MDS 3.0: brief interview for mental status.

Objectives: To test the feasibility and validity of the Brief Interview for Mental Status (BIMS) as a performance-based cognitive screener that could be easily completed by nursing home staff. The current study examines the performance of the BIMS as part of the national testing of the Minimum Data Set 3.0 (MDS 3.

Testing the PHQ-9 interview and observational versions (PHQ-9 OV) for MDS 3.0.

Objectives: To test the feasibility and validity of the Patient Health Questionnaire-9 item interview (PHQ-9) and the newly developed Patient Health Questionnaire Observational Version (PHQ-9 OV) for screening for mood disorder in nursing home populations.

Methods: The PHQ-9 was tested as part of the national Minimum Data Set 3.0 (MDS 3.

Making the investment count: revision of the Minimum Data Set for nursing homes, MDS 3.0.

Background: The Minimum Data Set (MDS) is a potentially powerful tool for implementing standardized assessment in nursing homes (NHs). Its content has implications for residents, families, providers, researchers, and policymakers, all of whom have expressed concerns about the reliability, validity, and relevance of MDS 2.0.

Overview of significant changes in the Minimum Data Set for nursing homes version 3.0.

The Minimum Data Set (MDS) is a standardized assessment that is completed on all residents admitted to Medicare certified nursing homes in the US. It is also completed on all residents admitted to Veteran Health Administration Community Living Centers. Its content addresses multiple domains of resident health and function and is intended to facilitate better recognition of each resident's needs.

Why not just ask the resident?

This research evaluated a draft preference assessment tool (draft-PAT) designed to replace the current Customary Routine section of the Minimum Data Set (MDS) for nursing homes. The draft-PAT was tested with a sample of nursing home residents to evaluate survey-level administration time and noncompletion rates, as well as item-level nonresponse rates, response distributions, and test-retest reliability. Modifications to the draft-PAT were then retested with a subsample of residents.

Nursing home assessment of cognitive impairment: development and testing of a brief instrument of mental status.

Objectives: To test the accuracy of a brief cognitive assessment of nursing home (NH) residents and to determine whether facility nurses can reliably perform this assessment.

Design: Cross-sectional, independent cognitive screening tests with NH residents.

Setting: Six Department of Veteran Affairs nursing facilities.

What the resident meant to say: use of cognitive interviewing techniques to develop questionnaires for nursing home residents.

Purpose: Emphasis on consumer-centered care for frail and institutionalized older adults has increased the development and adaptation of surveys for this population. Conventional methods used to pretest survey items fail to investigate underlying sources of measurement error. However, the use of the cognitive interview (CI), a method for studying how respondents answer survey items, is not well established or documented in this population.

The development of a CAHPS instrument for Nursing Home Residents (NHCAHPS).

We report on a federal initiative to develop a CAHPS (The Consumer Assessment of Healthcare Providers and Systems) survey to measure residents' experiences with quality-of-care and quality-of-life in nursing homes (known as NHCAHPS). We focus on how we created and tested questions for inclusion in the instrument and tested a possible cognitive screener to determine which residents could participate in a NHCAHPS interview. The major lessons learned were: (1) In contrast to other CAHPS surveys, ratings were more useful than reports because of the difficulty that residents had with summarizing over time and people; (2) consistent with other CAHPS surveys, the 0 to 10 response scale appeared to work well with nursing home residents for many of the quality-of-care questions; however, a different response scale was needed for many of the quality-of-life items; and (3) in contrast with typical survey methodology and other CAHPS surveys where explicit time reference periods are used, a non-specific present reference period in questions seemed to work best.

Derivation and confirmation of scales measuring medical directors' attitudes about the hospitalization of nursing home residents.

Objective: To derive and confirm scales measuring medical director's attitudes about hospitalization of nursing home residents.

Method: The authors surveyed nursing facility medical directors about the necessity of hospitalizing residents for eight clinical conditions and compared the ratings to those obtained from an expert panel to derive a relative hospitalization score. They also asked about factors that might influence hospitalization decisions.

Nursing home capabilities and decisions to hospitalize: a survey of medical directors and directors of nursing.

Objectives: To obtain information from decision makers about attitudes toward hospitalization and the factors that influence their decisions to hospitalize nursing home residents.

Design: Cross-sectional survey.

Setting: Four hundred forty-eight nursing homes, 76% of which were nonprofit, from 25 states.

Function and response of nursing facilities during community disaster.

Objectives: We sought to describe the role and function of nursing facilities after disaster.

Methods: We surveyed administrators at 144 widely dispersed nursing facilities after the Los Angeles Northridge earthquake.

Results: Of the 113 (78%) nursing facilities that responded (11 365 beds), 23 sustained severe damage, 5 closed (625 beds), and 72 lost vital services.

Tube-feeding versus hand-feeding nursing home residents with advanced dementia: a cost comparison.

Objective: To compare the costs associated with caring for severely demented residents nursing homes with and without feeding tubes.

Design: Retrospective cohort study.

Setting: A 700-bed long-term care facility in Boston.

Evaluating the planned substitution of the minimum data set-post acute care for use in the rehabilitation hospital prospective payment system.

Objective: The objective of this study was to evaluate the payment implications of substituting the Minimum Data Set-Post Acute Care (MDS-PAC) for the FIM trade mark instrument for use in the planned prospective payment system (PPS) for inpatient rehabilitation hospitals. FIM trade mark is a trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activites, Inc.

Research Design: We used a prospective cross-sectional design using consecutive sampling.

An assessment tool translation study.

Policymakers hoped to substitute a new, multi-purpose, functional assessment instrument, the minimum data set post-acute care (MDS-PAC), into the planned prospective payment system (PPS) for inpatient rehabilitation hospitals. PPS design requires a large database linking treatment costs with measures of the need for care, so the PPS was designed using the functional independence measure (FIM) database linked to Medicare hospital claims. An accurate translation from the MDS-PAC items to FIM--like items was needed to ensure payment equity under the substitution.

Tube-feeding versus hand-feeding nursing home residents with advanced dementia: a cost comparison.

Objective: To compare the costs associated with caring for severely demented residents nursing homes with and without feeding tubes.

Design: Retrospective cohort study.

Setting: A 700-bed long-term care facility in Boston Participants: Nursing home residents aged 65 years and over with advanced dementia and eating problems for whom long-term feeding tube had been discussed as a treatment option.

Transmission of financial incentives to physicians by intermediary organizations in California.

Many U.S. physicians participate in provider-sponsored organizations that act as their intermediaries in contracting with managed care plans, particularly where capitation contracts are used.