Browsing by Author "Glass, Anne"

Now showing 1 - 9 of 9
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    Assuring Quality Care: Exploring Strategies of Medicaid E&D Waiver Providers
    Brossoie, Nancy; Roberto, Karen A.; Teaster, Pamela B.; Glass, Anne (Virginia Tech, 2004)
    Implementing quality assurance (QA) programs in unregulated noninstitutional settings remains a challenge for home and community-based service providers. A sample of 65 Elderly & Disabled (E&D) Waiver providers in Virginia were presented with eight problem scenarios commonly found in home-care services. Each of the respondents was able to identify strategies they would use to recognize and address each problem. Findings suggest providers currently use multiple mechanisms as part of their overall QA program. Discussion focuses on the strengths of using multiple approaches and on increasing provider awareness of complementary QA strategies and reducing the reliance on staff report as a major QA strategy.
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    Elderly & Disabled Waiver Services: Development of the Client Satisfaction Survey-Short Forms
    Brossoie, Nancy; Roberto, Karen A.; Teaster, Pamela B.; Glass, Anne (Virginia Department of Medical Assisstance Services, 2005-04)
    This report is an addendum to an earlier report, Elderly & Disabled Waiver Services: Results of a Statewide Client Survey. Since the study’s distribution, further development and analysis of the Client Satisfaction Survey was conducted, with the purpose of creating a short form version to be administered by providers and utilization review analysts of Elderly and Disabled (E & D) Waiver services. Also, a second version of the short survey is presented for use during home visits as a supplement to questions asked of nursing supervisors and utilization review analysts.
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    Elderly & Disabled Waiver Services: Provider Survey, Executive Summary
    Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Department for Medical Assistance Services, 2003-03)
  • Elderly & Disabled Waiver Services: Results of a Statewide Client Satisfaction Survey
    Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Department of Medical Assisstance Services, 2004-10)
    As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted a statewide survey of clients receiving personal care services under the Medicaid Elderly and Disabled (E & D) Waiver. The goal was to learn about clients’ experiences with personal care, using performance, satisfaction, and outcome measures. Demographic data about clients and aides were also collected. A comparison of the study sample with the larger E & D Waiver population on the available indicators of age, gender, and location showed the sample was representative of the full E & D Waiver population. All planning districts were represented, and the regional distribution reflected that of the larger population. Therefore, findings and observations are likely to be applicable to the full population of E & D Waiver clients in Virginia.
  • Elderly & Disabled Waiver Services: Utilization Review Summary Report
    Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Department of Medical Assisstance Services, 2004-03)
    : As part of Virginia’s Real Choice Systems Change Grant (July 20, 2001), the Center for Gerontology at Virginia Tech is responsible for Goal 4: “Address gaps in quality assurance and client satisfaction for community-based waiver service programs through the development of performance, outcomes, and satisfaction measures for continuous quality improvement and use.” To meet this goal, the Center has conducted extensive research in client satisfaction with E&D Waiver services (reported elsewhere, e.g., Glass, Roberto, Teaster & Brossoie, 2003a). In addition, the Center reviewed the existing Utilization Review (UR) process, as it is currently the primary means of quality assessment (QA) for the E&D Waiver program in Virginia. Our evaluation, based on the following activities, indicates that mechanisms are now in place to address and monitor the quality of services delivered by provider agencies. Continual development and refinement of the UR process will help ensure clients receive quality services and are satisfied with the assistance they receive.
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    Elderly & Disabled Waiver Services: What Do We Know About Providers?
    Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Tech, 2003)
    Little is known about home and community based services (HCBS) and even less about the quality of those services. As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted a survey of agencies providing HCBS under the Medicaid Elderly and Disabled (E & D) Waiver. A written survey was sent to 160 providers across the state, based on a sampling plan designed to ensure representation of all planning districts and services mixes. Seventy surveys were returned for a response rate of 44%.
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    Elderly and Disabled Waiver Services: Important Dimensions From the Client's Perspective
    Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Department for Medical Assistance Services, 2003-06)
    Little is known about home and community based services (HCBS) and even less about the quality of those services. As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted an exploratory survey of clients receiving HCBS under the Medicaid Elderly and Disabled (E & D) Waiver. The goal of the survey was to learn about clients’ experiences with HCBS and to identify the most important dimensions of service provision from their perspectives. An initial focus group with 11 caregivers was first held in Big Stone Gap. Twenty-five telephone interviews were then completed (18 clients and 7 caregivers) in five areas of the Commonwealth. Fifteen were in urban areas (Northern Virginia, Richmond, and Chesapeake) and ten in rural or non-metropolitan areas (New River Valley and Planning Districts 13 and 14).
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    A medicaid resident assessment-based statewide analysis of intermediate care nursing homes
    Glass, Anne (Virginia Polytechnic Institute and State University, 1989)
    Through development of a conceptual model and an index measure based on actual performance, this dissertation focused on clarifying what is "very good" (and "very bad") in nursing home quality. The model expanded on the traditional narrow image of nursing home quality of care, and specified four major dimensions of this broader view of quality. The dimensions (staff intervention, nutrition/food service, physical environment, and community relations) were each reduced further to two subdimensions. Factors influencing quality were also delineated. The new model was then used to tie specific measurable indicators to the overall quality construct. Quality indicators derived from standardized assessments of Medicaid residents were employed in a study of 135 intermediate care facilities in Virginia. Process variables, such as use of physical restraints, catheters, and receipt of various therapies, were analysed for 12,327 residents. Outcome variables (weight loss, increased dependencies in activities of daily living, new pressure sores) were determined through longitudinal analysis for residents with an appropriate preceding assessment (n = 9,006). Assessments were aggregated in each home to calculate a mean (percentage incidence) for each of the 14 quality indicators. A scaling system was used to clearly identify industry"norms" for each variable. Quintiles based on relative incidence were employed to assign homes to five levels of performance. Scale scores were summed to obtain a facility index measure of relative quality. Reliability and validity were evaluated. Relationships of case-mix and selected structural variables (size, ownership, location, percent Medicaid, staff ratios) to the quality measure were analysed. Results suggested better performance by non-profit and smaller homes, but proprietary and non-prof it facilities were about evenly represented among the top tenth percentile of homes. Presence of a skilled care unit appeared to negatively influence quality. Possible interactions and explanations for this finding were considered. Most significantly, the study demonstrated that resident assessments can serve as excellent information sources about what goes on in nursing homes. However, additional variables must be incorporated to make a comprehensive quality measure, based on the model. Recommendations and policy implications were discussed.
  • Real Choices Systems Change Grant Final Report: Goal 4 Quality Assessment
    Roberto, Karen A.; Teaster, Pamela B.; Glass, Anne; Brossoie, Nancy (Virginia Department of Medical Assisstance Services, 2005-09)