Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 1 of 33

(as of 6/18/2019)

2019 Peer-Reviewed Publications by VNSNY Research Center Staff

Arbaje, A.I., Hughes, A., Werner, N., Carl, K., Hohl, D., Jones, K., Bowles, K.H., Chan, K., Leff, B., Gurses, AP. (2019). Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study. BMJ Quality and Safety. 28(2): 111-120. Bjarnadottir, R.I., Bockting, W., Dowding, D. (2019: in-press) Nurses’ perception of assessing sexual orientation and gender identity in home healthcare. LGBT Health. Chughtai, B., Thomas, D.M. Russell, D., Phongtankuel, V., Bowles, K.H., Prigerson, H. (2019). Prevalence and risk factors for fecal incontinence in home hospice. American Journal of Hospice and Palliative Care Medicine. 36(1): 33-37. Chughtai, B., Thomas, D., Russell, D., Bowles, K.H., Prigerson, H. (2019). Prevalence of and risk factors for urinary incontinence in home hospice patients. European Urology. 75(2): 268-271. Deb, P., Murtaugh, C., Bowles, K., Mikkelsen, M., Khajavi, H., Moore, S., Barron, Y., Feldman, P. (2019: in-press) Does early follow-up improve the outcomes of sepsis survivors discharged to Home Health Care? Medical Care. Dowding, D., Merrill, J.A., Barron, Y., Onorato, N., Jonas, K., Russell, D. (2019). Usability evaluation of a dashboard for home care nurses. Computer, Informatics, Nursing. 37(1): 11-19.

Feldman, P., Ryvicker, M., Evans, L., Barron, Y. (2019). The homecare aide workforce initiative: implementation and outcomes. Journal of Applied Gerontology. 38(2): 253-276.

Jones, C., Jones, J., Bowles, K.H., Schroeder, S., Masoudi, F.A., Coleman, E.A., Falvey, J., Levy, C.R., Boxer, R.S. (2019). Patient, Caregiver, and Clinician Perspectives on Expectations for Home Healthcare after Discharge: A Qualitative Case Study. Journal of Hospital Medicine. 14(2): 90-95.

Jones, C., Jones, J., Bowles, K.H., Flynn, L., Masoudi, F., Coleman, E., Levy, C., Boxer, R.S. (2019). Quality of Hospital Communication and Patient Preparation for Home Health Care: Results from a Statewide Survey of Home Healthcare Nurses and Staff. Journal of the American Medical Directors Association (JAMDA). 20(4): 487-491.

Masterson Creber, R., Russell, D., Dooley, F., Jordan, L., Baik, D., Goyal, P., Hummel, S., Hummel, E.K., Bowles, K.H. (2019). Use of the Palliative Performance Scale to estimate survival among home hospice patients with heart failure. European Society of Cardiology (ESC) Heart Failure. 6(2):371-78.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 2 of 33

Riegel, B., Huang, L., Mikkelsen, M., Kutney Lee, A., Hanlon, A., Murtaugh, C., Bowles, K.H. (2019) Early post-intensive care syndrome (PICS) among older adults sepsis survivors receiving home care. Journal of the American Geriatrics Society. 67(3): 520-526. Russell, D., Baik, D., Jordan, L., Dooley, F., Hummel, S., Prigerson, H.G., Bowles, K.H., Masterson-Creber, R. (2019; e-published ahead of print). Factors Associated with Live Discharge of Heart Failure Patients from Hospice: A Multimethod Study. Journal of the American College of Cardiology. Shang, J., Russell, D., Dowding, D., McDonald, M., Murtaugh, C., Liu, J., Larson, E. Brickner, C. (in press) A predictive risk model for infection-related hospitalization among home healthcare patients. Journal for Healthcare Quality. Squires, A., Ridge, L.J., Miner, S., McDonald, M.V., Greenberg, S.A., Cortes, T.A. (2019: e-published ahead of print) Provider perspectives about medication complexity in home care: A qualitative secondary analysis. Medical Care Research and Reviews.

Topaz, M., Murga, L., Bar-Bachar, O., McDonald, M., Bowles, K. (in press). NimbleMiner: an Open Source Nursing-sensitive Natural Language Processing System Based on Word Embedding. Computers, Informatics, Nursing. Topaz, M., Murga, L., Gaddis, K.M., McDonald, M.V., Bar-Bachar, O., Goldberg, Y., Bowles, K.H. (2019) Mining fall-related information in clinical notes: Comparison of rule-based and novel word embedding-based machine learning approaches. Journal of Biomedical Informatics. 90:103103. Yang, Y., Bass, E.J., Bowles, K.H., Sockolow, P.S. (2019). Impact of home care admission nurses’ goals on electric health record documentation strategies at the point of care. Computers, Informatics, Nursing. 37(1): 39-46. Yang, K., Colorito, K.M., Bowles, K.H., Woomer, G.R., Murtaugh, C.M. (2019: e-published ahead of print) Home care providers’ experience translating evidence-based fall prevention programs into practice. Home Health Care Services Quarterly.

Interviews & Profiles of the VNSNY Research Center and its Staff & Projects

Home Care Association News Staff (2019) Following the evidence: Tomorrow’s Home Care informed by Today’s Clinical Experience. Home Care Association of New York State.

Home Care Association News Staff (2019) Caregivers, Physicians & Public Servants to be Presented Home Care and Hospice Excellence Awards. Home Care Association of New York State. Available online: https://www.globenewswire.com/news-

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 3 of 33

release/2019/05/06/1817583/0/en/Caregivers-Physicians-Public-Servants-to-be-Presented-Home-Care-and-Hospice-Excellence-Awards.html NBC News Staff (2019) Caregivers, Physicians & Public Servants to be Presented Home Care and Hospice Excellence Awards. NBC29. Available online: https://www.nbc29.com/story/40422745/caregivers-physicians-public-servants-to-be-presented-home-care-and-hospice-excellence-awards Paul, Sharon (2019). Closing Health Disparities in the Black Community. Bronx Voice. Available online: http://bronxvoice.com/closing-health-disparities-in-the-black-community/ Paul, Sharon (2019). Closing Health Disparities in the Black Community. Bronx Voice. Print Paul, Sharon. (2019). Closing Health Disparities in the Black Community. El Especialito. Available online: http://elespecial.com/trate-la-presion-alta-para-evitar-mas-problemas Paul, Sharon. (2019). Closing Health Disparities in the Black Community. Long Island Weekly. Available online: https://longislandweekly.com/health-disparities-in-the-black-community/ Paul, Sharon. (2019). Closing Health Disparities. Manhattan Times. Available online: https://www.manhattantimesnews.com/closing-health-disparitiescierre-de-las-disparidades-de-salud/ Paul, S. (2019). Closing health disparities in the Black Community. New York Amsterdam News. Available online: http://amsterdamnews.com/news/2019/jan/31/closing-health-disparities-black-community/ Paul, Sharon. (2019). Closing health disparities in the Black Community. New York Beacon. Paul, Sharon. (2019). Closing health disparities in the Black Community. Your Health Voice. Available online: https://yourhealthbxvoice.blogspot.com/2019/02/closing-health-disparities-in-black.html Shell-Sanchez, Fatima. (2019). Heart-Healthy Tips to Follow All Year Long. Queens Times. Warraich, Haider et al. (2019). Failure is not an option: Optimizing Care for Heart Failure Patients at the End of Life. JACC: Heart Failure. Available online: https://www.ncbi.nlm.nih.gov/pubmed/31078472 Yahoo Finance News Staff (2019) Caregivers, Physicians & Public Servants to be Presented Home Care and Hospice Excellence Awards. Yahoo Finance. Available online: https://finance.yahoo.com/news/caregivers-physicians-public-servants-presented-140000387.html

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 4 of 33

2018 Peer-Reviewed Publications by VNSNY Research Center Staff Baik, D., Russell, D., Jordan, L., Bowles, K.H., Dooley, F., Masterson-Creber, R. (2018) Using the Palliative Performance scale to Estimate Survival for Patients at the End-of-Life: A systematic Review. Journal of Palliative Medicine. 21(11): 1651-1661. Chase, J.D., Hirschman, K.B., Hanlon, A.L., Huang, L., Bowles, K.H., Naylor, M. (2018). Physical functioning among older adults new to long-term services and supports. Gerontologist. 58(6): 1147-1155.

Chase, J.D., Huang, L., Russell, D., Hanlon, A., O’Connor, M., Robinson, K.M., Bowles, K.H. (2018). Racial/ethnic disparities in disability outcomes among post-acute home care patients. Journal of Aging and Health.30(9): 1406-1426.

Chase, J.D., Lozano, A., Hanlon, A., Bowles, K.H. (2018). Identifying factors associated with mobility decline among hospitalized older adults. Clinical Nursing Research. 27(1): 81-104.

Chase, J.D., Russell, D., Huang, L., Hanlon, A., O’Connor, M., Bowles, K.H. (2018: e-published ahead of print). Relationships between race/ethnicity and health care utilization among older post-acute home health care patients. Journal of the Applied Gerontology.

Dowding, D., Merrill, J.A., Onorato, N., Barrón, Y., Rosati, R.J., Russell, D. (2018). The impact of home care nurses’ numeracy and graph literacy on comprehension of visual display information: implications for dashboard design. Journal of the American Medical Informatics Association. 25(2):175-182. Dowding, D., Russell, D., Onorato, N., Merrill, J.A. (2018). Technology solutions to support care continuity in home care: a focus group study. Journal of Health Quality. 40(4):236-246.

Feinberg, J. L., Russell, D., Mola, A., Trachtenberg, M., Bick, I., Lipman, T.H., Bowles, K.H. (2018). A mixed methods evaluation of the feasibility and acceptability of an adapted cardiac rehabilitation program for home care patients. Geriatric Nursing. 39(2):191-198.

Feldman, P., McDonald, M., Eimicke, J., Teresi, J. (2018: e-published ahead of print). Black/Hispanic disparities in a vulnerable post-stroke home care population. Journal of Racial and Ethnic Health Disparities.

Gelfman, L., Barrón, Y., Moore, S., Murtaugh, C., Lala, A., Aldridge, M., Goldstein, N.E. (2018) Predictors of hospice enrollment for patients with advanced heart failure and effects on health care use. JACC: Heart Failure. 6(9): 780-789.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 5 of 33

Guiliante, M., Greenberg, S., McDonald, M.V., Squires, A.P., Moore, R, Cortes, T.A. (2018). Geriatric Interdisciplinary Team Training 2.0: A collaborative team-based approach to delivering care. Journal of Interprofessional Care. 32(5):629-633. Irani, E., Hirschman, K., Cacchione, P., Bowles, K.H. (2018). Home Health Nurse decision-making regarding visit intensity planning for newly admitted patients: a qualitative descriptive study. Home Health Care Services Quarterly. 37(3): 211-231.

Irani, E., Hirschman, K., Cacchione, P., Bowles, K.H. (2018). How home health nurse plan their work schedules: A qualitative descriptive study. Journal of Clinical Nursing. 27(21-22): 4066-4076.

