RESUMO
Background and Objectives: Person-centered care practices are essential to providing high-quality care for nursing home (NH) residents. A key component of implementing person-centered care is the assessment and fulfillment of residents' preferences. However, few NHs consistently assess and implement residents' preferences into care. From 2015 to 2019, the Ohio Department of Medicaid added the Preference for Everyday Living Inventory (PELI), a scientifically validated tool to assess residents' preferences, as a quality indicator to improve the person centeredness of Ohio's NHs. In this study, we sought to identify the associations between resident and organizational characteristics and PELI implementation in Ohio NHs. Research Design and Methods: We constructed an NH-level database that merged data from the Ohio Biennial Survey of Long-Term Care Facilities, Ohio Medicaid Cost Reports, the Certification and Survey Provider Enhanced Reports data, the WWAMI Rural Health Research Center, and the Minimum Data Set. Freestanding NHs were included if they were owned by a for-profit or not-for-profit organization, and had data collected in 1 of 2 years (n = 1,320; year 2015, n = 814; year 2017, n = 506). Descriptive statistics and multiple logistic regression were used to understand the relationships between resident demographics, NH organizational characteristics, and partial versus complete PELI implementation. Results: Most NHs (71.2%) reported complete implementation of the PELI over 2 years with implementation increasing over time. There was a relationship between complete PELI implementation and for-profit status, higher number of beds, higher Medicare funding, higher certified nursing assistants and activity staff hours, and urban location. Discussion and Implications: This work has important implications for the implementation of person-centered care interventions in NHs and our understanding of what NH characteristics are related to successful implementation. The next steps should include a continued, detailed assessment of PELI implementation and an exploration of the potential impact of PELI implementation on residents, staff, and organizational outcomes.
RESUMO
BACKGROUND: Nursing homes (NHs) are required to provide person-centered care, efforts often folded into broader culture change initiatives. Despite the known benefits of culture change, it is difficult to measure. This study aims to assess the criterion validity of the Preferences for Everyday Living Inventory (PELI) Implementation Indicator with other culture change measures. METHODS: Using data from Ohio-based NHs (n = 771), logistic regression techniques demonstrated the relationship between the PELI Implementation Indicator and two validated culture change measures, the Resident Preferences for Care (RPC) and Certified Nursing Assistant (CNA) Empowerment scales. RESULTS: There was a significant relationship between the two scales and complete PELI implementation holding all other variables constant. The RPC and CNA Empowerment scales were significantly associated with complete PELI implementation. DISCUSSION: Findings suggest that the PELI Implementation Indicator can be used as a pragmatic indicator of a community's adoption of person-centered care and culture change.
