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Program of all inclusive care for the elderly

J Margo Brooks Carthon, Jessica Rearden, Darcy Pancir, Kerry Gamble, Helyn Rothwell
Older Black patients are at increased risk for experiencing a hospital readmission. This disparity may be related to a variety of factors, including care received during hospitalization. The purpose of this study was to elicit the perceptions of older Black patients at high risk for readmission, and explore their nursing care needs and preferences during and following hospitalization. A qualitative descriptive design was used, including individual interviews with 19 Black members of a Program of All-Inclusive Care for the Elderly facility located in a northeastern urban setting...
November 10, 2016: Clinical Nursing Research
Sherry A Greenberg, Eileen Sullivan-Marx, Marilyn Lynn S Sommers, Jesse Chittams, Pamela Z Cacchione
Fear of falling (FOF) creates a psychological barrier to performing activities for many older adults. The negative impact of fear of falling increases risk of curtailment of activities, future falls, and injury. The specific aim for this study was to investigate the relationship between two fear of falling measures used in clinical research, the FOF Likert scale and Falls Self Efficacy Scale-International (FES-I). The study included a convenience sample of 107 high-risk, community-dwelling, mostly Black (94%) members from one Program for All-Inclusive Care for the Elderly program...
November 2016: Geriatric Nursing
John G Cagle, Keelan M McClymont, Julie N Thai, Alexander K Smith
OBJECTIVES: To describe preferences and experiences of caregivers of disabled older adults regarding being included in patient-clinician discussions about life expectancy. DESIGN: Qualitative interview study. SETTING: Caregivers were recruited from a Program of All-Inclusive Care for the Elderly (PACE), caregiver support groups and an advertisement on a nationwide caregiver advocacy group website. PARTICIPANTS: Active and bereaved caregivers whose primary language was either English or Cantonese who had provided care within the last 5 years to a disabled adult aged 65 and older (N = 42, 79% female, 60% white, average age 54)...
June 2016: Journal of the American Geriatrics Society
Miranda J Meunier, Jeannine M Brant, Simmy Audet, Dustin Dickerson, Karen Gransbery, Elizabeth L Ciemins
BACKGROUND AND PURPOSE: Caring for frail older adults is a significant healthcare concern as the frailest 10% of the population account for over 70% of healthcare expenditures. Research reveals the use of comprehensive models, such as Program of All-Inclusive Care for the Elderly (PACE), leads to improved functional outcomes for participants and cost savings through decreased utilization. This study examines how closing a PACE program impacts health outcomes of previously enrolled participants...
November 2016: Journal of the American Association of Nurse Practitioners
(no author information available yet)
This final rule will amend the fire safety standards for Medicare and Medicaid participating hospitals, critical access hospitals (CAHs), long-term care facilities, intermediate care facilities for individuals with intellectual disabilities (ICF-IID), ambulatory surgery centers (ASCs), hospices which provide inpatient services, religious non-medical health care institutions (RNHCIs), and programs of all-inclusive care for the elderly (PACE) facilities. Further, this final rule will adopt the 2012 edition of the Life Safety Code (LSC) and eliminate references in our regulations to all earlier editions of the Life Safety Code...
May 4, 2016: Federal Register
Pamela Z Cacchione, Lisa Eible, Le'Roi L Gill, Steven F Huege
Providing person-centered care (PCC) to older adults with dual diagnosis, co-occurring serious mental illness (SMI), and substance misuse is complex and requires an interprofessional team. Older adults, who qualify for both Medicaid and Medicare (i.e., dual-eligibles) are overrepresented in the population of older adults with SMI and substance misuse. Programs of All-Inclusive Care for the Elderly (PACE) exist to support community living needs of nursing home-eligible older adults and are increasingly in a position to serve older adults with SMI and substance misuse issues...
