JAMDA
Volume 10, Issue 8 , Pages 568-574 , October 2009

The Importance of Standardized Observations to Evaluate Nutritional Care Quality in the Survey Process

  • John F. Schnelle, PhD

      Affiliations

    • Vanderbilt University, School of Medicine, Division of General Internal Medicine and Public Health, Center for Quality Aging, Nashville, TN
    • Geriatric Research, Education, and Clinical Center, VA Medical Center, Nashville, TN
    • Corresponding Author InformationAddress correspondence to John F. Schnelle, PhD, Center for Quality Aging, 1161 21st Avenue South, S-1121 Medical Center North, Vanderbilt University Medical Center, Nashville, TN 37232–2400.
    • ,
  • Rosanna Bertrand, PhD

      Affiliations

    • Abt Associates, Cambridge, MA
    • ,
  • Donna Hurd, MSN

      Affiliations

    • Abt Associates, Cambridge, MA
    • ,
  • Alan White, PhD

      Affiliations

    • Abt Associates, Cambridge, MA
    • ,
  • David Squires

      Affiliations

    • Abt Associates, Cambridge, MA
    • ,
  • Marvin Feuerberg, PhD

      Affiliations

    • Vanderbilt University, School of Medicine, Division of General Internal Medicine and Public Health, Center for Quality Aging, Nashville, TN
    • ,
  • Kelly Hickey

      Affiliations

    • University of California, Los Angeles, School of Medicine, Division of Geriatrics, Los Angeles, CA
    • ,
  • Sandra F. Simmons, PhD

      Affiliations

    • Vanderbilt University, School of Medicine, Division of General Internal Medicine and Public Health, Center for Quality Aging, Nashville, TN
    • Geriatric Research, Education, and Clinical Center, VA Medical Center, Nashville, TN

References 

  1. Louwe H, Parry C, Kramer A, Feuerberg M. Improving nursing home enforcement: Findings from enforcement case studies. CMS Report. UCDHSC, Division of Health Care Policy and Research. Denver, CO: University of Colorado, Health Services Center; 2007;
  2. Health Care Financing Administration. Report to Congress: Study of Private Accreditation (Deeming of Nursing Homes, Regulatory Insensitive and Non-Regulatory Initiatives and Effectiveness of the Survey and Certification System). Volumes 1–4. Baltimore, MD: H.C.F.A. Baltimore; 1998;
  3. US Government Accountability Office. Report to Congress: Nursing Homes: Federal Monitoring Surveys Demonstrate Continued Understatement of Serious Care Problems and CMS Oversight Weakness (GAO-08–517). Washington, DC: United States Government Accounting Office; 2008;
  4. Task Force on Survey Certification and Enforcement. Broken and Beyond Repair: Recommendations to Reform the Survey and Certification System. Washington, DC: American Association of Home and Services for the Aging; 2008;
  5. Kayser-Jones J, Schell E. The effect of staffing on the quality of care at mealtime. Nurs Outlook. 1997;45(2):64–72
  6. Kayser-Jones J, Schell E, Porter C, Paul S. Reliability of percentage figures used to record the dietary intake of nursing home residents. Nurs Home Med. 1997;5:69–76
  7. Pokrywka HS, Koffler KH, Remsburg R, et al. Accuracy of patient care staff in estimating and documenting meal intake of nursing home residents. J Am Geriatr Soc. 1997;45:1223–1227
  8. Simmons SF, Reuben D. Nutritional intake monitoring for nursing home residents: A comparison of staff documentation, direct observation, and photography methods. J Am Geriatr Soc. 2000;48:209–213
  9. Simmons SF, Keeler E, Xiaohui ZM, Schnelle JF. Prevention of unintentional weight loss in nursing home residents: A controlled trial of feeding assistance. J Am Geriatr Soc. 2008;56:1466–1473
  10. Simmons SF, Schnelle JF. Individualized feeding assistance care for nursing home residents: Staffing requirements to implement two interventions. J Gerontol A Biol Sci Med Sci. 2004;59:M966–M973
  11. Centers for Medicare and Medicaid Services. Interpretive Guidelines State Operations Manual. Appendix P, survey protocol for long-term care facilities. Part 1, 2008 (Revision 26, 08–17–07). Available at: http://www.cms.hhs.gov/manuals/. Accessed February 22, 2008.
  12. The Division of Health Care Policy and Research & Centers for Medicare & Medicaid Services. 2008. QIS Resource Manual. University of Colorado. Available at: http://www.uchsc.edu/hcpr/qis_manual.php. Accessed February 22, 2008.
  13. Simmons SF, Babineau S, Garcia E, Schnelle JF. Quality assessment in nursing homes by systematic direct observation: Feeding assistance. J Gerontol A Biol Sci Med Sci. 2002;57:M665–M671
  14. Simmons SF, Schnelle JF. Feeding assistance needs of long-stay nursing home residents and the staff time to provide care. J Am Geriatr Soc. 2006;54:919–924
  15. Schnelle JF, Simmons SF, Harrington C, et al. Relationship of nursing home staffing to quality of care. Health Serv Res. 2004;39:225–250
  16. Abt Associates, Inc. University of Colorado Health Sciences Center, Borun Center of the University of California at Los Angeles. Quality Indicator Survey (QIS) Phase I Formative Evaluation (Centers for Medicare and Medicaid Services Contract #500–00–0032 TO #7). Baltimore, MD: ABT Associates; 2006;

 The analyses on which this publication is based were performed under Contract Number 500-00-0032, Task Order #7, entitled “Evaluation of the Quality Indicator Survey,” sponsored by the Centers for Medicare and Medicaid Services, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government. The authors assume full responsibility for the accuracy and completeness of the ideas presented.

PII: S1525-8610(09)00177-7

doi: 10.1016/j.jamda.2009.05.004

JAMDA
Volume 10, Issue 8 , Pages 568-574 , October 2009

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