LEADER 05852nam 2200721Ia 450 001 9910973278103321 005 20251017110132.0 010 $a9786610221691 010 $a9781280221699 010 $a1280221690 010 $a9780309554848 010 $a0309554845 010 $a9780585144344 010 $a0585144346 035 $a(CKB)110986584750746 035 $a(EBL)3376942 035 $a(SSID)ssj0000177497 035 $a(PQKBManifestationID)11183317 035 $a(PQKBTitleCode)TC0000177497 035 $a(PQKBWorkID)10217944 035 $a(PQKB)10190473 035 $a(MiAaPQ)EBC3376942 035 $a(Au-PeEL)EBL3376942 035 $a(CaPaEBR)ebr10062804 035 $a(CaONFJC)MIL22169 035 $a(OCoLC)940510469 035 $a(Perlego)4735100 035 $a(DNLM)626093 035 $a(BIP)787270 035 $a(EXLCZ)99110986584750746 100 $a19870219d1986 uy 0 101 0 $aeng 135 $aur|n|---||||| 181 $ctxt$2rdacontent 182 $cc$2rdamedia 183 $acr$2rdacarrier 200 10$aImproving the quality of care in nursing homes /$fCommittee on Nursing Home Regulation, Institute of Medicine 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$d1986 215 $a1 online resource (431 pages) 300 $a"Report of a study conducted under contract no. 500-83-0054 with the Health Care Financing Administration"--T.p. verso. 300 $a"Publication IOM-85-10"--T.p. verso. 311 0 $a9780309036467 311 0 $a0309036461 320 $aIncludes bibliography: p. 213-237 and index. 327 $aImproving the Quality of Care in Nursing Homes; Copyright; Preface; Acknowledgments; Contents; 1 Introduction and Summary ; PURPOSE OF THE STUDY; THE PUBLIC POLICY CONTEXT OF THE STUDY; PERSPECTIVE ON THE ISSUES; The Role of Nursing Homes; Quality of Care and Quality of Life; The Regulatory System; Other Factors Affecting Quality of Care in Nursing Homes; Other Regulatory Policies; Consumers, the Community, and Nursing Home Management and Staff; CONCLUSIONS; SUMMARY OF RECOMMENDATIONS; Regulatory Criteria; Monitoring Nursing Home Performance; Enforcing Compliance with Federal Standards 327 $aOther Factors Affecting Quality of Care and Quality of Life in Nursing Homes; Issues Requiring Further Study; Information Systems; Medicaid Payment Policies; Nursing Home Bed Supply; Staffing of Nursing Homes; Single- Versus Multiple-Occupancy Rooms; 2 Concepts of Quality, Quality Assessment, and Quality Assurance ; QUALITY OF CARE IN NURSING HOMES; Characteristics of the Residents; Care Needs; The Care Setting; Requirements for High-Quality Care; Planning And Providing Care; QUALITY OF LIFE; QUALITY ASSESSMENT CRITERIA; Structure; Process; Outcomes; ASSESSING QUALITY OF CARE 327 $aFunctional Competency/Impairment; Intellectual Impairment/Behavioral Problems; PERSPECTIVE ON QUALITY ASSURANCE; INTERPRETING AND USING INFORMATION FOR QUALITY ASSURANCE; Measurement of Care Quality; Standards; Case Mix; Standard Instruments; National, Regional, and Local Uses; QUALITY ASSURANCE AND THE REGULATORY SYSTEM; 3 Regulatory Criteria ; THE ISSUES; CONSOLIDATING THE TWO SETS OF CRITERIA; RESIDENT ASSESSMENT; REVISING AND STRENGTHENING THE CONDITIONS AND STANDARDS; Quality of Life; Quality of Care; Residents' Rights; Administration; Training of Nurse's Aides; Discrimination 327 $aNotification; Participation; Access; Physical Environment; NOTE ON STAFFING STANDARDS; General; Social Services; Licensed and Registered Nurses; 4 Monitoring Nursing Home Performance ; THE ISSUES; PROBLEMS WITH THE SURVEY PROCESS; Predictability; Inefficiency; Paper Compliance; Insensitivity to Resident Needs; Inconsistency; Isolation from Related Monitoring Processes; Variable State Regulatory Capacity; REDESIGNING THE SURVEY PROCESS; Consolidation of Medicare and Medicaid Survey Procedures; Timing and Frequency of Surveys; Two-Stage Survey Approach; The Resident Assessment Audit 327 $aThe Standard Survey; The Extended Survey; Case-Mix Referencing; Key Indicators; Triggering an Extended Survey: Scoring and Decision-Making; Survey Data Sources; Coordination with Complaint Programs; Consumer Involvement; Positive Incentives; Continuing Improvement of the Survey Process; Reliability and Validity of Instruments and Procedures; Consistency of Survey Results; PACS: AN NEW HCFA SURVEY PROTOCOL; INCREASING STATE REGULATORY CAPACITY; Federal Funding of Certification Activities; State Surveyor Qualifications; Federal Training Support; Dissemination of Research and Evaluation Results; Federal Oversight and Sanctioning Responsibilities 330 $aAs more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists. 606 $aOld age homes$xStandards$zUnited States 606 $aNursing homes$xStandards$zUnited States 615 0$aOld age homes$xStandards 615 0$aNursing homes$xStandards 676 $a362.1/6 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910973278103321 996 $aImproving the quality of care in nursing homes$94354193 997 $aUNINA