May 1, 2016: Journal of Gerontological Nursing
Judith A C Rietjens, Ida J Korfage, Lesley Dunleavy, Nancy J Preston, Lea J Jabbarian, Caroline Arnfeldt Christensen, Maja de Brito, Francesco Bulli, Glenys Caswell, Branka Červ, Johannes van Delden, Luc Deliens, Giuseppe Gorini, Mogens Groenvold, Dirk Houttekier, Francesca Ingravallo, Marijke C Kars, Urška Lunder, Guido Miccinesi, Alenka Mimić, Eugenio Paci, Sheila Payne, Suzanne Polinder, Kristian Pollock, Jane Seymour, Anja Simonič, Anna Thit Johnsen, Mariëtte N Verkissen, Esther de Vries, Andrew Wilcock, Marieke Zwakman, Agnes van der Heide Pl
BACKGROUND: Awareness of preferences regarding medical care should be a central component of the care of patients with advanced cancer. Open communication can facilitate this but can occur in an ad hoc or variable manner. Advance care planning (ACP) is a formalized process of communication between patients, relatives and professional caregivers about patients' values and care preferences. It raises awareness of the need to anticipate possible future deterioration of health. ACP has the potential to improve current and future healthcare decision-making, provide patients with a sense of control, and improve their quality of life...
April 8, 2016: BMC Cancer
Seo Hyon Baik, Inmaculada Hernandez, Yuting Zhang
BACKGROUND: As alternatives to warfarin, 2 novel oral anticoagulants (NOACs), dabigatran and rivaroxaban, were approved in 2010 and 2011 to prevent stroke and other thromboembolic events in patients with atrial fibrillation. It is unclear how patient characteristics are associated with the initiation of anticoagulants. OBJECTIVE: To evaluate how patient demographics, clinical characteristics, types of insurance, and patient out-of-pocket spending affect the initiation of warfarin and 2 NOACs--dabigatran and rivaroxaban...
March 2016: Journal of Managed Care & Specialty Pharmacy
Les P Covington, Jamie McCarrell, Nicole S Hoerster
OBJECTIVES: Evaluate the prevalence of anticholinergic medication use in the Program of All-Inclusive Care for the Elderly (PACE). DESIGN: Cross-sectional, retrospective chart review. SETTING: The Basics at Jan Werner PACE, Amarillo, Texas. PARTICIPANTS: PACE participants (n = 128) and long-term care residents (n = 105) 65 years of age and older. MAIN OUTCOME MEASURE: The primary outcome was percentage of prescribed medications with anticholinergic properties and risk factors associated with prescribing: study site, gender, race, age, and creatinine clearance...
March 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Tara A Cortes, Eileen M Sullivan-Marx
In November 2015, President Obama signed the Program of All-Inclusive Care for the Elderly (PACE) Innovation Act, which expands a proven model of care to serve high-cost and high-need populations. Specifically, the law provides the Centers for Medicare & Medicaid Services with the authority to waive Medicaid requirements that could not be waived without additional statutory authority. Those requirements include the age of the beneficiary to be served and nursing home eligibility as a condition for PACE enrollment...
March 2016: Journal of Gerontological Nursing
Chance Finegan, Fred Ullrich, Keith Mueller
Key Findings. (1) Rural enrollment in Medicare Advantage (MA) and other prepaid plans increased by 6.8 percent between March 2014 and March 2015 to 2.1 million members, or 21.2 percent of all rural residents eligible for Medicare. This compares to a national enrollment in MA and other prepaid plans of 31.1 percent (16.7 million) of enrollees. (2) Rural enrollment in Health Maintenance Organization (HMO) plans (including point-of-service, or POS, plans), Preferred Provider Organization (PP0) plans, and other pre-paid plans (including Medicare Cost and Program of All-Inclusive Care for the Elderly Plans) all increased by 5-13 percent...
July 2015: Rural Policy Brief
Heather Drouin, Jennifer Walker, Heather McNeil, Jacobi Elliott, Paul Stolee
BACKGROUND: Wagner's Chronic Care Model (CCM), as well as the expanded version (ECCM) developed by Barr and colleagues, have been widely adopted as frameworks for prevention and management of chronic disease. Given the high prevalence of chronic illness in older persons, these frameworks can play a valuable role in reorienting the health care system to better serve the needs of seniors. We aimed to identify and assess the measured goals of E/CCM interventions in older populations. In particular, our objective was to determine the extent to which published E/CCM initiatives were evaluated based on population, community, system and individual-level outcomes (including clinical, functional and quality of life measures)...
October 26, 2015: BMC Geriatrics
Leah Kemper, Abigail Barker, Timothy McBride, Keith Mueller
Key Data Findings. (1) Reclassification of rural and urban county designations (due to the switch from 2000 census data to 2010 census data) resulted in a 10 percent decline in the number of Medicare eligible Americans living in rural counties in 2014 (from roughly 10.7 million to 9.6 million). These changes also resulted in a decline in the number of MA enrollees considered to be living in a rural area, from 2.19 million to 1.95 million. However, the percentage of Medicare beneficiaries enrolled in MA and prepaid plans in rural areas declined only slightly from 20...
