Purchasing High-Quality Community Nursing Home Care: A Will to Work With VHA Diminished by Contracting Burdens
The Veterans Health Administration (VHA) purchases community nursing home care; however, the administrative burden may lead nursing homes to avoid contracting with the VHA. This study aimed to describe how the VHA's purchasing policies impede or facilitate contracting with nursing homes. Semist...
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| Veröffentlicht in: | Journal of the American Medical Directors Association 2022-11, Vol.23 (11), p.1757-1764 |
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| container_title | Journal of the American Medical Directors Association |
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| creator | Magid, Kate H. Galenbeck, Emily Haverhals, Leah M. Cornell, Portia Y. Moyo, Patience Mochel, Amy L. Corneau, Emily Rudolph, James L. Mor, Vincent Levy, Cari |
| description | The Veterans Health Administration (VHA) purchases community nursing home care; however, the administrative burden may lead nursing homes to avoid contracting with the VHA. This study aimed to describe how the VHA's purchasing policies impede or facilitate contracting with nursing homes.
Semistructured interviews of key stakeholders in the VHA's community nursing home contracting process.
We interviewed 15 VHA and 21 nursing home staff at 6 VHA medical centers and 17 nursing homes. VHA medical centers were selected from sites with the greatest magnitude of difference in quality rankings between VHA contracted and noncontracted nursing homes in the same market area.
Qualitative content analysis of interviews.
Five themes emerged: (1) VHA purchases nursing home care to fill gaps in geographic, specialty, and quality care needs; (2) business opportunities and the mission to care for Veterans motivate nursing homes to work with the VHA; (3) the VHA's reputation for unreliable or insufficient payment and inability of nursing homes to comply with federal wage standards serve as barriers to establishing contracts; (4) complexity of establishing a contract, ambiguity about new policies, and inadequate VHA staffing for the nursing home inspection team hinder the VHA's ability to establish contracts with nursing homes; and (5) nursing homes that have established corporate processes, nursing home administrators with prior experience working with the VHA, and relationships between VHA and nursing home staff serve as facilitators to establishing new nursing home contracts.
Nursing homes will work with the VHA, but the process of executing VHA contracts is burdensome. Streamlining and standardizing the purchasing processes and ensuring timely payment may expand the number of nursing homes willing to contract with the VHA, thereby increasing choices for Veterans and becoming a model for other long-term care networks. |
| doi_str_mv | 10.1016/j.jamda.2022.03.007 |
| format | Article |
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Semistructured interviews of key stakeholders in the VHA's community nursing home contracting process.
We interviewed 15 VHA and 21 nursing home staff at 6 VHA medical centers and 17 nursing homes. VHA medical centers were selected from sites with the greatest magnitude of difference in quality rankings between VHA contracted and noncontracted nursing homes in the same market area.
Qualitative content analysis of interviews.
Five themes emerged: (1) VHA purchases nursing home care to fill gaps in geographic, specialty, and quality care needs; (2) business opportunities and the mission to care for Veterans motivate nursing homes to work with the VHA; (3) the VHA's reputation for unreliable or insufficient payment and inability of nursing homes to comply with federal wage standards serve as barriers to establishing contracts; (4) complexity of establishing a contract, ambiguity about new policies, and inadequate VHA staffing for the nursing home inspection team hinder the VHA's ability to establish contracts with nursing homes; and (5) nursing homes that have established corporate processes, nursing home administrators with prior experience working with the VHA, and relationships between VHA and nursing home staff serve as facilitators to establishing new nursing home contracts.