Meyer, N., Harahy, M., Small, D., Prescott, H., Bowles, K., Gaieski, D.F., Mikkelsen, M. (2018). Temporal trends in incidence, sepsis-related mortality, and hospital-based acute care after sepsis. Critical Care Medicine. 46(3):354-360.

Miner, S., McDonald M.V., Squires A. (2018). Medication literacy and Somali older adults receiving home care. Home Healthcare Now. 36(5): 295-303.

Pesko, MF., Gerber, LM., Peng, TR., Press, MJ. (2018). Home Health Care: Nurse-physician communication, patient severity, and hospital readmission. Health Services Research. 53(2):1008-1024.

Russell, D., Dowding, D., McDonald, M.V., Adams, V., Rosati, R.J., Larson, E.L., Shang, J. (2018). Factors for compliance with infection control practices in Home Healthcare: findings from a survey of nurse’s knowledge and attitudes towards infection control. American Journal of Infection Control.46(11): 1211-1217.

Russell, D., Oberlink, M., Shah, S., Evans, E., Bassuk, K. (2018). Addressing the health and wellness needs of vulnerable rockaway residents in the wake of hurricane sandy: findings from a health coaching and community health worker program. Journal of Public Health Management and Practice. 24(2):137-145. Russell, D., Oberlink, M., Onorato, N., Feinberg, J., Bowles, K., Szanton, S. (2018: e-published ahead of print) Identifying Barriers in the Home Environment among Urban Community-dwelling older adults with functional difficulty: A Multi-Method Pilot Study. Activities Adaptation & Aging. Ryvicker, M. (2018) A conceptual framework for examining healthcare access and navigation: A behavioral-ecological perspective. Social Theory & Health. 16(3): 224-240 Ryvicker, M. (2018). An international perspective on improving occupational conditions for direct care workers in home health. Israel Journal of Health Policy Research. 7:51. Ryvicker, M., Bollens-Lund, E., Ornstein, K. (2018: e-published ahead of print). Driving status and transportation disadvantage among Medicare beneficiaries. Journal of Applied Gerontology.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 6 of 33

Ryvicker, M., Russell, D. (2018). Individual and environmental determinants of provider continuity among urban older adults with heart failure: A retrospective cohort study. Gerontology and Geriatric Medicine. 4:1-9. Ryvicker, M., Sridharan, S. (2018) Neighborhood environment and disparities in health care access among urban Medicare beneficiaries with Diabetes: a retrospective cohort study. INQUIRY. 55: 1-12. Topaz, M., Trifilio, M., Maloney, D, Bar-Bachar,O., Bowles, K.H. (2018) Improving patient prioritization during hospital-homecare transition: a pilot study of a clinical decision support tool. Research in Nursing and Health. 41(5): 440-447. Weissman, J. D., Russell, D. (2018). Relationships between living arrangements and health status among older adults in the United States, 2009-2014 findings from the national health interview survey. Journal of Applied Gerontology. 37(1):7-25. Woo, K., Dowding, D. (2018). Factors affecting the acceptance of telehealth services by heart failure patients: an integrative review. Telemedicine and e-Health. 24(4):292-300.

Interviews & Profiles of the VNSNY Research Center and its Staff & Projects AHRQ in the Professional Literature (2018). Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization. Published in: Circulation: Heart Failure. Authors: Yim C., Barrón, Y., Moore, S., Murtaugh, C., Lala, A., Aldridge, M., Goldstein, N., Gelfman, L. AHRQ News Now, May 22, 2018, Issue #585. Addelman, M. (2018) Nurses attitudes are key to better compliance with infection practices. Medical Express. Available online: https://medicalxpress.com/news/2018-06-nurses-attitudes-key-compliance-infection.html. Bowles, K. Director of VNSNY Research Center, Receives Award (2018) Innovations in Care. Available online: https://www.vnsny.org/pro_article/kathryn-bowles-rn-phd-director-vnsny-research-center-receives-award-study/ Columbia School of Nursing News Staff. (2018). Columbia Nursing Awarded $2.7 Million NINR Grant to Fund New Palliative Care Research Center. Columbia School of Nursing Newsroom. Available online: http://nursing.columbia.edu/columbia-nursing-awarded-27-million-ninr-grant-fund-new-palliative-care-research-center-0 Columbia School of Nursing News Staff (2018). Nurses’ Attitudes impact compliance with infection control practice. Columbia School of Nursing Newsletter. Available online: http://nursing.columbia.edu/nurses-attitudes-impact-compliance-infection-control-practice

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 7 of 33

Elsevier (2018) The home healthcare frontier: new study explores nurses’ knowledge attitudes toward infection control. Eurek Alert. Available online: https://www.eurekalert.org/pub_releases/2018-12/e-thh121318.php Flannery, M. (2018) Cutting-edge research leads to more targeted and effective home health care. VNSNY Thought Leadership. Available online: https://www.vnsny.org/pro_article/cutting-edge-research-leads-to-more-targeted-and-effective-home-health-care/ Ford, S. (2018) Challenging community nurse beliefs key to improving infection control, suggests survey. Nursing Times. Available online: https://www.nursingtimes.net/news/community/challenging-community-nurse-beliefs-improves-infection-control/7027194.article Hackett, D.W. (2018). 31% of Nurses Unsure Flu Vaccines Are Safe: Better educating nurses on the influenza vaccine benefits should enhance patient conversations. Precision Vaccinations. Available online: https://www.precisionvaccinations.com/better-educating-nurses-influenza-vaccine-benefits-should-enhance-patient-conversations Health Pulse Team. (2018). NYC Health + Hospitals moves into urgent care. Crain’s New York Business Health Pulse. Available online: https://www.crainsnewyork.com/health-pulse/nyc-health-hospitals-moves-urgent-care Holly, R. (2018). Improving Patient Prioritization during Care Transitions could halve re-hospitalization rates. Home Health Care News. Available online: https://homehealthcarenews.com/2018/10/improving-patient-prioritization-during-care-transitions-could-halve-readmission-rates/ Holly, R. (2018). Nurses’ Attitudes can determine infection control compliance. Home Health Care News. Available online: https://homehealthcarenews.com/2018/06/nurses-attitudes-can-determine-infection-control-compliance/ Holly, R. (2018) Why the largest nonprofit US home health provider goes big on research. Home Health Care News. Available online: https://homehealthcarenews.com/2018/12/why-the-largest-nonprofit-us-home-health-provider-goes-big-on-research/ Holly, R. (2018). Readmissions, ER Trips Higher Among Minority Groups in Home Health. Home Health Care News. Available online: https://homehealthcarenews.com/2018/05/readmissions-er-trips-higher-among-minority-groups-in-home-health/ Home Care Association News Staff (2018). Why the Largest Nonprofit US Home Health Provider Goes Big on Research. Home Care Headlines. Mattson, K. (2018). Home Health Nurses Lack Training in Geriatric Frailty, Depression. Available online: https://homehealthcarenews.com/2018/08/home-health-nurses-lack-training-in-geriatric-frailty-depression/

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 8 of 33

VNSNY News Staff (2018). Congratulations to this year’s ACE leadership graduates! (2018) Frontline VNSNY. Available online: http://frontline.vnsny.org/%e2%80%aaace-leadership-graduates/ VNSNY News Staff (2018). MaryGrace Trifilio, Research Analyst, VNSNY Center for Home Care Policy & Research. Frontline VNSNY. Available online: http://frontline.vnsny.org/marygrace-trifilio-research-analyst-vnsny-center-for-home-care-policy-research/ VNSNY News Staff (2018). New NYU-VNSNY Study shows benefits from bridging patients’ language gaps in person. VNSNY Today 4(3) 2. VNSNY News Staff (2018). NIH-funded VNSNY Study explores how neighborhood factors influence the health of local residents. Frontline VNSNY. Available online: http://frontline.vnsny.org/nih-funded-vnsny-study-explores-how-neighborhood-factors-influence-the-health-of-local-residents/ Other Publications by Center Staff Bowles, K. (2018) Following the evidence: Tomorrow’s Home Care informed by Today’s clinical experience. Medium. Oberlink, M., Davis, B. (2018) “Assessing the Aging-Friendliness of Two New York City Neighborhoods” in: The Global Age-Friendly Community Movement, Philip Stafford, ed. New York & Oxford: Berghan Books Yang, Y., Bass, E.J., Sockolow, P.S., Bowles, K.H. (2018). Knowledge elicitation of homecare admission decision making process via focus group, member checking and data visualization. 2018 Conference Proceedings, American Medical Informatics Association. October 27-31, 2018. San Francisco, CA.

Topaz. M. (2018) Project highlight: NimbleMiner: an open source nursing sensitive natural language processing software. International Medical Informatics Association, Nursing Informatics Special Interest Group. Quarterly Newsletter.

2017

Peer-Reviewed Publications by VNSNY Research Center Staff Alvarado, N., Honey, S., Greenhalgh, J., Pearman, A., Dowding, D., Cope, A., Long, A., Jayne, D., Gill, A., Kotze, A., Randell, R. (2017). Eliciting context-mechanism-outcome configurations: experiences from a realist evaluation investigating the impact of robotic surgery on teamwork in the operating theatre. Evaluation. 23(4): 444-462.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 9 of 33

Beissner, K.L., Bach, E., Murtaugh, C.M., Trifilio, M.G., Henderson, C.R., Barron, Y., Trachtenberg, M., Reid, M.C. (2017). Translating evidence-based protocols into the home health care setting. Home Healthcare Now, 35(2): 105-112. Bjarnadottir, R., Bockting, W., Dowding, D. (2017). Patient perspectives on answering questions about sexual orientation and gender identity. An integrative review. Journal of Clinical Nursing, 26: 1814–1833.

Bowles, K.H., Ratcliffe, S.R., Naylor, M.D., Holmes, J.H., Keim, S.K., Flores, E.J. (2017). Nurse generated EHR data supports post-acute care referral decision making: development and validation of a two-step algorithm. 2017 Conference proceedings, American Medical Informatics Association Annual Symposium. 465-474.

Chase, J., Huang, L., Russell, D., Hanlon, A., O’Connor, M., Robinson, K., Bowles, K.H. (2017). Racial and ethnic disparities in ADL disability after hospitalization among older adult home care recipients. Innovations in Aging. 1(1):1054-1055. Feinberg, J., Russell, D., Mola, A., Lipman,T.H., Bowles, K.H. (2017). Developing an adapted cardiac rehabilitation training for home care clinicians: Patient perspectives, clinician knowledge & curriculum overview. Journal of Cardiopulmonary Rehabilitation and Prevention. 37(6): 404-411. Holland, D.H., Brandt, C., Targonski, P.V., Bowles, K.H. (2017). Validating performance of a hospital-discharge planning decision tool in community hospitals. Journal of Professional Case Management. 22(5): 204-213.

Jones, C.D., Bowles, K.H., Richard, A., Boxer, R.S., Masoudi, F. (2017). High-value home health care for patients with heart failure an opportunity to optimize transitions from hospital to home. Circulation: Cardiovascular Quality and Outcomes. 10(5): e003676.

Jones, C.D., Jones, J.J., Richard, A., Bowles, K.H., Lahoff, D., Boxer, R.S., Masoudi, F.A., Coleman, E.A., Wald, H.L. (2017). “Connecting the Dots”: a qualitative study of home health nurse perspectives on coordinating care for recently-discharged patients. Journal of General Internal Medicine. 32(10): 1114-1121.

