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Implications for Policy: The Nursing Home as Least Restrictive Setting
Christine E. Bishop, Robyn Stone. The Gerontologist, 2014-01-17
Topic: Risk, prevention and care in population studies
Measurement using validated tools for resident and family satisfaction and health outcomes showed that culture change interventions or clusters of interventions had few negative impacts, but also seldom resulted in statistically significant improvement. The deep-culture-change homes significantly reduced survey deficiencies over the observation period compared with nonadopting nursing homes. Research on adoption of culture change reveals that adoption is more likely where state Medicaid payment rates are higher (Grabowski, Elliot, et al., 2014) and that higher payment rates are associated with capital improvements that are markers of culture change, including single rooms and household configurations (Miller, Cohen, Lima, & Mor, 2014). Research suggests that this information has not been easy for consumers to use, but competition for consumers on the basis of quality has had some impact (Park, Konetzka, & Werner, 2011).
Key findings
- Measurement using validated tools for resident and family satisfaction and health outcomes showed that culture change interventions or clusters of interventions had few negative impacts, but also seldom resulted in statistically significant improvement.
- The deep-culture-change homes significantly reduced survey deficiencies over the observation period compared with nonadopting nursing homes.
- Research on adoption of culture change reveals that adoption is more likely where state Medicaid payment rates are higher (Grabowski, Elliot, et al., 2014) and that higher payment rates are associated with capital improvements that are markers of culture change, including single rooms and household configurations (Miller, Cohen, Lima, & Mor, 2014).
- Research suggests that this information has not been easy for consumers to use, but competition for consumers on the basis of quality has had some impact (Park, Konetzka, & Werner, 2011).
Why it matters
This review found that culture change interventions in nursing homes seldom resulted in statistically significant improvement, though deep-culture-change homes reduced survey deficiencies. It concerns nursing home policy and quality, not the treatment, cure or prevention of Alzheimer's disease.
Study details
- Study designsystematic review
- Evidence strengthHigh
How this study scored 49/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Gerontologist) |
| Journal's citation record | 2 / 4 | The Gerontologist: journal h-index 238 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2014 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 3 / 7 | Cited 16 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.1 citations a year over 14 year(s) since 2014 |
| Impact for its field and year | 3 / 6 | Cited 4.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Robyn Stone: h-index 33 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Brandeis University: institution h-index 653 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 24443611) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 49 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Bishop, C. E., & Stone, R. (2014). Implications for Policy: The Nursing Home as Least Restrictive Setting. The Gerontologist. https://doi.org/10.1093/geront/gnt164
Vancouver
Bishop CE, Stone R. Implications for Policy: The Nursing Home as Least Restrictive Setting. The Gerontologist. 2014. doi:10.1093/geront/gnt164. PMID: 24443611.
BibTeX
@article{bishop2014-24443611,
author = {Bishop, Christine E. and Stone, Robyn},
title = {{Implications for Policy: The Nursing Home as Least Restrictive Setting}},
journal = {The Gerontologist},
year = {2014},
doi = {10.1093/geront/gnt164},
pmid = {24443611},
url = {https://doi.org/10.1093/geront/gnt164}
}
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