Reports/Studies

CANHR Reports
Assisted Living/Residential Care
Conservatorship & Guardianship
Elder Abuse
Litigation
Long Term Care Demographics
Long Term Care Insurance
Medi-Cal/Medicaid

Asset Transfers
Deficit Reduction Act of 2005
Estate Recovery
Fraud and Abuse
Payments for Long Term Care

Nursing Homes

Abuse
Disaster Preparedness
Oversight and Enforcement
Racial Discrimination
Public Information
Public Opinion
Quality
Resident Characteristics
Staffing

CANHR Reports

Nursing Home Abuse & California’s Broken Enforcement System (5/2006) (PDF, 460kb)

Press Release: 14 Dead from Improper Tube Feeding (9/2004)

Much Ado About Nothing: Debunking the Myths of Frequent and Frivolous Nursing Home Lawsuits in California (11/2003) (PDF, 2.76mb)

Better Read the Small Print! An Analysis of Admission Agreements in California’s Residential Care Facilities for the Elderly (3/2003) (PDF; 316kb)

Assisted Living/Residential Care Studies

• Quality of Care in Residential Care for the Elderly, A Study of the Limitations & Potential of Community Care Licensing’s Current Data Systems
  University of California, San Francisco with California Advocates for Nursing Home Reform (CANHR), Final Report, March 2008.


• Residential Care and Assisted Living: State Oversight Practices and State Information Available to Consumers Agency for Healthcare Research and Quality, No. 06-M051-EF, 09/2006


• Environmental Scan of Instruments to Inform Consumer Choice in Assisted Living Facilities Agency for Healthcare Research and Quality, No. 07-0032-EF, (12/2006)


• National Academy of State Health Policy: NASHP publishes reports on assisted living including:
  • State Residential Care and Assisted Living Policy (2004)
  • Informing Consumers about Assisted Living: State Practices
    (February 2005); and
  • Aging in Place in Assisted Living: State Regulations and Practice (February 2005)


• Critical Issues in Assisted Living National Senior Citizens Law Center. Analyzes how consumers are protected, or harmed, by states' assisted living policies. Available through NSCLC website, $14.95 + s/h (5/2005)


• Assisted Living: Examples of State Efforts to Improve Consumer Protections -- GAO Report GAO 04-684 (PDF, 395kb) (4/2004)


• CANHR Report Reveals Problems with Residential Care Admission Agreements (3/2003)


• Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings, State Policy Maker and Stakeholder Views in Six States
  DHHS (12/2003)


• Department of Social Services: Continuing Weaknesses in the Department's Community Care Licensing Programs May Put the Health and Safety of Vulnerable Clients at Risk California State Auditor 2002-114 (8/2003)


• Residential Care for the Elderly: Supply, Demand and Quality Assurance Prepared for the California Healthcare Foundation by Robert Newcomer & Robert Maynard, UCSF (1/2002)


• Assisted Living Industry Organizes to Stop Consumer Protections (6/2002)

• Guardianships: Little Progress in Ensuring Protection for Incapacitated Elderly People GAO Testimony (9/2006)


• Guardianship Monitoring: A National Survey of Court Practices AARP Public Policy Institute and ABA Commission on Law and Aging (6/2006)


• Guardians for Profit: When a Family Matter Turns Into a Business Los Angeles Times (11/13/06 - 11/16/06)


• Wards of the State: A National Study of Public Guardianship American Bar Association Commission on Law & Aging and Graduate Center for Gerontology, University of Kentucky (4/2005)


• Guardianships: Collaboration Needed to Protect Incapacitated Elderly People GAO-04-655, (7/2004)

• Abuse and Neglect of the Elderly in Nursing Homes and Long-Term Care Facilities
  This National Center on Elder Abuse bibliography highlights many articles, books, reports, and online resources regarding many aspects of abuse, neglect, and exploitation in nursing homes and assisted living facilities.


• Nursing Homes: More Can Be Done to Protect Residents from Abuse -- GAO Report GAO-02-312 (PDF, 596kb) (3/2002)


• Abuse of Residents Is a Major Problem in U.S. Nursing Homes - - Report for Rep Henry Waxman (PDF) (7/2001)

• Nursing Home Liability Insurance: An Overview, Bernadette Wright, Ph.D. AARP Public Policy Institute (July 2005)

• Long Term Care Facts and Figures: California Health Care Foundation (2/2007)

• Aged, Frail and Denied Care by Their Insurers New York Times (3/26/07)


• Private Long Term Care Insurance: A Viable Option for Low and Middle-Income Seniors?
  The Kaiser Commission on Medicaid and the Uninsured (2/2006)


• Do You Need Long-Term Care Insurance?
  Consumer Reports Magazine (11/03)


• Long-Term Care Insurance, Better Information Critical to Prospective Purchasers GAO Testimony Before the Senate Special Committee on Aging GAO/T-HEHS-00-196 (9/2000)

