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Burke RE, Greysen SR. Reducing SNF Readmissions: At What Cost? J
Hosp Med. 2018 Apr; 13(4):285-286.
Burke RE, Hess E, et al.Predicting Potential Adverse Events During a
Skilled Nursing Facility Stay: A Skilled Nursing Facility Prognosis Score.
J Am Geriatr Soc. 2018 May;66(5):930-936.
Ibrahim SA. Discharge Destination and Disparities in Postoperative Care.
JAMA. 2018 Apr 24; 319(16):1653-1654.
Burke RE, Jones CD, et al. Infuence
of Nonindex Hospital Readmission on Length of Stay and Mortality. MedCare. 2018
Burke RE, Jones
J, et al. Evaluating the Quality of Patient Decision-Making Regarding
Post-Acute Care. J Gen Intern Med. 2018 May; 33(5):678-684.
Falvey JR, Burke RE, et al. Involvement of Acute Care Physical
Therapists in Care Transitions for Older Adults Following
Acute Hospitalization: A Cross-sectional National Survey. J Geriatr Phys
Gustavson A, Boxer R, et al. Advancing Innovation in Skilled Nursing Facilities through Academic Collaborations. PTJ-PAL. 2018 Aug; 18(3): 5-16.
Jones CD, and Burke RE. “Inpatient Notes: Getting Past the “Black
Box" - Opportunities for Hospitalists to Improve Postacute
Care Transitions.” Ann Intern Med. 2018;168(10):HO2-HO3.
Ozkayanak M, Reeder B, et al. Characterizing Workflow to Inform
Clinical Decision Support Systems in Nursing Homes. Gerontologist. 2018.
Cumbler E, et al. Post-acute care reform: Implications and opportunities
for hospitalists. J Hosp Med. 2017 Jan;12(1):46-51.
Burke RE, Jones
CD, et al. Use of post-acute careafter hospital discharge in urban and rural
hospitals. Am J Accountable Care.2017 Mar; 5(1):16-22.
Daddato A, Wald HL, et al. A randomized trial of heart failure
disease management in skilled nursing facilities (SNF Connect): Lessons
learned. Clin Trials. 2017 Jun;14(3):308-313.
Gustavson AM, et al. Dementia, Comorbidity, and Physical Function in the
Program of All-Inclusive Care for the Elderly. J Geriatr Phys Ther. 2017.
Gustavson AM, Falvey JR, et al. Predictors of Functional Change in a
Skilled Nursing Facility Population. J Geriatr PhysTher. 2017.
Horney C, Capp
R, et al. Factors Associated With Early Readmission Among Patients Discharged
to Post-Acute Care Facilities. J Am Geriatr Soc. 2017 Jun;
Jones CD, Bowles KH, et al. High-Value Home Health Care for Patients with
Heart Failure: An Opportunity to Optimize Transitions from Hospital to
Home. Circ Cardiovasc Qual Outcomes. 2017;10(5).
Cumbler E, et al. Hospital to Post-Acute Care Facility Transfers: Identifying
Targets for Information Exchange Quality Improvement. J Am Med Dir Assoc.
2017 Jan; 18(1):70-73.
Jones CD, Wald
HL, et al. Characteristics Associated with Home Health Care Referrals at
Hospital Discharge: Results from the 2012 National Inpatient Sample. Health
Serv Res. 2017 04; 52(2):879-894.
J, et al. “Connecting the dots”: a qualitative study of home health nurse
perspectives on coordinating care for recently-discharged patients. J GenIntern
Lawrence E, et al. Nurses' Role in Managing "The Fit" of Older
Adults in Skilled Nursing Facilities. J Gerontol Nurs. 2017 Dec 01;
Jones W, Drake C, et al. Developing Mobile Clinical Decision Support
for Nursing Home Staff Assessment of Urinary Tract Infection using
Goal-Directed Design. Appl Clin Inform. 2017;8(2):632-650.
Laffon de Mazières C, Moreley JE, et al. Prevention of Functional Decline
by Reframing the Role of NursingHomes? J Am Med Dir Assoc. 2017
Lawrence E, et al. Implementation and dissemination of a transition of
care program for rural veterans: a controlled before and after study. Implement
Sci. 2017 Oct 23; 12(1):123.
Lum H, Obafemi O, et al. Use of Medical Orders for Scope of Treatment for
Heart Failure Patients During Postacute Care in Skilled Nursing Facilities. J
Am Med Dir Assoc. 2017 Oct 1;18(10):885-890.
Perraillon MC, Brauner DJ, etal. Nursing Home Response to Nursing Home
Compare: The Provider Perspective. Med Care Res Rev. 2017.
Greene MT, et al. Infection Prevention and Antimicrobial Stewardship
Knowledge for Selected Infections Among Nursing Home Personnel. Infect
Control HospEpidemiol. 2017;38(1):83-88.
Whitfield EA, et al. Hospital Readmission From Post-Acute Care Facilities:
Risk Factors, Timing, and Outcomes. J Am Med Dir Assoc. 2016 Mar 01;
Dolansky MA, Capone L, et al. Targeting heart failure
rehospitalizations in a skilled nursing facility: A case report. Heart
Lung. 2016 Sep-Oct;45(5):392-6.