Kang, Y., McHugh, MD., Chittams, J., Bowles, K.H. (2017). Risk factors for all-cause rehospitalization among Medicare recipients with heart failure receiving telehomecare. Telemedicine Journal and e-Health, 23.4: 305-312.

Keim, S.K., Bowles, K. (2017). Comparison of algorithm advice for post-acute care referral to usual clinical decision-making: examination of 30-day acute healthcare utilization. 2017 Conference proceedings, American Medical Informatics Association Annual Symposium. 1051-1059.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 10 of 33

Murtaugh, C., Beissner, K., Barron, Y., Trachtenberg, M., Bach, E., Henderson, C., Sridharan, S., Reid, M.C. (2017). Pain and function in home care: A need for treatment tailoring to reduce disparities? The Clinical Journal of Pain. 33(4): 300-309. Murtaugh, C., Deb, P., Zhu, C., Peng, T., Barrón, Y., Shah, S., Moore, S., Bowles, K.H, Kalman, J., Feldman, P., Siu, A. (2017). Reducing readmissions among heart failure patients discharged to home health care: Effectiveness of early and intensive nursing services and early physician follow-up. Health Services Research, 52(4):1445-1472. O’Connor, M., Hanlon, A.L., Mauer, E., Meghani, S., Masterson-Creber, R., Marcantonio, S., Naylor, M.D., Bowles, K.H., Coburn, K., Van Cleave, J., Davitt, J., Riegel, B., Keim, S., Greenberg, S.A., Sefcik, J.S., Topaz, M., Kong, D. (2017). Identifying distinct risk profiles to predict adverse events among community-dwelling older adults. Geriatric Nursing. 38(6):510-519.

Reid, M., Henderson, C., Trachtenberg, M., Beissner, K., Bach, E., Barrón, Y., Sridharan, S., Murtaugh, C. (2017). Implementing a pain self-management protocol in home care: A cluster randomized pragmatic trial. The Journal of the American Geriatrics Society. 65(8):1667-1675.

Russell, D., Diamond, E.L., Lauder, B., Dignam, R.R., Dowding, D.W., Peng, T.R., Prigerson, H.G., Bowles, K.H. (2017). Frequency and risk factors for live discharge from hospice. Journal of the American Geriatrics Society. 65(8):1726-1732. Russell, D., Mola, A., Onorato, N., Johnson, S., Williams, J., Andaya, M., Flannery, M. (2017). Preparing home health aides to serve as health coaches for home care patients with chronic illness: Findings and lessons learned from a mixed-method evaluation of two pilot programs. Home Health Care Management & Practice. 29(3):191-198.

Russell, D., Szanton, SL., Feinberg, JL., Bowles, K.H. (2017). A pilot study assessing in-home activity performance among vulnerable older adults in New York City. Innovation in Aging. 1(S1): 46. Sefcik, J. S., Ritter, A., Flores, E., Nock, R., Chase, J., Bradway, C., Potashnik, S., Bowles, K.H. (2017). Why older adults may decline offers of post-acute care services: A qualitative descriptive study. Geriatric Nursing, 38.3: 238-243. Squires, A., Peng., T.R., Barrón-Vaya, Y., Feldman, P. (2017). An exploratory analysis of patient-provider language-concordant home health care visit patterns. Home Health Care Management & Practice. 12(3):161-167.

Sockolow, P., Bass, E. J., Bowles, K., Holmberg. A., Quan, W., Yang, Y., & Potashnik, S. (2017). Data visualization of home care admission nurses’ decision-making. 2017 Conference proceedings, American Medical Informatics Association Annual Symposium. 1594-1606.

Taylor, P., Dowding, D., Johnson, M. (2017) Clinical decision making in the recognition of dying: A qualitative interview study. BMC Palliative Care. 16(1):11.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 11 of 33

Weissman, J. D., Russell, D., Beasley, J., Jay, M., Malaspina, D., Pegus, C. (2017). Disparities in healthcare utilization and functional limitations in adults with serious psychological distress in the United States, Findings from the NHIS: 2006-2014. Psychiatric Services, 68 (7): 653-659. Woo, K., Milworm, G., Dowding, D. (2017). Characteristics of quality improvement champions in nursing homes: A systematic review with implications for evidence-based practice. Worldviews on Evidence-Based Nursing. 14(6): 440-446. Yim C., Barrón, Y., Moore, S., Murtaugh, C., Lala, A., Aldridge, M., Goldstein, N., Gelfman, L. (2017). Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization. Circulation: Heart Failure. 10(3).

Interviews & Profiles of the VNSNY Research Center and its Staff & Projects Trifilio, M. (2017). A day in the life of a home healthcare research coordinator. Home Healthcare Now, 35(3): 176. AHRQ in the Professional Literature (2017). The impact of home care nurses’ numeracy and graph literacy on comprehension of visual display information: implications for dashboard design. Published in : Journal of American Medical Informatics Association. Authors: Dowding, D., Merrill, J.A., Onorato, N., Barron, Y., Rosati, R.J., Russell, D. AHRQ News Now, October 3, 2017, Issue #585. Flannery, M. (2017) Community outreach programs make a big impact on the health of vulnerable populations. Huffington Post, 08/03/2017. URL: https://www.huffingtonpost.com/entry/community-outreach-programs-make-a-big-impact-on-the_us_59836f21e4b0bd823202961e

2016 Peer-Reviewed Publications by VNSNY Research Center Staff Bowles, K.H., Ratcliffe, S., Potashnik, S., Topaz, M., Holmes, J., Shih, N-W., Naylor, M.D. (2016). H3IT Special Topic: Using electronic case summaries to elicit multi-disciplinary expert knowledge about referrals to post-acute care. Applied Clinical Informatics, 7(2): 368-379. Closs, S.J., Dowding, D., Allcock, N., Hulme, C., Keady, J., Sampson, E.L., et al. (2016). Towards improved decision support in the assessment and management of pain for people with dementia in hospital: a systematic meta-review and observational study. Health Services and Delivery Research, 4 (30). Diamond, E. L., Russell, D., Kryza-Lacombe, M., Bowles, K. H., Applebaum, A. J., Dennis, J. Prigerson, H. G. (2016). Rates and risks for late referral to hospice in patients with primary malignant brain tumors. Neuro-Oncology, 18(1): 78-86.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 12 of 33

Dowding, D., Lichtner, V., Allcock, N., Briggs, M., James, K., Keady, J., Closs, S. J. (2016). Using sense-making theory to aid understanding of the recognition, assessment and management of pain in patients with dementia in acute hospital settings. International Journal of Nursing Studies, 53(1): 152-162. Feldman, P.H., McDonald, M.V., Barrón, Y., Gerber, L.M., Peng, T.R. (2016). Home-based interventions for black patients with uncontrolled hypertension: a cluster randomized controlled trial. Journal of Comparative Effectiveness Research, 5(2):155-158. Landers, S., Madigan, E., Leff, B., Rosati, R.J., McCann, B.A., Hornbake, R., MacMillan, R., Jones, K., Bowles, K., Dowding, D. and Lee, T. (2016). The future of home health care: a strategic framework for optimizing value. Home Health Care Management & Practice, 28(4): 262-278. Lichtner, V., Dowding, D., Allcock, N., Keady, J., Sampson, E.L., Briggs, M., Corbett, A., James, K., Lasrado, R., Swarbrick, C., Closs, S.J. (2016). The assessment and management of pain in patients with dementia in hospital settings: a multi-case exploratory study from a decision making perspective. BMC Health Services Research, 16(1): 427. McDonald, M.V., Feldman, P.H., Barrón-Vayá, Y., Peng, T.R., Sridharan, S., Pezzin, L.E. (2016) Outcomes of clinical decision support (CDS) and correlates of CDS use for home care patients with high medication regimen complexity: A randomized trial. Journal for the Evaluation of Clinical Practice, 22(1): 10-19. Naylor, M.D., Hirschman, K.B., Hanlon, A.L., Abbott, K.M., Bowles, K.H., Foust, J., Shah,S., Zubritsky, C. (2016). Factors associated with changes in perceived quality of life among elderly recipients of long-term services and supports. Journal of the American Medical Director Association. 17(1):44-52 O’Connor, M., Murtaugh, C., Shah, S., Barrón-Vaya, Y., Bowles, K.H., Peng, T., Zhu, C., Feldman, P. (2016). Patient characteristics predicting readmission among individuals hospitalized for heart failure. Medical Care Research and Review, 73(1):3-40. Randell, R., Honey, S., Alvarado, N., Pearman, A., Greenhalgh, J., Long, A., Gardner, P., Gill, A., Jayne, D. and Dowding, D. (2016). Embedding robotic surgery into routine practice and impacts on communication and decision making: a review of the experience of surgical teams. Cognition, Technology & Work, 18(2): 423-437. Russell, D., Bowles, K. H. (2016). Continuity in Visiting Nurse Personnel Has Important Implications for the Patient Experience. Home Health Care Management & Practice, 28(2): 120-126. Topaz, M., Lai, K., Dowding, D., Lei, V. J., Zisberg, A., Bowles, K. H., Zhou, L. (2016). Automated identification of wound information in clinical notes of patients with heart diseases:

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 13 of 33

Developing and validating a natural language processing application. International Journal of Nursing Studies, 64(1): 25-31. Wajnberg, A., Soones, T. N., Smith, K. L., Russell, D., Ross, J. S., Federman, A. (2016). Identifying sociodemographic characteristics associated with burden among caregivers of the urban homebound the importance of racial and relationship differences. Gerontology and Geriatric Medicine. (2): 1-7. Weissman, J. D., Russell, D., Beasley, J., Jay, M., Malaspina, D. (2016). Relationships between adult emotional states and indicators of health care utilization: Findings from the National Health Interview Survey 2006–2014. Journal of Psychosomatic Research, 91(1): 75-81. Wilde, M.H., Crean, H.F., McMahon, J.M., McDonald, M.V., Tang, W., Brasch, J., Fairbanks, E., Shah, S. Zhang, F. (2016). Testing a model of self-management of fluid intake in community-residing long-term indwelling urinary catheter users. Nursing Research, 65(2): 97-106. Wilde, M.H., McMahon, J. M., Tang, W., McDonald, M. V., Brasch, J., Fairbanks, E., Shah, S. (2016). Self-care management questionnaire for long-term indwelling urinary catheter users. Neurourology and Urodynamics, 35(4): 492-496.

Other Publications by VNSNY Research Center Staff Russell, D. (2016). Book Review: Closing the gaps on efforts to improve healthcare quality at the end-of-life: A review of Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life by the Committee on Approaching Death: Addressing Key End of Life Issues. Washington, DC: National Academies Press, 2014. 638 pages.(ISBN: 978-0309303101). Published in: Death studies,40(1), 68-7.

Peer-Reviewed Publications by VNSNY Clinical Staff with Research Staff Support Dooley, F., McDonald, M. (2016). Recent research on medication management. Home Healthcare Now, 34(8): 450-454. Ortiz, I. (2016). A Day in the Life of a Home Health Aide/Health Coach. Home Healthcare Now, 34(6): 340-341.

