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Chapter 51 - Institutional Post-Acute and Long-Term Care Medicine

from Section IV - Principles of Care for the Elderly

Published online by Cambridge University Press:  30 June 2022

By
Rebecca Elon  and
Fatima Sheikh
Edited by
Jan Busby-Whitehead ,
Samuel C. Durso ,
Christine Arenson ,
Rebecca Elon ,
Mary H. Palmer  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
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Summary

This chapter takes an historical perspective in describing and analyzing the first 6 months of the COVID-19 pandemic in nursing facilities in the United States. Optimal institutional infection control practices in nursing facilities in the pre-COVID-19 era are described, as are many of the challenges faced by nursing facilities in response to the COVID-19 pandemic. The role of the nursing facility medical director is described within the historical context. The structure and content of medical care within the post-acute and long-term care institutional setting are presented. Resources are presented to assist clinicians practicing in nursing facilities.

Keywords

nursing homesinfection controlCOVID-19post-acute carelong-term caremedical care in nursing homesmedical directorshistory of medical care in nursing homes
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 631 - 640
Publisher: Cambridge University Press
Print publication year: 2022

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References

Reichel, W. Role of the medical director in the skilled nursing facility. In: Reichel, W, ed. Clinical Aspects of Aging. Baltimore, MD: The Williams & Wilkins Company, 1978, pp. 475–482.Google Scholar
Baltimore hears of laxity in care. The New York Times. 09/20/1970, p. 31.Google Scholar
Salmonella outbreak. Congressional Quarterly Almanac. 1970, 26th edition, 03–583. Washington, DC. Congressional Quarterly, 1971. https://library.cqpress.com/cqalmanac/document.php?id=cqal70-1294173.Google Scholar
Nursing home care in the United States: Failure in public policy. Supporting Paper #3. Doctors in nursing homes: The shunned responsibility. Special Committee on Aging of the US Senate. Senator Frank Church, Chairman. US Government Printing Office 42–711. Washington, DC, 1975.Google Scholar
Holshue, ML, DeBolt, C, Lindquist, S, et al. First case of 2019 novel coronavirus in the United States. NEJM. 2020; 382:929–936. doi: 10.1056/NEJMoa2001191.CrossRefGoogle ScholarPubMed
Kim, G, Wang, M, Pan, H, Davidson, GH, Roxby, AC, Neukirch, J, et al. A health system response to COVID-19 in long-term care and post-acute care: A three-phase approach. J Am Geriatr Soc. 2020; 68:1155–1161.Google Scholar
McMichael, TM, Currie, DW, Clark, S, Pogosjans, S, Kay, M, Schwartz, NG, et al. Epidemiology of COVID-19 in a long-term care facility in King County Washington. NEJM. 2020; 382:2005–2011 doi: 10.1056/NEJMOA2005412.Google Scholar
Cenziper, D, Jacobs, J, Mulcaly, S, et al. As the pandemic raged, regulators cleared most nursing homes of infection violations. The Washington Post, 10/28/2020.Google Scholar
Roxby, AC, Greninger, AL, Hatfield, KM, et al. Detection of SARS-CoV-2 among residents and staff members of an independent and assisted living community for older adults – Seattle, Washington, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69:416–418. doi: 10.15585/mmwr.mm6914e2external_icon.Google Scholar
Girvan, G, Roy, A. Nursing homes and assisted living facilities account for 42% of COVID-19 deaths. Foundation for Research on Equal Opportunity. August 31, 2020. https://freopp.org/the-covid-19-nursing-home-crisis-by-the-numbers-3a47433c3f70.Google Scholar
https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg.Google Scholar