Asset Transfers

• MediCal Care Research and Review Sage Journals Online (06/2007)


• Medicaid Long-Term Care: Few Transferred Assets before Appling for Nursing Home Coverage; Impact of Deficit Reduction Act is Uncertain
  GAO-07-280 (03/2007)


• Asset Transfer and Nursing Home Use: Empirical Evidence and Policy Significance Kaiser Family Foundation (04/2006)


• Frontline Perspectives on Long-Term Care Financing Decisions and Medicaid Asset Transfer Practices Kaiser Family Foundation (02/2006)


• Medicaid's Coverage of Nursing Home Costs: Asset Shelter for the Wealthy or Essential Safety Net Georgetown University Long Term Care Financing Project (5/2005)

Deficit Reduction Act of 2005

• Medicaid Long-Term Care: Few Transferred Assets before Appling for Nursing Home Coverage; Impact of Deficit Reduction Act is Uncertain
  GAO-07-280 (03/2007)
• Deficit Reduction Act of 2005: Implications for Medicaid Kaiser Family Foundation (02/2006)
• Self–Declaration of U.S. Citizenship for Medicaid OEI-02-03-00190 (7/2005)
• Medicaid: Transfers of Assets by Elderly Individuals to Obtain Long-Term Care Coverage GAO-05-968 (9/2005)

Estate Recovery

• Protections in Medicaid Estate Recovery: Findings, Promising Practices, and Model Notices Erica F. Wood and Ellen M. Klem, ABA Commission on Law and Aging, Published by AARP Public Policy Institute (5/2007)

Fraud & Abuse

• Medicaid Fraud and Abuse: CMS's Commitment to Helping States Safeguard Program Dollars is Limited GAO Testimony, GAO-05-855T (6/2005)


• Medicaid: States' Efforts to Maximize Federal Reimbursements Highlight Need for Improved Federal Oversight GAO Testimony, GAO-05-836T (6/2005)

Payments for Long Term Care

• Department of Health Services: It Has Not Yet Fully Implemented Legislation Intended to Improve the Quality of Care in Skilled Nursing Facilities
  California State Auditor, Bureau of State Audits, 2006-035 (2/2007)


• Medicaid Nursing Home Payments: States' Payment Rates Largely Unaffected by Recent Fiscal Pressures GAO-04-143 (10/2003)

Nursing Homes

Abuse

• The Faces of Neglect: Behind the Closed Doors of Nursing Homes
  National Citizens Coalition for Nursing Home Reform (5/06)


• Nursing Homes: More Can Be Done to Protect Residents from Abuse
  GAO-02-312   (3/2002)


• Elder Abuse in Residential Long-Term Care Facilities: What is Known About Prevalence, Causes and Prevention Catherine Hawes, Testimony Before the U.S. Senate Committee on Finance (6/2002)


• Abuse of Residents Is a Major Problem in U.S. Nursing Homes Report for Rep. Henry Waxman, Minority Staff, Special Investigations Division, Committee on Government Reform, U.S. House of Representatives (7/2001)

Disaster Preparedness

• Nursing Home Emergency Preparedness and Response During Recent Hurricanes DHHS Office of Inspector General, OEI-06-06-00020 (8/2006)


• Disaster Preparedness: Limitations in Federal Evacuation Assistance for Health Facilities Should Be Addressed GAO-06-826 (7/2006)

Oversight & Enforcement

• Department of Health Services: Its Licensing and Certification Division Is Struggling to Meet State and Federal Oversight Requirements for Skilled Nursing Facilities California State Auditor, Bureau of State Audits, 2006-106 (4/2007)


• Nursing Homes: Efforts to Strengthen Federal Enforcement Have Not Deterred Some Homes from Repeatedly Harming Residents, GAO-07-241 (3/07)


• Improving Nursing Home Enforcement: Findings From Enforcement Case Studies Health Care Policy and Research Center, University of Colorado (3/2007)


• Snapshot: Changing Face of Nursing Homes, California Health Care Foundation (2/2007)


• Nursing Home Enforcement: Application of Mandatory Remedies, DHHS Office of Inspector General, OEI-06-03-00410 (5/2006)


• Despite Increased Oversight, Challenges Remain in Ensuring High-Quality Care and Resident Safety -- Highlights of GAO-06-117 -- (PDF, 60kb) (12/2005)


• Nursing Home Enforcement: Collection of Civil Money Penalties DHHS Office of Inspector General, OEI-06-03-00420 (7/2005)


• Nursing Home Enforcement: The Use of Civil Money Penalties -- OEI-06-02-00720, Office of the Inspector General, Department of Health and Human Services -- (PDF, 562kb) (4/2005)


• Nursing Home Deaths: Arkansas Coroner Referrals Confirm Weaknesses in State and Federal Oversight of Quality of Care GAO-05-78 (11/2004)