Interviews & Profiles of the VNSNY Research Center and its Staff & Projects Agency for Health Care Research and Quality. (2016). Hospital readmissions less likely for discharged heart failure patients who receive combined care. AHRQ Electronic Newsletter, Issue #538. Available at: http://www.ahrq.gov/news/newsletters/e-newsletter/index.html Feldman, P. (2016). Member Spotlight. AcademyHealth: Long-term Services and Support Digest.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 14 of 33

Flannery, M. (2016). Cutting-edge research leads to more targeted and effective home health care. The Huffington Post. Published online on 03/22/2016. Available at: http://www.huffingtonpost.com/marki-flannery/cuttingedge-research-lead_b_9519064.html

Poltilove, J., Feinberg, J. (2016). Train clinicians together and increase knowledge, reduce rehospitalizations. Home Health Line. Published online on 02/29/2016. Available at: http://homehealthline.decisionhealth.com/Articles/Detail.aspx?id=521494

2015 Peer-Reviewed Publications by VNSNY Research Center Staff Bakallbashi, E., Vyas, A., Vaswani, N., Rosales, D., Russell, D., Dowding, D., & Hawkey, R. (2015). Enhancing cross-functional collaboration and effective problem solving through an innovation challenge for point-of-care providers. Journal of Nursing Administration, 45(7/8): 354-357. Christopher, M. A., Duhl, J., Rosati, R. J., & Sheehan, K. M. (2015). Advocacy for Vulnerable Patients: How Grassroots Organizations Can Influence Health Care Policy. The American Journal of Nursing, 115(3): 66-69. Dowding D, Randell R, Gardner P, Fitzpatrick G, Dykes P, Favela J, Hamer S, Whitewood-Moores Z, Hardiker N, Borycki E, Currie L. (2015). Dashboards for improving patient care: review of the literature. International Journal of Medical Informatics, 84:87-100. Feldman, P.H., McDonald, M.V., Trachtenberg, M.A., Schoenthaler, A., Coyne, N., Teresi, J. (2015). Center for Stroke Disparities Solutions community based care transition interventions: study protocol of a randomized controlled trial. Trials, 16(1): 32-43. Greenfield, E., Oberlink, M., Sharlach, A., Neal, M., Stafford, P. (2015). Age-friendly community initiatives: Conceptual issues and key questions. The Gerontologist. 55(2): 191-198.

Lichtner, V., Dowding, D., Closs, S.J. (2015). The relative meaning of absolute numbers: the case of pain intensity scores as decision support systems for pain management of patients with dementia. BMC Medical Informatics and Decision Making. 15(1):1.

McDonald, M.V., Feldman, P.H., Barrón-Vayá, Y., Peng, T.R., Sridharan, S., Pezzin, L.E. (2016) Outcomes of clinical decision support (CDS) and correlates of CDS use for home care patients with high medication regimen complexity: A randomized trial. Journal for the Evaluation of Clinical Practice, 22(1): 10-19. O’Connor, M., Hanlon, A., Naylor, M.D , Bowles, K.H.,. (2015) The impact of home health length of stay and number of skilled nursing visits on hospitalization among Medicare-reimbursed skilled home health beneficiaries. Research in Nursing and Health Care. 38(4), 257-

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 15 of 33

67. Pavlik, V.N., Chan, W., Hyman, D.J., Feldman, P., Ogedegbe, G., Schwartz, J.E., McDonald, M., Einhorn, P., Tobin, J. (2015) Evaluating health systems level hypertension control interventions for African-Americans: Lessons from a pooled analysis of three cluster randomized Trials. Current Hypertension Reviews, 11(2): 123-31.

Press, M.J., Gerber, L.M., Peng, T.R., Pesko, M.F., Feldman, P.H., Ouchida, K., Sridharan, S., Bao, Y., Barron, Y., Casalino, L.P. (2015). Postdischarge communication between home health nurses and physicians: measurement, quality, and outcomes. Journal of the American Geriatric Society. 63(7):1299-305.

Randell, R., Greenhalgh, J., Dowding, D. (2015). Using realist reviews to understand how health IT works, for whom, and in what circumstances. Journal of the American Medical Informatics Association, 22(e1): e216-e217.

Randell, R., Greenhalgh, J., Wyatt, J., Gardner, P., Pearman, A., Honey, S., Dowding, D. (2015). Electronic whiteboards: review of the literature. Studies in Health Technology and Informatics, 210(1): 389-93. Randell, R., Alvarado, N., Honey, S., Greenhalgh, J., Gardner, P., Gill, A., Jayne, D., Kotze, A., Pearman, A., Dowding, D. (2015). Impact of robotic surgery on decision making: perspectives of surgical teams. Proceedings of the AMIA 2015 Annual Symposium, pp.1057-1066. Taylor, P., Crouch, S., Howell, D. A., Dowding, D. W., Johnson, M. J. (2015). Change in physiological variables in the last 2 weeks of life: An observational study of hospital in-patients with cancer. Palliative Medicine, 29(2): 120-127. Wilde, M. H., McMahon, J. M., McDonald, M. V., Tang, W., Wang, W., Brasch, J., Fairbanks, E., Shah, S., Zhang, F., & Chen, D. (2015) Self-management intervention for long-term indwelling urinary catheter users: Randomized clinical trial. Nursing Research, 64(1): 24-34. Wilde, M.H., Liebel, D., Fairbanks, E., Wilson, P., Lash, M., Shah, S., McDonald, M.V., Brasch, J., Zhang, F., Scheid, E., McMahon, J.M. (2015) A hybrid process fidelity assessment in a home-based randomized clinical trial. Home Health Care Services Quarterly, 34(2):113-36. Doctoral Dissertations by Staff Evans, L. (2015). An examination of the effect of vision-related factors and availability of health care resources on depression, functional status, and falls among New York City senior center attendees. PhD Thesis. The Graduate Center of the City University of New York. New York, NY. Peer-Reviewed Publications by VNSNY Clinical Staff with Research Staff Support Rocks, D. & Cooper, E. (2015). Recent research on care coordination. Home Healthcare Now, 33(2): 104-109.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 16 of 33

Other Publications by VNSNY Research Center Staff Oberlink, M., Schwarz, J., & Greenberg, B.R. (2015). Building great communities: consider an age-friendly community assessment. Grantmakers in Aging. http://www.giaging.org/documents/140707_AF_matrix_final.pdf

Interviews & Profiles of the VNSNY Research Center and its Staff Bowles, K.H. (2015). VNSNY’s Research Center: pioneering new approaches to home health care. Frontline VNSNY, 2015(March): 6. Dowding, D. (2015). VNSNY”s Dr. Dawn Dowding investigates home care issues around sexual orientation and gender identity. Frontline VNSNY, 2015(June): 3. Feinberg, J. (2015). An interview with Jodi Feinberg, RN. Frontline VNSNY, 2015 (November): 2. Murtaugh, C.M. (2015). VNSNY Researchers help develop uniform assessment tool for post-acute care settings. Frontline VNSNY, 2015(April): 7. Russell, D. (2015). Joint project with NYU Langone provides HHA health coaching to high-risk heart failure patients. Frontline VNSNY, 2015(July): 3.

2014

Peer Reviewed Publications by VNSNY Research Center Staff Coleman, S., Nelson, E.A., Keen, J., Wilson, L., McGinnis, E., Dealey, C., Stubbs, N., Muir, D., Farrin, A., Dowding, D., Schols, J.M.G.A., Cuddigan, J., Berlowitz, D., Jude, E., Vowden, P., Bader, D.L., Gefen, A., Oomens, C.W.J., Schoonhoven, L., Nixon, J. (2014). Developing a pressure ulcer risk factor minimum data set and risk assessment framework. Journal of Advanced Nursing, 70(10):2339-2352. Coleman, S., Nixon, J., Keen, J., Wilson, L., McGinnis, E., Dealey, C., Stubbs, N., Farrin, A., Dowding, D., Schols, J.M.G.A., Cuddigan, J., Berlowitz, D., Jude, E., Vowden, P., Schoonhoven, L., Bader, D.L., Gefen, A., Oomens, C.W.J., Nelson, E.A. (2014). A new pressure ulcer conceptual framework. Journal of Advanced Nursing, 70(10):2222-2234. Dowding, D. W., Turley, M., & Garrido, T. (2014: e-published ahead of print). Nurses' use of an integrated electronic health record: results of a case site analysis. Informatics for Health and Social Care. Fairbanks, E., Shah, S. Wilde, M.H., McDonald, M.V., Brasch, J., McMahon, J.M. (2014). Successful recruitment methods in the community for a two-site clinical trial. Applied Nursing Research, 27(4):254-257.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 17 of 33

Kurowski, D., Russell, D., Hamilton, T., Napoli, R., Rosati, R. (2014). Factors for hospitalization in a medically complex population of pediatric home care patients. Home Health Care Management Practice, 26(3):146-153. O’Connor, M., Bowles, K.H., Feldman, P., St. Pierre, M., Jarrin, O., Shah, S., Murtaugh, C.M. (2014). Frontloading and intensity of skilled home health visits: a state of the science. Home Health Care Services Quarterly, 33(3):159-175.

Parenti, N., Reggiani, M.L.B., Iannone, P., Dowding, D. (2014). A systematic review on the validity and reliability of the Manchester Triage System. International Journal of Nursing Studies, 21(7):1062-1069.

Randell, R., Greenhalgh, J., Hindmarsh, J., Dowding, D., Jayne, D., Pearman, A., Gardner, P., Croft, J., Kotze, A. (2014). Integration of robotic surgery into routine practice and impacts on communication, collaboration and decision making: a realist process evaluation protocol. Implementation Science, 9(1): 52-59. Rosati, R., Russell, D., Peng, T., Brickner, C., Kurowski, D., Christopher, M., Sheehan, K. (2014). Medicare home health payment reform may jeopardize access for clinically complex and socially vulnerable patients. Health Affairs, 33(6):946-956. Samuriwo R., Dowding D. (2014) Nurses’ pressure ulcer related judgements and decisions in clinical practice: a systematic review. International Journal of Nursing Studies, 51(12):1667-1685.

Doctoral Dissertations by VNSNY Research Center Staff Brickner, C. (2014). Estimating the Relationship Between a Transient Effect and the Onset of An Acute Event: A Comparison of a Case Crossover Design and a Retrospective Cohort Design. PhD thesis. Rutgers University. New Brunswick, NJ.

