changes in advance care planning in nursing homes before and after the Patient Self-Determination Act: Report of a 10-state survey. J Am Geriatr Soc 1997;45:939-944.
51. Rubenstein LZ, Rhee L, Kane RL. The role of geriatric assessment units in caring for the elderly: An analytic review. J Gerontol 1982;37:513-521.
52. Applegate WB, Akins D, Vanderzwagg R et al. A geriatric rehabilitation and assessment unit in a community hospital. J Am Geriatr Soc 1983;31:206-210.
53. Tulloch AJ, Moore V. A randomized controlled trial of geriatric screening and surveillance in general practice. J R Coll Gen Practitioners 1979;29:733-742.
54. Hendricksen C, Lund E, Stromgard E. Consequences of assessment and intervention among elderly people: A three-year randomized controlled trial. Br Med J 1984;289:1522-1524.