The Changing Role of Non-Profit Organizations in the U.S. Long Term Care System.

The American long-term care system has changed dramatically over the last several years as the need for care has increased steadily with the aging of the boomer generation. Arguably, the most important change has occurred in the Medicaid-funded part of the system as several states, with strong federal support, have moved toward contracting with large for-profit insurance companies to provide overall administration of Medicaid long-term care services, largely displacing the non-profit organizations that constitute the nation's Aging Network. We are concerned that the displacement of the mission-oriented model of long-term care that is administered by the Aging Network will negatively affect access, quality, and cost in state Medicaid long-term care programs.

Influenza vaccination rates and beliefs about vaccination among nursing home employees.

Background: Recent studies have suggested that vaccination of nursing home staff members may reduce the incidence of influenza among nursing home residents. Current national estimates of employee vaccination rates (around 50%) indicate that residents may be at an unnecessarily high risk of contracting influenza. This article reports on the influenza vaccination rates and attitudes toward the vaccine among employees in 37 nursing homes in 3 states.

Nurse managers' perspectives of structural and process characteristics related to residents' advance directives in nursing homes.

This article examines associations between nursing home structural and process characteristics and presence of advance directives and trends over 5 years of advance directives in Florida nursing homes. Our results underscore the importance of nursing homes' processes in facilitating discussions of nursing home residents' end-of-life care preferences.

Helping nursing homes prepare for disasters.

Responding to the deaths and suffering of older adults in long-term care facilities following Hurricanes Katrina, Rita, and Wilma, the John A. Hartford Foundation funded an initiative called Hurricane and Disaster Preparedness for Long-Term Care Facilities. Long-term care providers are now acknowledged as health care providers by most federal and state emergency response centers.

A Pilot Study Evaluating the Feasibility of Psychological First Aid for Nursing Home Residents.

OBJECTIVES: The objectives of the pilot study were to modify existing psychological first aid (PFA) materials so they would be appropriate for use with institutionalized elders, evaluate the feasibility of using nursing home staff to deliver the intervention to residents, and solicit feedback from residents about the intervention. The STORM Study, an acronym for "services for treating older residents' mental health", is the first step in the development of an evidence-based disaster mental health intervention for this vulnerable and underserved population. METHOD: Demographic characteristics were collected on participating residents and staff.

Use of mental health services by nursing home residents after hurricanes.

Objective: A growing body of research supports the value of mental health intervention to treat people affected by disasters. This study used a mixed-methods approach to evaluate pre- and posthurricane mental health service use in Florida nursing homes.

Methods: A questionnaire was administered to 258 directors of nursing, administrators, and owners of nursing homes, representing two-thirds of Florida's counties, to identify residents' mental health needs and service use.

Florida's model of nursing home Medicaid reimbursement for disaster-related expenses.

Purpose: This study describes Florida's model of Medicaid nursing home (NH) reimbursement to compensate NHs for disaster-related expenses incurred as a result of 8 hurricanes within a 2-year period. This Florida model can serve as a demonstration for a national model for disaster-related reimbursement.

Design And Methods: Florida reimburses NHs for approved disaster-related costs through hurricane interim rate requests (IRRs).

The controversy inherent in managing frail nursing home residents during complex hurricane emergencies.

Emergency planning for vulnerable populations constitutes a major element of community disaster preparedness and is an area in which guidance is particularly sparse. As evidenced by the well-publicized deaths of nursing home residents following Hurricanes Katrina and Rita, the need to improve nursing home emergency preparedness is self-evident. Nevertheless, as efforts to improve preparedness develop, a central controversy remains.

A comparative study of laws, rules, codes and other influences on nursing homes' disaster preparedness in the Gulf Coast states.

In 2005, Hurricanes Katrina and Rita devastated several Gulf Coast states and caused many deaths. The hurricane- related deaths of 70 nursing home residents--34 believed drowned in St. Rita's Nursing Home in Louisiana and 36 from 12 other nursing homes--highlighted problems associated with poorly developed and executed disaster plans, uninformed evacuation decision-making, and generally inadequate response by providers and first responders (DHHS, 2006; Hyer, Brown, Berman, & Polivka-West, 2006).

Establishing and refining hurricane response systems for long-term care facilities.

In February 2006 the John A. Hartford Foundation funded a long-term care "Hurricane Summit," sponsored by the Florida Health Care Association. Representatives from five Gulf Coast states that sustained hurricane damage during 2005 and from Georgia, a receiving state for hurricane evacuees, attended.