Other Publications by VNSNY Research Center Staff Feldman, P. (2014). The PRIDE initiative: Building the capacity and scalability of integrated managed care plans. Health Affairs Blog website. Available from: http://healthaffairs.org/blog/2014/02/13/the-pride-initiative-building-the-capacity-and-scalability-of-integrated-managed-care-plans-for-dual-eligibles/. Feldman, P. (2014). Key Attributes of high-performing integrated health plans for Medicare-Medicaid enrollees. Center for Health Care Strategies, Inc. website. Available from: http://www.chcs.org/resource/key-attributes-high-performing-integrated-health-plans-medicare-medicaid-enrollees/

Peer-Reviewed Publications by VNSNY Clinical Staff with Research Staff Support Coyne, N. & Correnti, D. (2014). Effectiveness of motivational interviewing to improve chronic condition self-management – What does the research show us? Home Healthcare Nurse, 32(1):56-62. Sealy, L. & Oliva, A. (2014). Hypertension management guidelines ppdate and research on the importance of blood pressure control. Home Healthcare Nurse, 32(10):603-609. Sunkin, A., Bach, E., Reid, M.C. (2014). The Hurt Blocker. Can a psychotherapeutic technique relieve pain in older adults? Weill Cornell Medicine, 13(2):19-20.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 18 of 33

2013 Abbatiello, G. & Rosenfeld, P. (2013). Research on Cognitive Impairment in Community and Home Settings. Home Healthcare Nurse, 31(2):104-10.

Abramson E.L., Pfoh, E.R., Barrón, Y., Quaresimo, J., Kaushal, R. (2013). The effects of electronic prescribing by community-based providers on ambulatory medication safety. Joint Commission Journal on Quality and Patient Safety, 39(12):545-52. Bach, E., Beissner, K., Murtaugh, C., Trachtenberg, M., Reid, M.C. (2013). Implementing a cognitive-behavioral pain self-management program in home health care, Part 2: Feasibility and acceptability cohort study. J Geriatr Phys Ther., 36(3):130-137. Beissner, K., Bach, E., Murtaugh, C., Parker, S., Trachtenberg, M., Reid, M.C. (2013). Implementing a Cognitive-Behavioral Pain Self-Management Program in Home Health Care, Part 1: Program Adaptation. J Geriatr Phys Ther., 36(3):123-129. Gerber LM, Mann SJ, McDonald MV, Chiu YL, Sridharan S, Feldman PH. (2013). Diuretic use in black patients with uncontrolled hypertension. Am J Hypertens. 26(2):174-179. McDonald MV, Peng TR, Sridharan S, Foust JB, Kogan P, Pezzin LE, Feldman PH. (2013). Automating the medication complexity index. J Am Med Inform Assoc. 20(3): 499-505. Russell, D., Rosati, R. J, Peng, T. R., Barrón, Y., Andreopoulos, E. (2013). Continuity in the provider of home health aide services and the likelihood of improvement in activities of daily living. Home Health Care Management & Practice. 25(1):6-12. Ryvicker, M., Feldman, P., Chiu, Y., Gerber, L. (2013). The role of patient activation in improving blood pressure outcomes in black patients receiving home care. Med Care Res Rev, 70(6):636–652. Ryvicker, M., McDonald, M., Trachtenberg, M., Peng, T., Sridharan, S., Feldman, P. (2013). Can the Care Transitions Measure predict re-hospitalization risk or home health nursing use of home healthcare patients? Journal for Healthcare Quality. 35(5):32-40. Wilde, M.H., Zhang, F., Fairbanks, E., Shah, S., McDonald, M.V., & Brasch, J. (2013). Perceived value of a urinary catheter self-management program in the home. Home Healthcare Nurse, 31(9):465-473. Wilde, MH, McDonald, MV, Brasch, J, McMahon, JM, Fairbanks, E, Shah, S, Tang, W, Scheid, E. (2013). Long-term urinary catheter users self-care practices and problems. J Clin Nurs. 22(3-4):356–367. Peer Reviewed Publications by VNSNY Clinical Staff with CHCPR Support Cutrino, A. & Santamaria, J. (2013). Research on family caregivers – understanding levels of burden and how to provide assistance. Home Healthcare Nurse, 31(6):331-337. Zaldivar, A. & Bohnarczyk, N. (2013). New Approaches to Delivering Primary and Preventive Care to the Older Population. Home Healthcare Nurse, 31(4):219-25.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 19 of 33

2012 Oberlink, M. (2012). Online surveys engage older adults in community planning. In Blanchard, J.M. & Anthony, B. (Eds.) Aging in Community. Chapel Hill, NC: Second Journey Publications. Rosati, R.J. (2012). Information Management in Pelletier, L.R. & Beaudin, C.L. (Eds.), Q solutions: Essential resources for the healthcare quality professional. Glenview, IL: National Association of Healthcare Quality. Rosenfeld, P., Pyc, L., Rosati, R.J., Marren, J.M. (2012). Developing a Competency Tool for Home Health Care Nurse Managers. Home Health Care Management & Practice, 24(1):5-12. Rosenfeld, P., Russell, D. (2012). A Review of Factors Influencing Utilization of Home and Community-Based Long-Term Care: Trends and Implications to the Nursing Workforce. Policy, Politics & Nursing Practice, 13(2):72-80. DOI 10.1177/1527154412449747. Russell, D., Rosati, R., Andreopoulos, E. (2012). Continuity in the Provider of Home-Based Physical Therapy Services and Its Implications for Outcomes of Patients. Physical Therapy 92(2):227-235. Ryvicker, M., Gallo, W., Fahs, M. (2012). Environmental factors associated with primary care access among urban older adults. Social Science & Medicine, 75(5):914-921. Ryvicker, M., Peng, T., Feldman, P. (2012). Patient activation and disparate healthcare outcomes in a racially diverse sample of chronically ill older adults. Journal of Health Care for the Poor and Underserved. 23(4):1577-1589. Peer Reviewed Publications by VNSNY Clinical Staff with CHCPR Support Beck, C. & Chopra, S. (2012). Research on Health Related Quality of Life and Cardiac Conditions. Home Healthcare Nurse, 30(1):54-60. Dorrejo, X. & Wilson, P. (2012). Research on Culturally Tailored Interventions Aimed at Improving Chronic Disease Risk Factors and Management. Home Healthcare Nurse, 30(9):560-566. Lugo, M. & Hamilton, T. (2012). Research in Advancing Pediatric Palliative Care. Home Healthcare Nurse, 30(2):126-131.

2011 Gerber, L.M., Barrón, Y., Mongoven, J., McDonald, M., Henriquez, E., Andreopoulos, E., & Feldman, P.H. (2011). Activation among chronically-ill older adults with complex medical needs: Challenges to supporting effective self-management. Journal of Ambulatory Care Management. 34(3):292-303. King, L. & Galuppo, J.M. (2011). Research on diabetes: Prioritization, quality of life, medication adherence, and self-efficacy. Home Healthcare Nurse, 29(5):320-325. Murtaugh, C., Spillman, B., & Wang, X. (2011). Lifetime risk and duration of chronic disease and disability. The Journal of Aging and Health. 23(3):554-577.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 20 of 33

Pezzin, L.E., Feldman, P.F., Mongoven, J.M., McDonald, M.V., Gerber, L.M., & Peng, T.R. (2011). Improving blood pressure control: Results of home-based post-acute care interventions. Journal of General Internal Medicine. 26(3):280-286. Rosenfeld, P., Pyc, L., Rosati, R., Marren, J. (2011). Developing a Competency Tool for Home Health Care Nurse Managers. Home Health Care Management & Practice. 24(1): 5-12. Russell, D., Rosati, R.J., Marren, J.M., & Rosenfeld, P. (2011). Implementing a transitional care program for high-risk heart failure patients: Findings from a community-based partnership between a certified home healthcare agency and a regional hospital. Journal for Healthcare Quality. 33(6):17-23. Russell, D., Rosati, R.J., Rosenfeld, P., & Marren, J. (2011). Continuity in home health care: Is consistency in nursing personnel associated with better patient outcomes? Journal for Healthcare Quality. 33(6):33-39. Ryvicker, M. (2011). Staff-resident interaction in the nursing home: An ethnographic study of socio-economic disparities and community contexts. Journal of Aging Studies. 25(3):295-304. Ryvicker, M., Feldman, P. H., Rosati, R. J., Sobolewski, S., Maduro, G. A. and Schwartz, T. (2011). Improving Functional Outcomes in Home Care Patients: Impact and Challenges of Disseminating a Quality Improvement Initiative. Journal for Healthcare Quality. 33(5): 28–36. doi: 10.1111/j.1945-1474.2011.00156.x. Shao, H., Peng, T.R., Bruce, M.L. & Bao, Y. (2011). Diagnosed depression among Medicare home health patients: National prevalence estimates and key characteristics. Psychiatric Services. 62(5):538-540. Silver, G., Keefer, J., & Rosenfeld, P. (2011) Assisting Patients to Age in Place: An Innovative Pilot Program Utilizing the Patent Centered Care Model (PCCM) in Home Care. Home Health Care Management & Practice July 28, 2011 1084822311411657. Trachtenberg, M. & Ryvicker, M. (2011). Research on transitional care: from hospital to home. Home Healthcare Nurse, 29(10):645-651. Peer Reviewed Publications by VNSNY Clinical Staff with CHCPR Support Mandel, M. & Savoy, E. (2011). Research on supporting patients and family caregivers with palliative and end of life care. Home Healthcare Nurse, 29(3):148-154. McTernan, S.E. & Meiri, H. (2011). Research on childhood obesity prevention and intervention. Home Healthcare Nurse, 29(2):118-123.

2010 Pezzin, L. E., Feldman, P., Mongoven, J. M., McDonald, M., Gerber, L. M., & Peng, T. (2010). Improving Blood Pressure Control: Results of home-based Post-acute Care Interventions. J Gen Intern Med, 26(3), 280-286. Rosenfeld, P., Chaya, J., Lewis-Holman, S., & Davin, D. (2010). Can an ADN Internship Program Prepare New RNs for Careers in Home Health Care Nursing? Findings from an Evaluation Study at Visiting Nurse Service of New York. Home Health Care Management & Practice, 22(4), 254-261.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 21 of 33

Russell, D., Rosenfeld, P., Ames, S., & Rosati, R. J. (2010). Using technology to enhance the quality of home health care: three case studies of health information technology initiatives at the Visiting Nurse Service of New York. J Healthc Qual, 32(5), 22-29. Ryvicker, M. (2010). Staff-resident interaction in the nursing home: An ethnographic study of socio-economic disparities and community contexts. Journal of Aging Studies. Slavov, I. (2010). Dose-response analysis using generalized propensity score: An application in home health care. Alexandria, VA: American Statistical Association. Document Number _ Vladeck, F., Segel, R., Oberlink, M., Gursen, M., & Rudin, D. (2010). Health Indicators: A Proactive and Systematic Approach to Healthy Aging. Cityscape, 12(2), 67-84.