• U.S. Senator Charles Grassley's (R - Iowa) letter to the U.S. Dept. of Health and Human Services regarding the corruption of the nursing home inspection system. (7/2004)


• Prevalence of Serious Problems, While Declining, Reinforces Importance of Enhanced Oversight -- GAO Report GAO-03-561 -- (PDF, 632kb) (7/2003)


• Nursing Home Deficiency Trends and Survey and Certification Process Consistency DHHS Office of Inspector General, OEI-02-01-00600 (3/2003)


• Nursing Homes: Complaint Investigation Processes Often Inadequate to Protect Residents GAO-99-80 (3/1999)


• Nursing Homes: Additional Steps Needed to Strengthen Enforcement of Federal Quality Standards GAO 99-46 (3/1999)


• California Nursing Homes: Care Problems Persist Despite Federal and State Oversight GAO 98-202 (7/1998)

Racial Discrimination

• Separate and Unequal: Racial Segregation and Disparities in Quality Across U.S. Nursing Homes: Residential segregation in U.S. cities disproportionately places blacks in poorer-performing nursing homes.
  By David Barton Smith, Zhanlian Feng, Mary L. Fennell, Jacqueline S. Zinn, and Vincent Mor. Data Watch (Sept./Oct. 2007).

Public Information

• Nursing Homes: Business as Usual Consumer Reports Magazine (5/2006)


• Inspection Results on Nursing Home Compare: Completeness and Accuracy, DHHS Office of Inspector General, OEI-01-03-00130 (6/2004)


• A Consumer Guide to Choosing a Nursing Home (2002) -- NCCNHR's perspective on the new 'Nursing Home Compare' site.


• HHS Nursing Home Compare Site Has Major Flaws Prepared for Rep. Henry Waxman and Senator Charles Grassley, Minority Staff, Special Investigations Division, Committee on Government Reform, U.S. House of Representatives (2/2002)

Public Opinion

• The Public’s Views on Nursing Homes
  Kaiser Family Foundation Public Opinion Spotlight (12/2007)


• National Survey on Nursing Homes Kaiser Family Foundation/NewsHour (10/2001)

Quality

• The Faces of Neglect: Behind the Closed Doors of Nursing Homes National Citizens Coalition for Nursing Home Reform (5/2006)


• Nursing Homes: Business as Usual Consumer Reports Magazine (5/2006)


• Long-Term Care Facilities: Information on Residents Who Are Registered Sex Offenders or Are Paroled for Other Crimes GAO-06-326 (3/2006)


• State of Neglect The New Orleans Times-Picayune, April 17-21, 2005


• Report on California's Nursing Homes, Home Health Agencies and Hospice Programs, prepared by Charlene Harrington and Janis O'Meara, UCSF, for the California HealthCare Foundation (12/2004)


• Operation Guardians 2001-02 and 2002-03 Results, California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse (1/2004)


• Nursing Home Conditions in Los Angeles County: Many Homes Fail to Meet Federal Standards for Adequate Care Prepared for Rep. Henry Waxman, Minority Staff, Special Investigations Division, Committee on Government Reform, U.S. House of Representatives (2/2003)


• Neglected to Death, St. Louis Post-Dispatch, October 12-19, 2002


• Nursing Home Care: When Will We Get it Right? Alliance for Retired Americans (6/2002)

Resident Characteristics

• Characteristics of Nursing Home Residents
  Kaiser Commission on Medicaid and the Uninsured (6/2007)

Staffing

• Nurse Aide Registries: Long Term Care Facility Compliance and Practices DHHS Office of Inspector General, OEI-07-04-00140 (7/2005)


• We Shall Travel On: Quality of Care, Economic Development, and the International Migration of Long-Term Care Workers AARP Public Policy Institute (2005)


• Relationship of Nursing Home Staffing to Quality of Care -- John F Schnelle, Sandra F Simmons, Charlene Harrington, Mary Cadogan, Emily Garcia, and Barbara M Bates-Jensen; Health Services Research, 39 (2):225-250 -- (PDF, 168kb) (4/2004)


• Nursing Home Medical Directors Survey U.S. Office of Inspector General, Department of Health and Human Services (2/2003)


• Nurse Aide Training, DHHS Office of Inspector General, OEI-05-01-00030 (11/2002)


• Available Data Show Average Nursing Staff Time Changed Little after Medicare Payment Increase -- GAO Report GAO-03-176 (11/2002) (PDF)


• Quality of Care More Related to Staffing than Spending GAO-02-431R (6/2002)


• Government Study Provides 'Compelling Evidence' for Nurse Staffing Standards in Nursing Home" (2/2002)


• Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes, Report to Congress: Phase II Final U.S. Centers for Medicare and Medicaid Services, prepared by Abt Associates Inc. (2005)

To access additional General Accounting Office (GAO) reports, visit the GAO web site at http://www.gao.gov

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