Related Experiment Videos
Nursing homes with persistent deficiency citations for physical restraint use.
1RAND, Pittsburgh, Pennsylvania 15213, USA. NICK_CASTLE@RAND.org
Medical Care
|October 24, 2002
Summary
Persistent physical restraint use in nursing homes is linked to lower caregiver staffing and higher Medicaid patient numbers. Facilities with persistent restraint issues have distinct characteristics, even after reforms.
Area of Science:
- Gerontology
- Healthcare Quality
- Nursing Home Management
Background:
- Physical restraint use in nursing homes has been a long-standing quality concern.
- The Nursing Home Reform Act aimed to reduce restraint prevalence.
- Persistent quality issues in restraint use remain despite regulatory efforts.
Purpose of the Study:
- To identify organizational and resident characteristics associated with persistent poor quality in physical restraint use.
- To analyze nursing homes with deficiency citations for restraint use on two or three consecutive inspections.
Main Methods:
- Utilized nationally representative data from the Online Survey, Certification, and Reporting (OSCAR) system (1996-1999).
- Employed descriptive analyses and multinomial logistic regression.
Main Results:
- 5.2% of nursing homes had citations for restraint use on two consecutive inspections; 2.3% on three.
- Higher Medicaid census and Activities of Daily Living (ADL) levels were associated with persistent restraint citations.
- Higher caregiver staffing levels were negatively associated with persistent restraint citations.
Conclusions:
- Despite the Nursing Home Reform Act's impact, persistent restraint quality problems exist.
- Nursing homes with persistent issues differ in RN staffing, Medicaid census, and ADL levels.
- These findings highlight specific targets for quality improvement initiatives in nursing homes.