2009 CHAMP. (2009). Care Coordination, Management, and Transitions (Series C, Report 2). New York: VNSNY Center for Home Care Policy and Research. Retrieved on February 22, 2010 http://www.champ-program.org/page/68/evidence-briefs. CHAMP. (2009). Chronic Pain Management (Series C, Report 6). New York: VNSNY Center for Home Care Policy and Research. Retrieved on February 22, 2010 http://www.champ-program.org/page/68/evidence-briefs. CHAMP. (2009). Cognitive Function (Series C, Report 4). New York: VNSNY Center for Home Care Policy and Research. Retrieved on February 22, 2010 http://www.champ-program.org/page/68/evidence-briefs. CHAMP. (2009). Framework for Geriatric Home Health Care (Series C, Report 1). New York: VNSNY Center for Home Care Policy and Research. Retrieved on February 22, 2010 http://www.champ-program.org/page/68/evidence-briefs. CHAMP. (2009). Medication Management (Series C, Report 3) New York: VNSNY Center for Home Care Policy and Research. Retrieved on February 22, 2010 http://www.champ-program.org/page/68/evidence-briefs. CHAMP. (2009). Palliative Care and Advanced Illness Management (Series C, Report 7). New York: VNSNY Center for Home Care Policy and Research. Retrieved on February 22, 2010 http://www.champ-program.org/page/68/evidence-briefs. CHAMP. (2009). Physical Function (Series C, Report 5). New York: VNSNY Center for Home Care Policy and Research. Retrieved on February 22, 2010 http://www.champ-program.org/page/68/evidence-briefs. Feldman, P. H., McDonald, M. V., Mongoven, J. M., Peng, T. R., Gerber, L. M., & Pezzin, L. E. (2009). Home-based blood pressure interventions for blacks. Circ Cardiovasc Qual Outcomes, 2(3), 241-248. McDonald, M. V., Pezzin, L. E., Peng, T. R., & Feldman, P. H. (2009). Understanding the complexity of hypertensive African American home care patients: challenges to intervention. Ethn Dis, 19(2), 148-153. Murtaugh, C., Peng, T., Totten, A., Costello, B., Moore, S., & Aykan, H. (2009). Complexity in geriatric home healthcare. J Healthc Qual, 31(2), 34-43.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 22 of 33

Naik, D., Totten, A., & Feldman, P. H. (2009). Promoting excellence in geriatric home care: proceedings and findings from a national conference. Caring, 28(4), 32-36. Naylor, M. D., Feldman, P. H., Keating, S., Koren, M. J., Kurtzman, E. T., Maccoy, M. C., et al. (2009). Translating research into practice: transitional care for older adults. J Eval Clin Pract, 15(6), 1164-1170. Oberlink, M., & Stafford, P. B. (2009). The Indiana AdvantAge Initiative: Measuring Community Elder-Friendliness and Planning for the Future. Journal for the American Society on Aging, 33(2), 91-94. Roane, D., Danik, K., & Oberlink, M. (2009). Evaluation of a community-based geriatric mental health program. World Psychiatry, 8:Supplement(1), 275. Rosati, R. J. (2009). Evaluation of remote monitoring in home health care. In: E.C. Conley, C. Doarn & A. Hajjam-El-Hassani (Eds.) Proceedings of the International Conference on eHealth, Telemedicine and Social Medicine, eTELEMED 2009 (pp. 151 - 153). Los Alamitos, CA: IEEE Computer Society. Rosati, R. J. (2009). The history of quality measurement in home health care. Clin Geriatr Med, 25(1), 121-134, vii-viii. Rosati, R. J. (2009). Home healthcare quality. J Healthc Qual, 31(2), 3-4. Rosati, R. J., Marren, J. M., Davin, D. M., & Morgan, C. J. (2009). The linkage between employee and patient satisfaction in home healthcare. J Healthc Qual, 31(2), 44-53. Ryvicker, M. (2009). Preservation of self in the nursing home: Contradictory practices within two models of care. Journal of Aging Studies, 23(1), 12-23.

2008 Chaya, J., Reilly, M., Moriarity, M., Davin, D., Nero-Reid, V., & Rosenfeld, P. (2008). Preparing Newly Licensed Associate Degree Nurses to Work in Home Health Care. Home Health Care Management and Practice, 21(1), 44-53. McDonald, M. V., King, L. J., Moodie, M., & Feldman, P. H. (2008). Exploring diabetic care deficiencies and adverse events in home healthcare. J Healthc Qual, 30(6), 5-12. McDonald, M. V., & Peterson, L. E. (2008). Finding Success in Medication Management. Home Health Care Management & Practice, 20(2), 135-140. McGuire, A., Newman, A., & McTernan, S. E. (2008). Recent Research in Pediatrics: Implications for Home Health Nursing. Research Brief. Home Healthcare Nurse, 26(2), 91-95. Oberlink, M. (2008). Opportunities for Creating Livable Communities. AARP Public Policy Institute. Rosenfeld, P., & Adams, R. E. (2008). Factors associated with hospital retention of RNs in the New York City Metropolitan Area: an analysis of the 1996, 2000, and 2004 National Sample Survey of Registered Nurses. Policy Polit Nurs Pract, 9(3), 158-172.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 23 of 33

Rosenfeld, P., Taylor, E., Liu, C., & Volland, P. (2008). Articulating the Evidence Base for Effective Social Work Practices with the Elderly: Building the Case for a Geriatric Social Work Policy Agenda. Social Work and Public Health, 23(6), 23-38. Ryvicker, M., Marren, J., Sobolewski, S., Acampora, T., Flannery, M., Buff, E., et al. (2008). Spreading improvement strategies within a large home healthcare organization. J Healthc Qual, 30(2), 48-58.

2007 Boyce, P. S., & Feldman, P. (2007). ReACH National Demonstration Collaborative: Early Results of Implementation. Home Health Care Serv Q, 26(4), 105-120. Edwards, J. C., Feldman, P. H., Sangl, J., Polakoff, D., Stern, G., & Casey, D. (2007). Sustainability of partnership projects: a conceptual framework and checklist. Jt Comm J Qual Patient Saf, 33(12 Suppl), 37-47. Feldman, P., Ryvicker, M., Rosati, R., Schwartz, T., & Maduro, G. (2007). HHA Partnering Collaborative Evaluation: Practice/Policy Brief: Prepared for the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. Feldman, P. H., Bridges, J., & Peng, T. (2007). Team structure and adverse events in home health care. Med Care, 45(6), 553-561. Feldman, P. H., Nadash, P., & Gursen, M. D. (2007). Long-term Care. In A. R. Kovner & J. R. Knickman (Eds.), Jonas and Kovner's Health Care Delivery in the United States (9th ed.). New York: Springer Publishing Company. Foust, J. B. (2007). Discharge planning as part of daily nursing practice. Appl Nurs Res, 20(2), 72-77. Lawrence, F. P., Damron-Rodriguez, J., Rosenfeld, P., Sisco, S., & Volland, P. (2007). Strengthening Field Education in Aging through University-Community Agency Partnership: The Practicum Partnership Program. Journal of Gerontological Social Work, 50(1/2), 135-154. Murtaugh, C. M., Peng, T., Aykan, H., & Maduro, G. (2007). Risk adjustment and public reporting on home health care. Health Care Financ Rev, 28(3), 77-94. Nash, D., Andreopoulos, E., Horowitz, D., Sohler, N., & Vlahov, D. (2007). Differences among U.S. states in estimating the number of people living with HIV/AIDS: impact on allocation of federal Ryan White funding. Public Health Rep, 122(5), 644-656. Oberlink, M. (2007). Active Living for Older Adults: Using Survey Information to Make Neighborhoods Walkable and Safe. Smart Growth Online, 1-4. Oberlink, M. (2007). Issues in Creating Livable Communities for People with Disabilities: Proceedings of the Panel. National Council on Disability, 1-26. Prince, G. J., & McDonald, M. V. (2007). Research on changing practitioner and patient behavior. Home Healthc Nurse, 25(2), 89-93.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 24 of 33

Rosati, R. J., & Huang, L. (2007). Development and testing of an analytic model to identify home healthcare patients at risk for a hospitalization within the first 60 days of care. Home Health Care Serv Q, 26(4), 21-36. Rosenfeld, P. (2007). Workplace practices for retaining older hospital nurses: implications from a study of nurses with eldercare responsibilities. Policy Polit Nurs Pract, 8(2), 120-129. Rosenfeld, P., Dennis, J., Hanen, S., Henriquez, E., Schwartz, T. M., Correoso, L., et al. (2007). Are there racial differences in attitudes toward hospice care? A study of hospice-eligible patients at the Visiting Nurse Service of New York. Am J Hosp Palliat Care, 24(5), 408-416. Siegler, E. L., Murtaugh, C. M., Rosati, R. J., Schwartz, T., Razzano, R., Sobolewski, S., et al. (2007). Improving Communication at the Transition to Home Health Care: Use of an Electronic Referral System. Home Health Care Management & Practice, 19(4), 267-271. Sobolewski, S., & Foust, J. B. (2007). Research on Self-Management Support. Research Brief. Home Healthcare Nurse, 25(6), 358-361. Weiss, L., Gany, F., Rosenfeld, P., Carrasquillo, O., Sharif, I., Behar, E., et al. (2007). Access to multilingual medication instructions at New York City pharmacies. J Urban Health, 84(6), 742-754.

2006 Feldman, P. H., Clark, A., & Bruno, L. (2006). Advancing the agenda for home healthcare quality: conference proceedings and findings. Home Healthc Nurse, 24(5), 282-289. Feldman, P. H., & McDonald, M. (2006). Clinical Guidelines and Recent Research on Hypertension and Heart Failure. Home Healthc Nurse, 24(1), 50-53. Feldman, P. H., McDonald, M., Rosati, R. J., Murtaugh, C., Kovner, C., Goldberg, J. D., et al. (2006). Exploring the utility of automated drug alerts in home healthcare. J Healthc Qual, 28(1), 29-40. Grabowski, D. C., & Ahrens, J. (2006). The cost-effectiveness of home- and community-based long-term care services: Review and synthesis of the most recent evidence (Policy Brief No. 25). New York: The Center for Home Care Policy and Research, Visiting Nurse Service of New York. Gray, B. H., Scheinmann, R., Rosenfeld, P., & Finkelstein, R. (2006). Aging without Medicare? Evidence from New York City. Inquiry, 43(3), 211-221. Oberlink, M. (2006). Livable Communities for Adults with Disabilities. Center for Home Care Policy & Research Policy Brief, 29, 1-6. Rosati, R. (2006). Focusing on Home Healthcare Quality. Journal for Healthcare Quality, 28(1), 54-55. Rudin, D. (2006). Home health care quality conferences: Promoting change through dialogue (Policy Brief No. 28). New York: The Center for Home Care Policy and Research, Visiting Nurse Service of New York.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 25 of 33

Scharpf, T. P., Colabianchi, N., Madigan, E. A., Neuhauser, D., Peng, T., Feldman, P. H., et al. (2006). Functional status decline as a measure of adverse events in home health care: an observational study. BMC Health Serv Res, 6, 162. Siegler, E. L., Murtaugh, C. M., Rosati, R. J., Clark, A., Ruchlin, H. S., Sobolewski, S., et al. (2006). Improving the transition to home healthcare by rethinking the purpose and structure of the CMS 485: first steps. Home Health Care Serv Q, 25(3-4), 27-38. Stewart, K. (2006). Perspectives on the recent decline in disability at older ages (Policy Brief No. 27). New York: The Center for Home Care Policy and Research, Visiting Nurse Service of New York. Wilson, P., & Rodgers, B. (2006). Research on falls prevention and physical activity in older adults and a notice of a new web-based quality system by the Agency for Healthcare Research and Quality. Home Healthcare Nurse, 24(10), 632-636.

