Research Publications

Demand for home health is growing. Registered and licensed practical/vocational nurses (RNs and LPN/LVNs) are integral to the provision of home health services, but a limited body of evidence suggests that the workforce is unstable and possibly shrinking. We assessed RNs’ and LPN/LVNs’ transitions…

People with dementia have complex medical, functional, and social needs and experience highly variable care quality and out- comes across the U.S. health care system. Community-based physicians, nurse practitioners, and physician assistants serve crit- ical roles in diagnosing and managing dementia…

Each year, long-term acute care hospitals (LTACHs) care for over 70,000 individuals with complex and serious illness requiring prolonged inpatient care for weeks or months following a short-stay hospitalization. While LTACHs are most distinct from other post-acute care settings for their…

Medicaid Home and community-based services (HCBS) and home-based clinical care (i.e., Medicare home health care) aim to support independence and well-being in the community, especially for older adults living with disability and complex health conditions, such as dementia. Many older adults receive…

Improving care coordination for people living with dementia (PLWD) requires understanding of the types of clinicians delivering care and the settings in which they practice. We identified all beneficiaries with dementia in traditional Medicare in 2019. We used the Medicare Carrier file — i.e…

Important health workforce research that we undertake here is part of a national effort to monitor and plan for the health care needs of US residents. The UCSF Health Workforce Research Center on Long-Term Care (UCSF HWRC), housed at Healthforce Center, is a dynamic hub of policy-oriented research…

Is nurse practitioner (NP) care associated with end-of-life outcomes for nursing home residents with Alzheimer disease and related dementias (ADRD), and do these associations differ between states with full versus restrictive NP scope of practice regulations? The results of this cohort study…

Abstract: Increased engagement of nurse practitioners (NPs) has been recommended as a way to address care delivery challenges in settings that struggle to attract physicians, such as primary care and rural areas. Nursing homes also face such physician shortages. We evaluated the role of state…

Background: Vulnerable older adults living with Alzheimer’s disease or Alzheimer’s disease and related dementia (AD/ADRD) and chronic pain generally receive fewer pain medications than individuals without AD/ADRD, especially in nursing homes. Little is known about pain management in older adults…

Important health workforce research that we undertake here is part of a national effort to monitor and plan for the health care needs of US residents. The UCSF Health Workforce Research Center on Long-Term Care (UCSF HWRC), housed at Healthforce Center, is a dynamic hub of policy-oriented research…

Background: The COVID‐19 pandemic greatly affected health care workers, both physically and psychologically, by increasing their workload and stress. This may also have increased their risk of occupational injuries. This study analyzed workers' compensation (WC) claims among California…

Nurse turnover can compromise the quality and continuity of home health care. Scope of practice laws, which determine the tasks nurses are allowed to perform and delegate, are an important element of autonomy and vary across states. In this study, researchers used human resource records from a…

Emerging technological advances hold potential to assist the long-term care (LTC) workforce in caring for an aging population in the home and LTC settings. Technology may alter workforce needs and mitigate rising workforce demand. This study identified and assessed emerging technologies that may…

Older adults with Alzheimer's disease and related dementias (ADRD) often face burdensome end-of-life care transfers. Advanced practice clinicians (APCs), which include nurse practitioners and physician assistants, increasingly provide primary care to this population. To fill current gaps in the…

Up to half of all individuals who receive long-term services and supports (LTSS) are living with Alzheimer’s disease or another form of dementia. Direct care workers provide most of the care across LTSS and are the foundation of a dementia-capable workforce — yet they are underprepared, under-…

The aging of the US population is a well-documented phenomenon. In just 7 years, an estimated 73 million Americans will be aged 65 and over, equal to 21% of the population. Aging is associated with increased consumption of health care, and more specifically, long-term care services and supports (…

Increasing rates of Alzheimer disease and related dementia (ADRD) has resulted in greater reliance on adult day health centers (ADHCs) and their skilled workforce. Little is known about staffing in ADHCs that provide ADRD services compared with ADHCs that do not. This study examines whether there…

Objective/Issue Little is known about the contributions of different provider specialties in prescribing medications for nursing home residents living with dementia. In this study, we examine prescribing patterns for common psychiatric medications and for opioid and non-opioid analgesics in long-…

Issue Health care workers in long-term care (LTC) settings face concerns related to financial security resulting from low wages, inconsistent hours, and a lack of benefits. These factors contribute to higher rates of LTC workers holding multiple jobs. The COVID-19 pandemic has added a new set of…

Registered nurses (RNs) are a key component of the long-term care (LTC) workforce and prior research demonstrates their importance to ensuring patient safety in LTC settings. RNs who work in LTC settings earn less than those who work in hospitals and also are more likely to be from racial and…

This study seeks to measure wage differences between registered nurses (RNs) working in long-term care (LTC) (eg, nursing homes, home health) and non-LTC settings (eg, hospitals, ambulatory care) and whether differences are associated with the characteristics of the RN workforce between and within…

Personal Care Aides (PCAs) are vital to the well-being of people with disabilities yet there are shortages of these workers in many parts of the country. PCAs are employed to support people with disabilities by providing assistance with basic daily needs (such as meal preparation, bathing, dressing…

Person-centered care (PCC) is the standard for the delivery of long-term services and supports (LTSS). In this article, we summarize the state of the science on meaningful outcomes and workforce development and discuss what is needed to ensure that person-centered LTSS becomes a universal reality.…

The Support at Home pilot program provided financial support for the purchase of home care services by middle-income adults with disabilities in San Francisco to support aging in place. The mixed-methods evaluation of the program incorporated administrative records, surveys of clients and…

Patient safety is a global concern, yet little is known about how and whether perceptions of patient safety culture (PSC) vary by nurses' countries of origin and preparation. This is particularly important in American nursing homes (NHs), which are increasingly hiring non-US born and prepared…

Policy & Politics in Nursing and Health Care, 8th Edition continues to be the leading text on nursing action and activism. Approximately 150 expert contributors present a wide range of topics in policies and politics, providing a more complete background than can be found in any other…