Falvey JR, Burke RE, etal. Role of Physical Therapists in Reducing
Hospital Readmissions: Optimizing Outcomes for Older Adults During Care
Transitions From Hospital to Community. Phys Ther. 2016 08; 96(8):1125-34.
Joyce N, et al. Gap between Recommendations and Practice of Palliative
Care and Hospice in Cancer Patients. J Palliat Med. 2016;19(9):957-63.
Jones CD, Cumbler E, et al. Hospital to Post-Acute
Care Facility Transfers: Identifying Targets for Information Exchange
Quality Improvement. J Am Med Dir Assoc. 2017 Jan;18(1):70-73.
Zargoush M, et al. Sequence of Functional Loss and Recovery in
Nursing Homes. Gerontologist. 2016;56(1):52-61.
Lum HD, Jones J, et al. Advance Care
Planning Meets Group Medical Visits: The Feasibility of Promoting
Conversations. Ann Fam Med. 2016;14(2):125-32.
ManheimCE, Haverhals LM, et al.
Allowing Family to be Family: End-of-Life Care in Veterans Affairs Medical
Foster Homes. J Soc Work End Life Palliat Care. 2016;12(1-2):104-25.
Orr NM, Boxer
RS, et al. Skilled Nursing Facility Care for Patients With Heart
Failure: Can We Make It "Heart Failure Ready?" J Card Fail. 2016
Reeder B, Chung
J, Stevens-Lapsley J. Current Telerehabilitation Research with Older
Adults at Home: An Integrative Review. J Gerontol Nurs. 2016:42(10):15-20.
Ersek M, et al. Implementing goals of care conversations with veterans in VA
long-term care setting: a mixed methods protocol. Implement Sci.2016;11(1):132.
Stevens-Lapsley JE, Loyd BJ, et al. Progressive multi-component home-based physical therapy for deconditioned
older adults following acute hospitalization: a pilot randomized controlled
trial. Clin Rehabil. 2016;30(8):776-85.
Zhu W, Luo L, Jain T, et al. DCDS: A Real-time Data Capture and
Personalized Decision Support System for Heart Failure Patients
in Skilled Nursing Facilities. AMIA Annu Symp Proc. 2017 Feb
Glasheen JJ, et al. Understanding predictors of prolonged
hospitalizations among general medicine patients: A guide and preliminary
analysis. Journal of Hospital Medicine. 2015;10(9):623–626.
Juarez-Colunga E, et al. Rise of post–acute care facilities as a
discharge destination of us hospitalizations. JAMA Internal
Burke RE, Juarez-Colunga E, et al. Patient and Hospitalization
Characteristics Associated With Increased Postacute Care Facility Discharges
from US Hospitals.Med Care. 2015;53(6);492-500.
Falvey JR, Burke
RE, Stevens-Laplsey JE. Physical Function and Hospital Readmissions. JAMA
Intern Med. 2015;175(10):1722.
Jones CD, Ginde AA, et al. Increasing home healthcare referrals upon
discharge from US hospitals: 2001-2012. J Am Geriatr Soc. 2015;63(6):1265–1266.
Jurgens CY, Goodlin S, et al. Heart failure management
in skilled nursing facilities: a scientific statement from
the American Heart Association and the Heart Failure Society of
America. J Card Fail. 2015 Apr;21(4):263-99.
Grabowski DC, et al. Nursing home 5-star rating system
axacerbates disparities in quality, by payer source. Health Aff
Grabowski DC, et al. The Role of Severe Dementia in Nursing Home Report Cards.
Med Care Res Rev. 2015;72(5):562-79.
Lum HD, Jones J,
et al. Unique challenges of hospice for patients with heart failure: A
qualitative study of hospice clinicians. 2015;170(3):524-30.
Lum HD, Sudore
RL, et al. Advance Care Planning in the Elderly. Med Clin North Am. 2015;
2013 and Earlier
Dolansky MA, Hitch JA, Piña IL, Boxer RS. Improving heart failure
disease management in skilled nursing facilities: lessons learned. Clin
Nurs Res. 2013 Nov;22(4):432-47.
Ozkaynak M, Brennan PF, et al. Patient-centered care requires a
patient-oriented workflow model. J Am Med Inform Assoc. 2013.
Reeder B, Meyer E, et al. Framing the evidence for health smart homes and
home-based consumer health technologies as a public health intervention
for independent aging: a systematic review. Int J Med Inform.
RS, Dolansky MA, et al. The Bridge Project: improving heart failure care
in skilled nursing facilities. J Am Med Dir Assoc. 2012
Misky GJ, Wald
JL, et al. Post-hospitalization transitions: Examining the effects
of timing of primary care provider follow-up. J Hosp Med. 2010;5(7):392-7.
Radcliff TA, Levy
CR. Examining guideline-concordant care for acute myocardial infarction
(AMI): the case of hospitalized post-acute and long-term care (PAC/LTC)
residents. J Hosp Med. 2010;5(2):E3-E10.
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