Abstract:
OBJECTIVES:To identify the impact of the regulations implemented in Maryland in 2001, related to nursing home attending physicians and medical directors, and nursing home quality assurance requirements, on Maryland nursing homes, administrators, and physicians. DESIGN:Two surveys were mailed to all nursing home administrators in Maryland, one for their completion and one to give to their medical directors to complete. These surveys were to be returned by mail to the authors. SETTING:All nursing homes in all jurisdictions in Maryland. PARTICIPANTS:Two-fifths of administrators and medical directors in Maryland nursing homes completed and returned the survey. MEASUREMENTS:Results were tabulated for each question of each survey, and were calculated as percentages of the total responses. Additionally, individual comments were reviewed. RESULTS:A relatively large sample of administrators and medical directors in Maryland responded. Most respondents were positive or at least neutral about the impact of these regulations on them and their organizations. Many administrators agreed that there had been improvements in medical director participation and performance. There were significant advances in medical director compensation. There were relatively few negative comments about the impact. CONCLUSION:Requirements for physician and medical director accountability appear to have had a positive impact on medical director performance and relationships with nursing home administrators. Additional study is warranted to measure the impact of that performance on patient care outcomes and facility performance.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Boyce BF,Bob H,Levenson SAdoi
10.1097/01.JAM.0000066022.74526.CFkeywords:
subject
Has Abstractpub_date
2003-05-01 00:00:00pages
157-63issue
3eissn
1525-8610issn
1538-9375pii
S1525-8610(04)70326-6journal_volume
4pub_type
杂志文章abstract::Older adults living in nursing homes are the most vulnerable group of the COVID-19 pandemic. There are many difficulties in isolating residents and limiting the spread in this setting. We have developed a simple algorithm with a traffic light format for resident classification and sectorization within nursing homes, b...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.023
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:We examined the dose-response relationships of body composition indices with mortality and identified the best predictor. DESIGN AND SETTING:Kusatsu Longitudinal Study and Hatoyama Cohort Study, Japan. PARTICIPANTS:In total, 1977 community-dwelling Japanese adults age ≥65 years (966 men and 1011 women) par...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.11.018
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVES:Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilit...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.05.034
更新日期:2020-12-01 00:00:00
abstract::Unintentional weight loss is a common problem among nursing home residents and one that can lead to adverse and costly clinical outcomes. Observational studies have shown that residents often receive inadequate and poor-quality feeding assistance during meals, and residents consume few calories between meals from oral...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2006.12.003
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:To explore next-of-kin's (NOK's) perceptions of end-of-life (EOL) care in the nursing home setting and to compare these perceptions for residents receiving hospice care plus usual care versus usual care only. DESIGN:Mailed survey. SETTING:Three nursing homes in central Massachusetts. PARTICIPANTS:Nursing ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.07.017
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:Delirium superimposed on dementia (DSD) is common, morbid, and costly, yet frequently undiagnosed. Our study aimed to develop a brief screening test to improve health care worker recognition of DSD. DESIGN/SETTING/PARTICIPANTS:Older hospitalized adults with dementia were prospectively enrolled from medical a...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.05.011
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:Protein supplementation has been proposed as an effective dietary strategy to increase skeletal muscle mass and improve physical performance in frail elderly people. Our objective was to assess the impact of 24 weeks of dietary protein supplementation on muscle mass, strength, and physical performance in fra...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2012.07.005
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:The purpose of the study was to develop and validate a simple caregiver-rated questionnaire to screen for chronic obstructive pulmonary disease (COPD) in nursing home residents. DESIGN:Part 1: Identification of screening parameters by the Delphi process using geriatric and pulmonary experts. Part 2: Retrosp...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.11.007
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:The aim of this systematic review was to summarize the validity of nutritional screening tools to detect the risk of malnutrition in community-dwelling older adults. DESIGN:A systematic review and meta-analysis. The protocol for this systematic review was registered in the PROSPERO database (CRD42017072703)...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.06.024
更新日期:2019-10-01 00:00:00
abstract::Throughout the millennia, the cannabis plant has been utilized as a recognized therapy for pain relief and symptom management. Following the Prohibition-era stigmatization and criminalization of all forms of cannabis of the early 20th century, there has been a recent nationwide and worldwide resurgence in interest and...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.11.013
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVES:To describe the relation between physician visits and physicians' recognition of a resident's terminal phase in long-term care facilities (LTCFs) in Belgium, England, Finland, Italy, the Netherlands, and Poland. DESIGN:In each country, a cross-sectional study was conducted across representative samples of L...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamda.2018.08.015
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Cognitive impairment is common in people living with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF); however, accurate estimates of prevalence are lacking. To date, there are no meta-analyses that have specifically investigated prevalence of mild cognitive impairment (MCI) in th...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jamda.2017.01.014
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of the modified Hospital Elder Life Program (mHELP) comprising 3 nurse-administered protocols in older patients undergoing gastrointestinal (GI) surgery. DESIGN:Cluster randomized trial. SETTING:Two 36-bed GI wards at a university-affiliated medical center in Taiwan. PARTICIPANTS:Ol...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2018.09.016
