Nursing Homes Outcomes Initiative

by Nicholas G. Castle


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Nursing homes operate in an environment that has become increasingly more challenging. Residents are admitted in a sicker condition, competition from other longterm care providers has increased, and reimbursement for many services may not be adequate. The changing health care marketplace is necessitating new levels of accountability from long-term care providers. Increasingly: (1) hospitals; (2) managed care plans; and, (3) residents / family members, want evidence that they are purchasing effective care.

Outcomes research is providing this evidence. Outcomes research also has implications for quality improvement and accreditation. As such, outcomes are assuming a higher priority for administrators of long-term care facilities. In this report, the authors present an Outcomes Report. First the authors define outcomes; second, they show how outcomes can and are being used in long-term care; third, they present what outcomes are used.

This report is part of the RAND Corporation Draft series. The unrestricted draft was a product of the RAND Corporation from 1993 to 2003 that represented preliminary or prepublication versions of other more formal RAND products for distribution to appropriate external audiences. The draft could be considered similar to an academic discussion paper. Although unrestricted drafts had been approved for circulation, they were not usually formally edited or peer reviewed.

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