Nursing homes will work with the VHA, but the process of executing VHA contracts is burdensome. Streamlining and standardizing the purchasing processes and ensuring timely payment may expand the number of nursing homes willing to contract with the VHA, thereby increasing choices for Veterans and becoming a model for other long-term care networks.</description><identifier>ISSN: 1525-8610</identifier><identifier>EISSN: 1538-9375</identifier><identifier>DOI: 10.1016/j.jamda.2022.03.007</identifier><identifier>PMID: 35429454</identifier><language>eng</language><publisher>Elsevier Inc</publisher><subject>community care ; nursing home ; Veterans Affairs ; VHA-purchased care</subject><ispartof>Journal of the American Medical Directors Association, 2022-11, Vol.23 (11), p.1757-1764</ispartof><rights>2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-3aa2307a4199306a5267c2e5787a264f84f4fcfa31485da9aa306d8e117514453</citedby><cites>FETCH-LOGICAL-c403t-3aa2307a4199306a5267c2e5787a264f84f4fcfa31485da9aa306d8e117514453</cites><orcidid>0000-0003-3001-5820</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1525861022002389$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids></links><search><creatorcontrib>Magid, Kate H.</creatorcontrib><creatorcontrib>Galenbeck, Emily</creatorcontrib><creatorcontrib>Haverhals, Leah M.</creatorcontrib><creatorcontrib>Cornell, Portia Y.</creatorcontrib><creatorcontrib>Moyo, Patience</creatorcontrib><creatorcontrib>Mochel, Amy L.</creatorcontrib><creatorcontrib>Corneau, Emily</creatorcontrib><creatorcontrib>Rudolph, James L.</creatorcontrib><creatorcontrib>Mor, Vincent</creatorcontrib><creatorcontrib>Levy, Cari</creatorcontrib><title>Purchasing High-Quality Community Nursing Home Care: A Will to Work With VHA Diminished by Contracting Burdens</title><title>Journal of the American Medical Directors Association</title><description>The Veterans Health Administration (VHA) purchases community nursing home care; however, the administrative burden may lead nursing homes to avoid contracting with the VHA. This study aimed to describe how the VHA's purchasing policies impede or facilitate contracting with nursing homes.
Semistructured interviews of key stakeholders in the VHA's community nursing home contracting process.
We interviewed 15 VHA and 21 nursing home staff at 6 VHA medical centers and 17 nursing homes. VHA medical centers were selected from sites with the greatest magnitude of difference in quality rankings between VHA contracted and noncontracted nursing homes in the same market area.
Qualitative content analysis of interviews.
Five themes emerged: (1) VHA purchases nursing home care to fill gaps in geographic, specialty, and quality care needs; (2) business opportunities and the mission to care for Veterans motivate nursing homes to work with the VHA; (3) the VHA's reputation for unreliable or insufficient payment and inability of nursing homes to comply with federal wage standards serve as barriers to establishing contracts; (4) complexity of establishing a contract, ambiguity about new policies, and inadequate VHA staffing for the nursing home inspection team hinder the VHA's ability to establish contracts with nursing homes; and (5) nursing homes that have established corporate processes, nursing home administrators with prior experience working with the VHA, and relationships between VHA and nursing home staff serve as facilitators to establishing new nursing home contracts.
Nursing homes will work with the VHA, but the process of executing VHA contracts is burdensome. Streamlining and standardizing the purchasing processes and ensuring timely payment may expand the number of nursing homes willing to contract with the VHA, thereby increasing choices for Veterans and becoming a model for other long-term care networks.</description><subject>community care</subject><subject>nursing home</subject><subject>Veterans Affairs</subject><subject>VHA-purchased care</subject><issn>1525-8610</issn><issn>1538-9375</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kNtKw0AQhhdRtFafwJt9gcQ95iAo1HioUDyA2stl3GyarTmU3UTw7U2sCN54NTP88_3M_AidUBJSQqPTdbiGOoeQEcZCwkNC4h00oZInQcpjuTv2TAZJRMkBOvR-TQgjNI320QGXgqVCiglqHnunS_C2WeG5XZXBUw-V7T5x1tZ134zdfe-2clsbnIEzZ3iGl7aqcNfiZeveh6Er8et8hq9sbRvrS5Pjt9Gi6RzoboQve5ebxh-hvQIqb45_6hS93Fw_Z_Ng8XB7l80WgRaEdwEHYJzEIGiachKBZFGsmZFxEgOLRJGIQhS6AE5FInNIAYatPDGUxpIKIfkUXWx9N_1bbXJtxksqtXG2BvepWrDqr9LYUq3aD5XKiMkkGQz41kC71ntnil-WEjXGr9bqO341xq8IV0P8A3W-pczw24c1TnltTaNNbp3Rncpb-y__BdpgjhE</recordid><startdate>20221101</startdate><enddate>20221101</enddate><creator>Magid, Kate H.</creator><creator>Galenbeck, Emily</creator><creator>Haverhals, Leah M.</creator><creator>Cornell, Portia Y.</creator><creator>Moyo, Patience</creator><creator>Mochel, Amy L.