January 2015: Rural Policy Brief
Carla Bouwmeester, Jacqueline Kraft, Kathleen M Bungay
OBJECTIVE: To assess, using a standard observational tool, the ability of patients to demonstrate and maintain proper inhaled medication administration techniques following pharmacist education. DESIGN: Six-month observational study. SETTING: Patients' homes or adult day health center. PARTICIPANTS: Patients in a Program for All-inclusive Care for the Elderly (PACE) prescribed one or more inhaled medications used at least once daily...
October 2015: Respiratory Medicine
Micah Segelman, Xueya Cai, Christine van Reenen, Helena Temkin-Greener
PURPOSE OF THE STUDY: To compare the risk of long-term nursing home (NH) admission and the level of functional and cognitive impairment at the time of long-term NH admission in the Program of All-Inclusive Care for the Elderly (PACE) and in 1915(c) aged and aged and disabled waiver programs. DESIGN AND METHODS: Cohorts of new waiver and PACE enrollees in 12 states were identified (in 2005-2007) and followed (through 2009) using the Medicaid Analytic Extract and the Minimum Data Set...
August 18, 2015: Gerontologist
Scott Martin Vouri, Stephanie M Crist, Siobhan Sutcliffe, Shane Austin
OBJECTIVES: To examine changes in mood after nine months of enrollment in a Program of All-Inclusive Care for the Elderly (PACE). DESIGN: Cohort study. SETTING: Alexian Brothers PACE, St. Louis, Missouri. PARTICIPANTS: Newly enrolled patients 55 years of age and older, living in the PACE service area, eligible for nursing facility care and able to live safely in the community, with continuous care, for at least nine months (N = 182)...
August 2015: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Jayita Kedar Deodhar, Mary Ann Muckaden
CONTEXT: Training programs for volunteers prior to their working in palliative care are well-established in India. However, few studies report on continuing professional development programs for this group. AIMS: To conduct a preliminary assessment of educational needs of volunteers working in palliative care for developing a structured formal continuing professional development program for this group. SETTINGS AND DESIGN: Cross-sectional observational study conducted in the Department of Palliative Medicine of a tertiary care cancer institute in India...
May 2015: Indian Journal of Palliative Care
Marsha D Fretwell, Jane S Old, Kay Zwan, Kiran Simhadri
The Program of All-inclusive Care for the Elderly (PACE) is at a crossroads in its evolution as a community-based alternative to institutionally based nursing home care. Because of their perceived value and cost savings to Medicaid and Medicare, PACE programs are under increasing pressure to expand the numbers of individuals they serve while simultaneously reducing the overall cost of care. During the first 5 years of operations, the Elderhaus PACE Program in Wilmington, North Carolina, has reduced use of acute hospital care and skilled nursing home care while demonstrating that 46% of their participants improved and 20% of participants maintained their level of functional independence...
March 2015: Journal of the American Geriatrics Society
Bao-Ngoc Nguyen, Richard L Amdur, Mustafa Abugideiri, Rodeen Rahbar, Richard F Neville, Anton N Sidawy
BACKGROUND: Common femoral endarterectomy (CFE) for limited arterial occlusive disease is considered a fairly low-risk operation of short duration. This study investigated the timing of 30-day outcomes as they related to hospital discharge and predicted the risk of operative mortality of this procedure. METHODS: All patients in the National Surgical Quality Improvement Program database who underwent isolated CFE between 2005 and 2010 were selected for the test sample...
June 2015: Journal of Vascular Surgery
Richard G Stefanacci, Shelley Reich, Alex Casiano
To determine which practices would have the most impact on reducing hospital and emergency department admissions and nursing home placement among older adults with multiple comorbid conditions, a literature search and survey were conducted to identify and prioritize comprehensive care principles as practiced in the Program of All-inclusive Care for the Elderly (PACE). PACE medical directors and members of the PACE interdisciplinary team (IDT) were surveyed to gain their insights on the most impactful practices, which were identified as: End-of-Life Management, Caregiver Support, Management of Red Flags, Medication Management, Participant and Caregiver Health Care System Literacy, and Care Coordination...
October 2015: Population Health Management
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