Although short-stay, post-acute nursing home stays are increasing, little is known about the impact of volume of post-acute care on quality of life (QOL) within nursing homes. We analyzed data from the 2010 Minnesota QOL and Consumer Satisfaction survey (N = 13,433 residents within 377 facilities) and federal Minimum Data Set to determine the influence of living in a facility with an above-average proportion of post-acute care residents on six domains of resident QOL. In bivariate analyses, an above-average proportion of Medicare-funded post-acute care had a significant negative influence on four domains (mood, environment, food, engagement) and overall facility QOL. However, when resident and facility covariates were added to the model, only the food domain remained significant. Although the challenges of caring for residents with a diverse set of treatment and caregiving goals may negatively affect overall facility QOL, negative impacts are moderated by individual resident and nursing home characteristics.
AbrahamsonK.ClarkD.PerkinsA.ArlingG. (2012). Does cognitive impairment influence quality of life among nursing home residents?The Gerontologist, 52, 632-640.
2.
AbrahamsonK.LewisT.PerkinsA.ClarkD.NazirA.ArlingG. (2013). The influence of cognitive impairment, special care unit placement, and nursing facility characteristics on resident quality of life. Journal of Aging and Health, 25, 574-588.
3.
American Health Care Association (2011) “2011 Quality Report: A comprehensive report on the quality of care in America’s nursing and rehabilitation facilities”
AndersenC. K.Wittrup-JensenK. U.LolkA.AndersenK.Kragh-SorensenP. (2004). Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health and Quality of Life Outcomes, 2(52).
6.
BrodM.StewartA. L.SandsL.WaltonP. (1999). Conceptualization and measurement of quality of life in dementia: The dementia quality of life instrument (DQoL). The Gerontologist, 39, 25-35.
7.
DegenholtzH. B.KaneR. A.KaneR. L.BershadskyB.KlingK. C. (2006). Predicting nursing facility residents’ quality of life using external indicators. Health Services Research, 41, 335-356.
8.
DragesetJ.NygaardH. A.EideG. E.BondevikM.NortvedtM. W.NatvigG. K. (2008). Sense of coherence as a resource in relation to health-related quality of life among mentally intact nursing home residents-a questionnaire study. Health and Quality of Life Outcomes, 6(85).
9.
HoeJ.HancockG.LivingstonG.WoodsB.ChallisD.OrrellM. (2009). Changes in the quality of life of people with dementia living in care homes. Alzheimer Disease & Associated Disorders, 23, 285-290.
10.
KaneR. A. (2003). Definition, measurement, and correlates of quality of life in nursing homes: Toward a reasonable practice, research, and policy agenda. The Gerontologist, 43(Spec No, 2), 28-36.
11.
KaneR. A.KlingK. C.BershadskyB.KaneR. L.GilesK.DegenholtzH. B.. . . CutlerL. J. (2003). Quality of life measures for nursing home residents. The Journals of Gerontology. Series A: Biological Sciences & Medical Sciences, 58, 240-248.
12.
KasperJ. (2005). Who stays and who goes home: Using national data from nursing home discharges and long stay residents to draw implications for nursing home transition programs (Kaiser Family Foundation, 2005).
13.
KonetzkaR. T.NortonE. C.SloaneP.KilpatrickK.StearnsS. (2006). Medicare prospective payment and quality of care for long stay nursing facility residents. Medical Care, 44, 270-276.
14.
KonetzkaR. T.YiD.NortonE. C.KilpatrickK. E. (2004). Effects of Medicare payment changes on nursing home staffing and deficiencies. Health Services Research, 39, 463-488. doi:10.1111/j.1475-6773.2004.00240.x
15.
LawtonM. P. (2001). Quality of care and quality of life in dementia care units. In NoelkerL. S.HarelZ. (Eds.), Linking quality of long-term care and quality of life (pp. 136-162). New York, NY: Springer.
16.
LinehanK. (2012, December). Medicare’s post-acute payment: A review of the issues and policy proposals (National Quality Forum Issue Brief No. 847). George Washington University, Washington, D.C.
17.
LogsdonR. G.GibbonsL. E.McCurryS. M.TeriL. (2002). Assessing quality of life in older adults with cognitive impairment. Psychosomatic Medicine, 64, 510-519.
18.
MedPac. (2014, March). Report to the congress: Medicare payment policy.
19.
RipponI.KnealeD.de OliveiraC.DemakakosP.SteptoeA. (2014). Perceived age discrimination in older adults. Age and Ageing, 43, 379-386. doi:10.1093/ageing/aft146
20.
SelwoodA.ThorgrimsenL.OrrellM. (2005). Quality of life in dementia-a one-year follow-up study. International Journal of Geriatric Psychiatry, 20, 232-237.
21.
ShippeeT. P. (2011). On the edge: Balancing health, participation, and autonomy to maintain active independent living in two retirement facilities. Journal of Aging Studies, 26, 1-15.
22.
ShippeeT. P.Henning-SmithC.KaneR. LLewisT. (2015). Resident and facility-level predictors of quality of life in long-term care. The Gerontologist, 55(4), 643-655.
23.
ShippeeT.P.HongH.Henning-SmithC.KaneR.L. (2015). Longitudinal changes in nursing home resident-reported quality of life. Research on Aging, 37(6), 555-580.
24.
ShippeeT. P.Henning-SmithC.RheeT.HeldR.KaneR. (2015) Racial differences in Minnesota nursing home resident quality of life: the importance of looking beyond individual predictors. Journal of Aging and Health, Advance online publication.
25.
SloaneP. D.ZimmermanS.WilliamsC. S.ReedP. S.GillK. S.PreisserJ. S. (2005). Evaluating the quality of life of long-term care residents with dementia. The Gerontologist, 45(1 Spec No, 1), 37-49.
26.
SpetzJ.HarlessD.HerreraC.MarkB. (2013).Using minimum nurse staffing regulations to measure the relationship between nursing and hospital quality of care. Medical Care Research and Review, 70, 380-399.
27.
TolesM.BarrosoJ.Colón-EmericC.CorazziniK.McConnellE.AndersonR. A. (2012). Staff interaction strategies that optimize delivery of transitional care in a skilled nursing facility: A multiple case study. Family & Community Health, 35, 334-344.
28.
Vital Research. (2010). Implementation of the 2010 Consumer Satisfaction and Quality of Life Survey in Minnesota nursing homes and satisfaction survey of family members of residents in Minnesota nursing homes: Final report (Prepared for the Minnesota Department of Human Services). Los Angeles, CA: Author.
29.
WernerR.StuartE.PolskyD. (2010). Public reporting drove quality gains at nursing homes. Health Affairs, 29, 1706-1713.
30.
ZimmermanS.SloaneP. D.WilliamsC. S.ReedP. S.PreisserJ. S.EckertJ. K.. . . DobbsD. (2005). Dementia care and quality of life in assisted living and nursing homes. The Gerontologist, 45(Special issue 1), 133-146.