2005 Ahrens, J. (2005). Homes of choice: Towards more effective linkages between housing and services: (Policy Brief No. 24). New York: The Center for Home Care Policy and Research, Visiting Nurse Service of New York. Ahrens, J. (2005). The impact of Medicare home health policy changes on Medicare beneficiaries: part II. Policy Brief (Cent Home Care Policy Res Policy Brief No. 19), 1-6. Ahrens, J. (2005). The need for evidence-based guidelines in home care. Home Healthc Nurse, 23(3), 147-149. Ahrens, J. (2005). The positive impact of hospice care on the surviving spouse. Home Healthc Nurse, 23(1), 53-55. Ahrens, J. (2005). Public funding for long-term care services for older people in residential care settings. Policy Brief (Cent Home Care Policy Res)(23), 1-5. Ahrens, J., & Murtaugh, C. (2005). Creating more choices for older adults: financing LTC through an integrated income and disability annuity. Policy Brief (Cent Home Care Policy Res)(21), 1-4. Bruno, L., & Ahrens, J. (2005). Examining "operational failures" to reduce home care errors. Caring, 24(2), 34-35, 37, 39. Byers, J. F., & Rosati, R. J. (2005). Module One: Foundation, Techniques and Tools. In L. R. Pelletier & C. L. Beaudin (Eds.), Q Solutions: Essential Resources for the Healthcare Quality Professional (Vol. 27). Glenview, IL: National Association for Healthcare Quality. Byers, J. F., & Rosati, R. J. (2005). Research provides the MEAT for quality improvement. J Healthc Qual, 27(4), 2. Clark, A. (2005). Improving the delivery of care for diabetes patients with a collaborative model. Home Healthc Nurse, 23(3), 177-182.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 26 of 33

Clark, A. (2005). Measuring quality of care nationwide. Caring, 24(3), 42-45. Feldman, P. H., & Ahrens, J. (2005). Linking Housing and Long-Term Care Services for Older Adults. Center for Home Care Policy & Research Summary Report, 1-17. Feldman, P. H., Murtaugh, C. M., Pezzin, L. E., McDonald, M. V., & Peng, T. R. (2005). Just-in-time evidence-based e-mail "reminders" in home health care: impact on patient outcomes. Health Serv Res, 40(3), 865-885. Feldman, P. H., Nadash, P., & Gursen, M. D. (2005). Long-term Care. In A. R. Kovner & J. R. Knickman (Eds.), Jonas and Kovner's Health Care Delivery in the United States (8th ed.). New York: Springer Publishing Company. Kinatukara, S., Rosati, R. J., & Huang, L. (2005). Assessment of OASIS reliability and validity using several methodological approaches. Home Health Care Serv Q, 24(3), 23-38. King, L., & Ahrens, J. (2005). Toward Creating an Informatics Infrastructure in Home Health Care. Caring, 24(1), 12-18. McDonald, M. V., Pezzin, L. E., Feldman, P. H., Murtaugh, C. M., & Peng, T. R. (2005). Can just-in-time, evidence-based "reminders" improve pain management among home health care nurses and their patients? J Pain Symptom Manage, 29(5), 474-488. Murtaugh, C. M., Pezzin, L. E., McDonald, M. V., Feldman, P. H., & Peng, T. R. (2005). Just-in-time evidence-based e-mail "reminders" in home health care: impact on nurse practices. Health Serv Res, 40(3), 849-864. Nadash, P., & Ahrens, J. (2005). Long-term care: an overview. Policy Brief (Cent Home Care Policy Res)(22), 1-9. Nadash, P., & Ahrens, J. (2005). Managed care and long-term care: a potential solution? Policy Brief (Cent Home Care Policy Res)(20), 1-6. Nadash, P., & Ahrens, J. (2005). Strategies to support HCBS. Policy Brief (Cent Home Care Policy Res)(26), 1-6. Neder, S., Rosati, R., & Huang, L. (2005). Assessment of OASIS inter-rater reliability and validity using several methodological approaches. Home Healthcare Services Quarterly, 24(3), 23-38. Pynoos, J., Feldman, P. H., & Ahrens, J. (2005). Linking housing and services for older adults: Obstacles, options, and opportunities. In. Binghamton, NY: The Haworth Press, Inc. Rosenfeld, P. (2005). Women in green: The contributions of Hadassah nursing to immigrant and refugee health in pre-state and the early years of the state of Israel. Nurs Hist Rev, 13, 101-119. Rosenfeld, P., Kim, H., Londono, G., Kovner, C., & Mezey, M. (2005). Adult ambulatory care visits to nurses and physicians: methodological limitations of the medical expenditure panel survey data. Policy Polit Nurs Pract, 6(3), 221-228.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 27 of 33

Stone, P. W., Harrison, M. I., Feldman, P., Linzer, M., Peng, T., Roblin, D., et al. (2005). Advances in patient safety: From research to implementation. Volumes 1-4, AHRQ Publication Nos. 050021 (1-4) Rockville, MD: Agency for Healthcare Research and Quality. Stone, P. W., Harrison, M. I., Feldman, P., Linzer, M., Peng, T., Roblin, D., et al. (2005). Organizational Climate of Staff Working Conditions and Safety - An Integrative Model. Advances in Patient Safety, 2, 467-481.

2004 Ahrens, J. (2004). Home care payment changes in a post-BBA world. Caring, 23(4), 40-44. Ahrens, J. (2004). Italian study concludes "home hospitalization" benefits stroke patients. Caring, 23(8), 40-42; quiz 44-45. Clark, A., & Nadash, P. (2004). The effectiveness of a nurse-led transitional care model for patients with congestive heart failure. Home Healthc Nurse, 22(3), 160-162. Feldman, P. (2004). Interview with a quality leader: Penny Feldman on home healthcare quality and research. Journal for Healthcare Quality, 26(3), 31-37. Feldman, P. (2004). Penny Feldman on home healthcare quality and research. Interview by Susan V. White. J Healthc Qual, 26(3), 31-37. Feldman, P. H. (2004). Improving care for older people in the home health care setting: Challenges for practice, education and policy. National Advisory Council on Nurse Education and Practice; Fourth Report to the Secretary of Health & Human Services and the Congress. Feldman, P. H., & Ahrens, J. (Fall 2004). Leveraging resources for home- and community-based services in a time of fiscal retrenchment. Conference Report: New York: Center for Home Care Policy and Research, Visiting Nurse Service of New York. Feldman, P. H., & McDonald, M. V. (2004). Conducting translation research in the home care setting: lessons from a just-in-time reminder study. Worldviews Evid Based Nurs, 1(1), 49-59. Feldman, P. H., Oberlink, M. R., Simantov, E., & Gursen, M. D. (2004). A tale of two older Americas: Community opportunities and challenges. The AdvantAge Initiative 2003 National Survey of Adults Aged 65 and Older: New York: The Center for Home Care Policy and Research, Visiting Nurse Service of New York. Feldman, P. H., Peng, T. R., Murtaugh, C. M., Kelleher, C., Donelson, S. M., McCann, M. E., et al. (2004). A randomized intervention to improve heart failure outcomes in community-based home health care. Home Health Care Serv Q, 23(1), 1-23. Feldman, P. H., Peterson, L. E., Reische, L., Bruno, L., & Clark, A. (2004). Charting the course for home health care quality: action steps for achieving sustainable improvement: conference proceedings. Home Healthc Nurse, 22(12), 841-850.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 28 of 33

Gursen, M. D., & Ahrens, J. (2004). The key to a new home care protocol: prospective visits. Caring, 23(1), 40-44. Keepnews, D., Capitman, J. A., & Rosati, R. J. (2004). Measuring patient-level clinical outcomes of home health care. J Nurs Scholarsh, 36(1), 79-85. Nadash, P. (2004). Two models of managed long-term care: comparing PACE with a Medicaid-only plan. Gerontologist, 44(5), 644-654. Nadash, P., & Ahrens, J. (2004). Bringing managed care home to the long-term care population. Policy Brief (Cent Home Care Policy Res)(18), 1-6. National Council on Disability. (2004). Livable Communities for Adults with Disabilities. Washington, DC: A report prepared by M. Oberlink, M. Gursen, E. Simantov, & P.H. Feldman for the National Council on Disability, Document Number) Navaie-Waliser, M., Lincoln, P., Karuturi, M., & Reisch, K. (2004). Increasing job satisfaction, quality care, and coordination in home health. J Nurs Adm, 34(2), 88-92. Navaie-Waliser, M., Mersman, C., & Lincoln, P. (2004). Implementing a pediatric asthma program: enabling self-care management through education. Home Healthc Nurse, 22(9), 633-639. Navaie-Waliser, M., Misener, M., Mersman, C., & Lincoln, P. (2004). Evaluating the needs of children with asthma in home care: the vital role of nurses as caregivers and educators. Public Health Nurs, 21(4), 306-315. Oberlink, M., Gursen, M., Simantov, E., & Feldman, P. H. (2004). Livable communities for adults with disabilities. Washington, DC: National Council on Disability. Rosenfeld, P., Kobayashi, M., Barber, P., & Mezey, M. (2004). Utilization of nurse practitioners in long-term care: findings and implications of a national survey. J Am Med Dir Assoc, 5(1), 9-15. Rosenfeld, P., Smith, M. O., Iervolino, L., & Bowar-Ferres, S. (2004). Nurse residency program: a 5-year evaluation from the participants' perspective. J Nurs Adm, 34(4), 188-194. Simantov, E., & Oberlink, M. (2004). The great information divide: Where do older adults turn for help? Fact Sheet. New York: Center for Home Care Policy and Research, Visiting Nurse Service of New York. Accessible: http://www.vnsny.org/advantage/fact/AI_FS_Services.pdf. Simantov, E., & Oberlink, M. (2004). Housing cost burden casts a shadow over older people's future. Fact Sheet. New York: Center for Home Care Policy and Research, Visiting Nurse Service of New York. Accessible: http://www.vnsny.org/advantage/fact/AI_FS_Housing.pdf. Simantov, E., & Oberlink, M. (2004). Staying healthy, living longer: Gaps in preventive care among older adults. Fact Sheet. New York: Center for Home Care Policy and Research, Visiting Nurse Service of New York. Accessible: http://www.vnsny.org/advantage/fact/AI_FS_Care.pdf. Simantov, E., & Oberlink, M. (2004). When older adults are involved in the community, the benefits are mutual. Fact Sheet. New York: Center for Home Care Policy and Research, Visiting Nurse Service of New York. Accessible: http://www.vnsny.org/advantage/fact/AI_FS_Involvement.pdf.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 29 of 33

Vetter, M. J., Bristow, L., & Ahrens, J. (2004). A model for home care clinician and home health aide collaboration: diabetes care by nurse case managers and community health workers. Home Healthc Nurse, 22(9), 645-648.