Hammond, B. The hospital lobbyists behind Cuomo’s nursing home scandal. The Wall Street Journal. 09/19–20/2020, p. A11.Google Scholar
American Geriatrics Society Policy Brief: COVID-19 and nursing homes. J Am Geriatr Soc. 2020; 68:908–911. doi :10.1111/jgs.16477.Google Scholar
Richer, AD, Associated Press. 2 charged over handling of outbreak at veterans’ home. 09/26/2020.Google Scholar
www.cms.gov/newsroom/press-releases/nursing-home-covid-19-data-and-inspections-results-available-nursing-home-compare.Google Scholar
Code of Federal Regulations, Section 483.80 Infection Control www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf.Google Scholar
Code of Maryland Regulations COMAR Title 10 Department of Health and Mental Hygiene, Subtitle 07 – Hospitals, Chapter 02 – Comprehensive care facilities and extended care facilities. https://health.maryland.gov/docs/Long%20Term%20Care%20Regulations%20FINAL.pdf.Google Scholar
Strausbaugh, LJ, Sukumar, SR, Joseph, CL, High, KP. Infectious disease outbreaks in nursing homes: An unappreciated hazard for frail elderly persons. Clinical Infectious Diseases. 2003; 36(7):870–876. doi: 10.1086/368197.CrossRefGoogle ScholarPubMed
Influenza vaccine for 2020–2021. The Medical Letter. Issue 1607, 09/21/2020.Google Scholar
Gravenstein, S, Davidson, HE, Taljaard, M, et al. Comparative effectiveness of high dose versus standard dose influenza vaccination on numbers of US nursing home residents admitted to hospital: A cluster randomized trial. Lancet Respir Med. 2017; 5:738.CrossRefGoogle Scholar
Carman, WF, Elder, AG, Wallace, LA, et al. Effect of influenza vaccination of healthcare workers on mortality of elderly people in long-term care: A randomized controlled trial. Lancet. 2000; 355:93–97.Google Scholar
Roup, BJ. Infection prevention training impacts outbreak recognition and control in long-term care facilities in Maryland. Am Jour Infection Control. 2011; 39(5):E162. doi: 10.1016/j/ajic.2011.04.274.Google Scholar
www.cdc.gov/healthywater/office/emergency/outbreak-case-tracking-line-list.doc.Google Scholar
https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000471.asp. OIG Audit of nursing home infection prevention and control programs’ deficiencies.Google Scholar
Reichel, W. Role of the medical director in the skilled nursing facility: Historical perspectives. In Reichel W, , ed. Clinical Aspects of Aging, 2nd edition. Baltimore, MD: The Williams & Wilkins Company, 1978, pp. 570–579.Google Scholar
AMDA – The Society for Post-Acute and Long-Term Care Medicine. www.paltc.org.Google Scholar
Altemeier, TM, Pattee, JJ, Wagner, PN. Core educational objectives for the administrative aspects of medical direction in nursing homes. The Journal of Medical Direction. 1992; 2(2):59–66.Google Scholar
JAMDA – The Journal of Post-Acute and Long-Term Care Medicine. www.jamda.org.Google Scholar
The American Board of Post-Acute and Long-Term Care Medicine. www.abplm.org.Google Scholar
Elon, R. Finding the ideal medical director for your nursing home. Caring for the Ages. 2020 (Nov. 1); 21(8):6–7. doi: 10.1016/j.carage.2020.10.006.Google Scholar
Senge, PM. The Fifth Discipline: The Art and Practice of the Learning Organization. New York: Doubleday, 1990.Google Scholar
Kane, RL, Flood, S, Bershadsky, B, Keckhafer, G. Effect of an innovative Medicare managed care program on the quality of care for nursing home residents. The Gerontologist. 2004; 44(1):95–103. doi: 10.1093/geront/44.1.95.Google Scholar
The American Geriatrics Society. www.americangeriatrics.org.Google Scholar
Journal of the American Geriatrics Society. https://onlinelibrary.wiley.com/journal/15325415.Google Scholar
The Geriatrics Review Syllabus, 10th edition. The American Geriatrics Society. https://geriatricscareonline.org/ProductTypeStore/books-online-texts/1.Google Scholar

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