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Good scientific evidence indicates that calcium and vitamin D supplementation decrease the incidence of osteoporosis-related fractures among institutionalized elderly. OBJECTIVE:The objective was to study the frequency of prescribing calcium and vitamin D supplements in elderly institutionalized individuals...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1097/01.JAM.0000110649.22467.B4
更新日期:2004-03-01 00:00:00
abstract:PURPOSE:The culture change (CC) movement aims to transform the traditional nursing home (NH) that is institutional in design with hierarchical management structure into a homelike environment that empowers residents and frontline staff. This study examines differences in adoption of CC practices according to a NH's sel...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.11.002
更新日期:2010-09-01 00:00:00
abstract::The purpose of this literature review was to assess the current state of affairs in end-of-life care for persons with dementia, to identify barriers to the provision of high-quality care, and to describe exemplary programs that have discovered ways to overcome these barriers. The literature reviewed included English-l...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVES:Green House and other small nursing home (NH) models are considered "nontraditional" due to their size (10-12 beds), universal caregivers, and other home-like features. They have garnered great interest regarding their potential benefit to limit Coronavirus Disease 2019 (COVID-19) infections due to fewer peo...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2021.01.069
更新日期:2021-01-26 00:00:00
abstract:OBJECTIVES:To determine the prevalence, rate of underdiagnosis and undertreatment, and association with activities of daily living dependency of spasticity in a nursing home setting. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:This study is an analysis of a deidentified data set generated by a prior qualit...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.005
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence and characteristics of advance care planning (ACP) among persons dying in long-term care (LTC) facilities, and to examine the relationship between respondent, facility, decedent, and family characteristics and ACP. DESIGN:After-death interviews of family members of decedents and ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2008.10.015
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To describe the prevalence of periodic eye examinations by eye professionals and to examine nursing facility resident characteristics associated with lack of periodic screening. DESIGN:Retrospective chart review. SETTING:Two Midwestern nursing facilities. PARTICIPANTS:Between 1995 and 1997, 134 subjects ag...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Individuals with heart failure (HF) who are hospitalized and admitted to skilled nursing facilities (SNFs) are at high risk for rehospitalization and death. The care preferences of this high-risk population have not been studied. OBJECTIVES:To describe care preferences of patients with HF admitted to SNFs f...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.05.021
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Although many older adults require skilled nursing facility (SNF) care after acute hospitalization, it is unclear whether internal medicine residents have sufficient knowledge of the care that can be provided at this site. METHODS:We developed a 10-item multiple choice pre-test that assessed knowledge of th...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.08.004
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Poor gait performance predicts risk of developing dementia. No structured critical evaluation has been conducted to study this association yet. The aim of this meta-analysis was to systematically examine the association of poor gait performance with incidence of dementia. METHODS:An English and French Medli...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jamda.2015.12.092
更新日期:2016-06-01 00:00:00
abstract::Heart failure (HF) in older adults presents challenges that are different in many ways than those for younger adults. Diagnosis of HF in older adults can be delayed due to attributing early symptoms to normal changes of aging or, in the setting of a normal ejection fraction, failing to appreciate diastolic heart failu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2008.03.004
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVES:For persons with dementia, the appropriate duration of cholinesterase inhibitor (ChEI) use remains unclear. We examined patterns of ChEI use during nursing home (NH) transition and the factors associated with discontinuation following admission. DESIGN:Population-based retrospective cohort study using linke...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.07.020
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:Telomere length is associated with aging-related pathologies. Although the association between telomere length and frailty has been studied previously, only a few studies assessing longitudinal changes in telomere length and frailty exist. DESIGN:Longitudinal cohort study. SETTING AND PARTICIPANTS:A subpop...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.05.011
更新日期:2018-08-01 00:00:00
abstract::Osteoporosis is expected to increase as our population pyramid shifts toward old age. It is associated with increased risk of fractures, leading to complications of limitation of ambulation, loss of independence, and chronic pain. Depression is also a common occurrence in the elderly population. Currently, up to 35% o...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2011.09.003
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to examine whether a 12-week combined physical exercise training and nutritional intervention improves physical performance and enhances health-related quality of life (HRQOL) among prefrail elderly women living in the community. DESIGN:This was a randomized controlled trial in...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2014.12.005
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVES:To provide an estimate and level of uncertainty for Medicaid cost savings due to Minnesota's Return to Community Initiative (RTCI). DESIGN:Medicaid cost savings are estimated using a semi-Markov model and simulation approach. SETTING AND PARTICIPANTS:RTCI is a statewide program that assists private paying ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.07.016
更新日期:2020-08-28 00:00:00
abstract::A case is reported of an initially 78-year-old man whose presentation and course, closely followed over 10 years by an academic neurologist, were consistent with classic idiopathic Parkinson's disease (PD), including unilateral onset, obvious cogwheeling, and a very good prolonged response to levodopa/carbidopa (LD/CD...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1097/01.JAM.0000141949.31853.25
更新日期:2004-11-01 00:00:00