</creator><creator>Corneau, Emily</creator><creator>Rudolph, James L.</creator><creator>Mor, Vincent</creator><creator>Levy, Cari</creator><general>Elsevier Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3001-5820</orcidid></search><sort><creationdate>20221101</creationdate><title>Purchasing High-Quality Community Nursing Home Care: A Will to Work With VHA Diminished by Contracting Burdens</title><author>Magid, Kate H. ; Galenbeck, Emily ; Haverhals, Leah M. ; Cornell, Portia Y. ; Moyo, Patience ; Mochel, Amy L. ; Corneau, Emily ; Rudolph, James L. ; Mor, Vincent ; Levy, Cari</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-3aa2307a4199306a5267c2e5787a264f84f4fcfa31485da9aa306d8e117514453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>community care</topic><topic>nursing home</topic><topic>Veterans Affairs</topic><topic>VHA-purchased care</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Magid, Kate H.</creatorcontrib><creatorcontrib>Galenbeck, Emily</creatorcontrib><creatorcontrib>Haverhals, Leah M.</creatorcontrib><creatorcontrib>Cornell, Portia Y.</creatorcontrib><creatorcontrib>Moyo, Patience</creatorcontrib><creatorcontrib>Mochel, Amy L.</creatorcontrib><creatorcontrib>Corneau, Emily</creatorcontrib><creatorcontrib>Rudolph, James L.</creatorcontrib><creatorcontrib>Mor, Vincent</creatorcontrib><creatorcontrib>Levy, Cari</creatorcontrib><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the American Medical Directors Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Magid, Kate H.</au><au>Galenbeck, Emily</au><au>Haverhals, Leah M.</au><au>Cornell, Portia Y.</au><au>Moyo, Patience</au><au>Mochel, Amy L.</au><au>Corneau, Emily</au><au>Rudolph, James L.</au><au>Mor, Vincent</au><au>Levy, Cari</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Purchasing High-Quality Community Nursing Home Care: A Will to Work With VHA Diminished by Contracting Burdens</atitle><jtitle>Journal of the American Medical Directors Association</jtitle><date>2022-11-01</date><risdate>2022</risdate><volume>23</volume><issue>11</issue><spage>1757</spage><epage>1764</epage><pages>1757-1764</pages><issn>1525-8610</issn><eissn>1538-9375</eissn><abstract>The Veterans Health Administration (VHA) purchases community nursing home care; however, the administrative burden may lead nursing homes to avoid contracting with the VHA. This study aimed to describe how the VHA's purchasing policies impede or facilitate contracting with nursing homes.
Semistructured interviews of key stakeholders in the VHA's community nursing home contracting process.
We interviewed 15 VHA and 21 nursing home staff at 6 VHA medical centers and 17 nursing homes. VHA medical centers were selected from sites with the greatest magnitude of difference in quality rankings between VHA contracted and noncontracted nursing homes in the same market area.
Qualitative content analysis of interviews.
Five themes emerged: (1) VHA purchases nursing home care to fill gaps in geographic, specialty, and quality care needs; (2) business opportunities and the mission to care for Veterans motivate nursing homes to work with the VHA; (3) the VHA's reputation for unreliable or insufficient payment and inability of nursing homes to comply with federal wage standards serve as barriers to establishing contracts; (4) complexity of establishing a contract, ambiguity about new policies, and inadequate VHA staffing for the nursing home inspection team hinder the VHA's ability to establish contracts with nursing homes; and (5) nursing homes that have established corporate processes, nursing home administrators with prior experience working with the VHA, and relationships between VHA and nursing home staff serve as facilitators to establishing new nursing home contracts.
Nursing homes will work with the VHA, but the process of executing VHA contracts is burdensome. Streamlining and standardizing the purchasing processes and ensuring timely payment may expand the number of nursing homes willing to contract with the VHA, thereby increasing choices for Veterans and becoming a model for other long-term care networks.</abstract><pub>Elsevier Inc</pub><pmid>35429454</pmid><doi>10.1016/j.jamda.2022.03.007</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3001-5820</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of the American Medical Directors Association, 2022-11, Vol.23 (11), p.1757-1764 |
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| source | Elsevier ScienceDirect Journals |
| subjects | community care nursing home Veterans Affairs VHA-purchased care |
| title | Purchasing High-Quality Community Nursing Home Care: A Will to Work With VHA Diminished by Contracting Burdens |
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