Improving the Quality of Care in Nursing Homes

Front Cover
National Academies Press, Feb 1, 1986 - Medical - 432 pages

As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.


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Preface v
Concepts of Quality Quality Assessment and Quality 45
Quality Assurance and the Regulatory System 67
Note on Staffing Standards 98
Monitoring Nursing Home Performance 104
Enforcing Compliance with Federal Standards 146
Other Factors Affecting Quality of Care and Quality of Life in Nursing Homes
Issues Requiring Further Study 190
Actions Required and Cost Implications of the Recom 203
Notes 213
Appendix A History of Federal Nursing Home Regulation 238
Appendix B Existing SNF Conditions of Participation and ICF Stan 254
Report of Survey of State Health Facility Licensure and 315
Selected Data on Nursing Homes and Residents 351
Appendix E Key Indicators of Quality of Care 378

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