2003 Feldman, P., & Oberlink, M. (2003). The Advantage Initiative: Developing community indicators to promote the heath and well-being of older people. Family and Community Health Journal, 26(4), 268-274. Feldman, P. H. (2003). From philosophy to practice: selected issues in financing and coordinating long-term care. J Aging Health, 15(1), 5-14. Feldman, P. H. (Summer 2003). Review: No place like home: A history of nursing and home care in the United States. Contemporary Gerontology, 9(3). Feldman, P. H., & Kane, R. L. (2003). Strengthening research to improve the practice and management of long-term care. Milbank Q, 81(2), 179-220, 171. Feldman, P. H., Oberlink, M., Rudin, D., Clay, J., Edwards, B., & Stafford, P. B. (2003). Best practices: Lessons for communities in supporting the health, well-being, and independence of older people. AdvantAge Initiative Website. Feldman, P. H., & Oberlink, M. R. (2003). Developing community indicators to promote the health and well-being of older people. Fam Community Health, 26(4), 268-274. McDonald, M., & Nadash, P. (2003). Effective health care: Integrating research into practice. Caring, 22(7), 52-55. Murtaugh, C. M., McCall, N., Moore, S., & Meadow, A. (2003). Trends in Medicare home health care use: 1997-2001. Health Aff (Millwood), 22(5), 146-156. Nadash, P. (2003). Adult day centers: everything you wanted to know but were afraid to ask! Caring, 22(8), 6-8. Nadash, P. (2003). Helping patients avoid repeat hospital admissions. Caring, 22(5), 52-54. Nadash, P., & Feldman, P. H. (2003). The effectiveness of a "restorative" model of care for home care patients. Home Healthc Nurse, 21(6), 421-423. Neder, S., & Nadash, P. (2003). Individualized education can improve foot care for patients with diabetes. Home Healthc Nurse, 21(12), 837-840. Peng, T. R., Navaie-Waliser, M., & Feldman, P. H. (2003). Social support, home health service use, and outcomes among four racial-ethnic groups. Gerontologist, 43(4), 503-513. Rosati, R. (2003). Creating quality improvement projects. In E. L. Siegler, S. Mirafzali & J. B. Foust (Eds.), A Guide to Hospitals and Inpatient Care. New York: Springer Publishing.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 30 of 33

Rosati, R. J., Huang, L., Navaie-Waliser, M., & Feldman, P. H. (2003). Risk factors for repeated hospitalizations among home healthcare recipients. J Healthc Qual, 25(2), 4-10; quiz 10-11. Schoen, C., Simantov, E., Gross, R., Brammli, S., & Leiman, J. (2003). Disparities in women's health and health care experiences in the United States and Israel: findings from 1998 National Women's Health Surveys. Women Health, 37(1), 49-70. Spillman, B. C., Murtaugh, C. M., & Warshawsky, M. J. (2003). Policy implications of an annuity approach to integrating long-term care financing and retirement income. J Aging Health, 15(1), 45-73.

2002 Ahrens, J., Feldman, P. H., & Frey, D. (2002). Preventing medication errors in home care. Policy Brief (Cent Home Care Policy Res)(12), 1-6. Donelan, K., Hill, C. A., Hoffman, C., Scoles, K., Feldman, P. H., Levine, C., et al. (2002). Challenged to care: informal caregivers in a changing health system. Health Aff (Millwood), 21(4), 222-231. Feldman, P., Nadash, P., & Gursen, M. D. (2002). Long-term Care. In A. R. Kovner & J. S. (Eds.), Jonas and Kovner's Health Care Delivery in the United States (7th ed.). New York: Springer Publishing Company. Lee, J. S., & Peng, T. (2002). A profile of Asian/Pacific Islander elders in home health care. Journal of Gerontological Social Work, 36(1/2), 171-185. Meredith, S., Feldman, P., Frey, D., Giammarco, L., Hall, K., Arnold, K., et al. (2002). Improving medication use in newly admitted home healthcare patients: a randomized controlled trial. J Am Geriatr Soc, 50(9), 1484-1491. Murtaugh, C. M., & Litke, A. (2002). Transitions through postacute and long-term care settings: patterns of use and outcomes for a national cohort of elders. Med Care, 40(3), 227-236. Nadash, P. (2002). New York State's Medicaid-only managed long-term care program. New York: The Center for Home Care Policy and Research. Navaie-Waliser, M., Feldman, P. H., Gould, D. A., Levine, C., Kuerbis, A. N., & Donelan, K. (2002). When the caregiver needs care: the plight of vulnerable caregivers. Am J Public Health, 92(3), 409-413. Navaie-Waliser, M., Spriggs, A., & Feldman, P. H. (2002). Informal caregiving: differential experiences by gender. Med Care, 40(12), 1249-1259. Peng, T. R., Navaie-Waliser, M., & Feldman, P. H. (2002). Social support, service use, and health outcomes among elders in home health care: Similarities and disparities by race/ethnicity. The Gerontologist, 43(4). Siegler, E. L., Del Monte, M. L., Rosati, R. J., & von Gunten, C. F. (2002). What role should the nephrologist play in the provision of palliative care? J Palliat Med, 5(5), 759-762.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 31 of 33

2001 Donelson, S., Murtaugh, C., & Feldman, P., et al. (March 2001). Clarifying the definition of homebound and medical necessity using OASIS data. Final Report prepared for the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services (Contract #HHS-100-99-0020). New York, NY: Center for Home Care Policy & Research, Visiting Nurse Service of NY. Feldman, P. H., Nadash, P., & Gursen, M. (2001). Improving communication between researchers and policy makers in long-term care: or, researchers are from Mars; policy makers are from Venus. Gerontologist, 41(3), 312-321. Meredith, S., Feldman, P. H., Frey, D., Hall, K., Arnold, K., Brown, N. J., et al. (2001). Possible medication errors in home healthcare patients. J Am Geriatr Soc, 49(6), 719-724. Murtaugh, C., Spillman, B. C., & Warshawsky, M. J. (2001). In sickness and in health: An annuity approach to financing long-term care and retirement income. The Journal of Risk and Insurance, 68(2), 225-253. Navaie-Waliser, M., Feldman, P. H., Gould, D. A., Levine, C., Kuerbis, A. N., & Donelan, K. (2001). The experiences and challenges of informal caregivers: common themes and differences among whites, blacks, and hispanics. Gerontologist, 41(6), 733-741.

2000 Davidson, H., Schluger, N. W., Feldman, P. H., Valentine, D. P., Telzak, E. E., & Laufer, F. N. (2000). The effects of increasing incentives on adherence to tuberculosis directly observed therapy. Int J Tuberc Lung Dis, 4(9), 860-865. Donelson, S. M. (2000). What gets measured gets done. Rehab Manag, 13(1), 54-56. Donelson, S. M., & Feldman, P. H. (2000). How to determine if PPS will provide adequate resources for your population: one agency's experience. Home Healthc Nurse, 18(6), 363-369. Leach, C. W., Peng, T. R., & Volckens, J. (2000). Is racism dead? Comparing (expressive) means and (structural equation) models. Br J Soc Psychol, 39 ( Pt 3), 449-465. Levine, C., Kuerbis, A. N., Gould, D. A., Navaie-Waliser, M., Feldman, P. H., & Donelan, K. (2000). A survey of family caregivers in New York City: Findings and implications for the health care system. New York: The United Hospital Fund. Murtaugh, C., Stevenson, D., Feldman, P., & Oberlink, M. (Fall/Winter 2000). State expenditures on home and community-based care for disabled elders. Fact Sheet. New York, NY: Center for Home Care Policy and Research. Stevenson, D., Murtaugh, C., Feldman, P., & Oberlink, M. (Fall/Winter 2000). Expanding publicly financed assisted living and other residential alternatives for disabled older persons: Issues and options. Policy Brief. New York, NY: Center for Home Care Policy and Research.

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 32 of 33

Stevenson, D., Murtaugh, C., Feldman, P., & Oberlink, M. (Fall/Winter 2000). Expanding publicly financed managed long-term care programs to provide greater access to home and community-based care. Policy Brief. New York, NY: Center for Home Care Policy and Research. Warshawsky, M. J., Spillman, B. C., & Murtaugh, C. (2000). Integration of the life annuity and long-term care insurance: Theory, evidence, practice, and policy. Pension Research Council Working Paper Number 2000-11. Philadelphia, PA: The Wharton School, University of Pennsylvania.

1999 Butler, R., Grossman, L., & Oberlink, M. (1999). Life in an Older America. New York: The Century Foundation. Feldman, P. (1999). From post-acute to chronic care: Cost and policy implications of Medicare home health expansion. In P. Katz, R. Kane & M. Mezey (Eds.), Advances in Long-Term Care. Vol. IV. New York: Springer Publications. Feldman, P. (1999). Labor market issues in home-based care. In D. Fox & C. Raphael (Eds.), Home-Based Care for a New Century. Cambridge, MA: Blackwell Publishers. Feldman, P. H. (1999). "Doing more for less": advancing the conceptual underpinnings of home-based care. J Aging Health, 11(3), 261-276. Fulmer, T., Feldman, P., Kim, T. S., Carty, B., Beers, M., Molina, M., et al. (1999). An intervention study to enhance medication compliance in community-dwelling individuals. Journal of Gerontological Nursing, 25(8), 6-14. Gardner, E. N., Murtaugh, C. M., Ray, N. F., & Thamer, M. (1999). The cost of Medicaid-covered services provided to disabled adults with neurologic disorders: implications for managed care. Am J Manag Care, 5(11), 1417-1425. Murtaugh, C., Sparer, M., Feldman, P., & Lee, J. S., et al. (1999). State strategies for allocating resources to home and community-based care. Final report submitted to the Robert Wood Johnson Foundation.

1998 Feldman, P. (1998). Work force issues and quality of long-term care. Commissioned by the Committee on Improving Quality in Long-Term Care, Division of Health Care Services, Institute of Medicine as a background document for Wunderlich, G.S., and Kohler, P., Editors; Improving the quality of long-term care, National Academy Press, 2001. Gold, M., Feldman, P. & Heiser, N. (1998). Improving the use of data in health policymaking: Lessons from RWJF’s Information for State Health Policy Program. Washington, DC: Mathematica Policy Research, Inc.

1997

Peer-Reviewed & Other Publications

1993 – Present

(Alphabetic order by first author) Authors in bold are Research Center staff

Page 33 of 33

Feldman, P. (1997). State variations in Medicare expenditures. An editorial. American Journal of Public Health, 87(10), 1595-1596. Feldman, P., & Bishop, C. (1997). Medicare home health care services. Letter to the Editor. New England Journal of Medicine, 336(3), 226. Feldman, P., Donelson, S., & Gagen, D. (1997). Evaluating outcomes in the home care setting. Monitor, Medical Outcomes Trust, Boston, MA, 2(4), 14-16. Feldman, P., Latimer, E., & Davidson, H. (1997). Reply to Hornbrook on doing policy-relevant evaluation research. Health Serv Res, 32(1), 123-125. Feldman, P., & Murtaugh, C. (1997). Medicare home health payment reform. Letter to the Editor. Health Affairs, 16(2), 260-261. Feldman, P. H., Gold, M., & Chu, K. (1997). State health policy information: what worked? Health Aff (Millwood), 16(1), 207-210. Murtaugh, C. M., Kemper, P., Spillman, B. C., & Carlson, B. L. (1997). The amount, distribution, and timing of lifetime nursing home use. Med Care, 35(3), 204-218.

1996 Feldman, P. H., Latimer, E., & Davidson, H. (1996). Medicaid-funded home care for the frail elderly and disabled: evaluating the cost savings and outcomes of a service delivery reform. Health Serv Res, 31(4), 489-508.