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Article ; Online: Evidence on the Effects of the Federal COVID-19 Vaccine Mandate on Nursing Home Staffing Levels.

Plummer, Elizabeth / Wempe, William F

Journal of the American Medical Directors Association

2023 Volume 24, Issue 4, Page(s) 451–458

Abstract: Objective: To assess the federal COVID-19 vaccine mandate's effects on nursing homes' nurse aide and licensed nurse staffing levels in states both with and without state-level vaccine mandates.: Design: Cross-sectional study using data from Centers ... ...

Abstract	Objective: To assess the federal COVID-19 vaccine mandate's effects on nursing homes' nurse aide and licensed nurse staffing levels in states both with and without state-level vaccine mandates. Design: Cross-sectional study using data from Centers for Medicare and Medicaid Services, Centers for Disease Control and Prevention, and Economic Innovation Group. Including nursing home facility fixed effects provides evidence on the intertemporal effects of the federal vaccine mandate within nursing homes. Setting and participants: The sample contains 15,031 nursing homes, representing all US nursing homes with available data. Methods: On January 13, 2022, the US Supreme Court upheld the federal COVID-19 vaccine mandate for health care workers in Medicare- and Medicaid-eligible facilities, with workers generally required to be vaccinated by March 20, 2022 (ie, the compliance date). We examined actual nursing home staffing levels in 3 time periods: (1) pre-Court decision; (2) precompliance date; and (3) postcompliance date. We separately examined staffing levels for nurse aides and licensed nursing staff. Because 28% of nursing homes were in states with state-imposed vaccine mandates that predated the Supreme Court's ruling, we divided the sample into 2 groups (nursing homes in mandate states vs nonmandate states) and performed all analyses separately. Results: Staff vaccination rates and staffing levels were higher in mandate states than nonmandate states in all 3 time periods. After the Court's decision, staff vaccination rates increased 5% in nonmandate states and 1% in mandate states (on average). We find little evidence that the Court's vaccine mandate ruling materially affected nurse aide and licensed nurse staffing levels, or that nursing homes in mandate states and nonmandate states were differentially affected by the Court's ruling. Staffing levels over time were generally flat, with some evidence of a modestly greater increase for nurse aide staffing in mandate states than nonmandate states, and a modestly smaller decrease for licensed nurse staffing in mandate states than nonmandate states. Finally, regression results suggest that for both nurse aides and licensed nurses, staffing levels were lower in rural and for-profit nursing homes, and higher in Medicare-only, higher quality, and hospital-based nursing homes. Conclusions and implications: Results suggest the federal COVID-19 vaccine mandate has not caused clinically material changes in nursing home's nurse aide and licensed nurse staffing levels, which continue to be primarily associated with factors that are well-known to researchers and practitioners.
MeSH term(s)	Aged ; Humans ; United States ; COVID-19 Vaccines ; Cross-Sectional Studies ; COVID-19/prevention & control ; Medicare ; Personnel Staffing and Scheduling ; Nursing Homes ; Workforce
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2023-01-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2022.12.024
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 5971: Show issues

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Article ; Online: Nursing Home COVID Relief Under QIP's Performance-Based Formula: Does Performance Actually Matter, and Should It?

Plummer, Elizabeth / Wempe, William F

Medical care research and review : MCRR

2022 Volume 79, Issue 6, Page(s) 851–860

Abstract: The Quality Incentive Program (QIP) distributed US$2 billion to nursing homes (NHs) that met performance goals primarily related to their COVID-19 infection rates. We examine how QIP affected 15,331 NHs with different facility and community attributes, ... ...

Abstract	The Quality Incentive Program (QIP) distributed US$2 billion to nursing homes (NHs) that met performance goals primarily related to their COVID-19 infection rates. We examine how QIP affected 15,331 NHs with different facility and community attributes, and the extent to which QIP payments per resident-week (QIP$) were associated with NHs' COVID-related attributes. We find that QIP$ was primarily determined by county (not facility) infection rates. QIP distributed US$2 billion to NHs for months in which they experienced virtually no COVID-19 cases; US$0 was distributed for months in which they experienced more than 300,000 cases. We find that QIP$ was larger for smaller, nonprofit NHs located in more rural and economically distressed communities. Regression analyses reveal that recipients of larger QIP$ maintained greater supplies of personal protective equipment, conducted more staff testing, and limited admissions of infected residents, and that greater staff testing and limited admissions are also associated with NHs' sustained success in receiving QIP payments. Policymakers should consider whether performance-based payment systems are optimal for addressing public health emergencies.
MeSH term(s)	Humans ; United States ; COVID-19 ; Nursing Homes ; Skilled Nursing Facilities ; Hospitalization
Language	English
Publishing date	2022-06-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	1232314-7
ISSN	1552-6801 ; 1077-5587
ISSN (online)	1552-6801
ISSN	1077-5587
DOI	10.1177/10775587221096260
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Book: Manuscripts from the William S. Glazier collection

Plummer, John / Glazier, William S

1959

Institution	Pierpont Morgan Library
Author's details	comp. by John Plummer. [Pierpont Morgan Library]
Keywords	Illumination of books and manuscripts/Exhibitions
Language	English
Size	34 S., zahlr. Ill.
Publisher	Pierpont Morgan Library
Publishing place	New York, NY
Document type	Book
Note	37 Pl.
Database	Former special subject collection: coastal and deep sea fishing

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Article ; Online: Dental morphology in Homo habilis and its implications for the evolution of early Homo.

Davies, Thomas W / Gunz, Philipp / Spoor, Fred / Alemseged, Zeresenay / Gidna, Agness / Hublin, Jean-Jacques / Kimbel, William H / Kullmer, Ottmar / Plummer, William P / Zanolli, Clément / Skinner, Matthew M

Nature communications

2024 Volume 15, Issue 1, Page(s) 286

Abstract: The phylogenetic position of Homo habilis is central to debates over the origin and early evolution of the genus Homo. A large portion of the species hypodigm consists of dental remains, but they have only been studied at the often worn enamel surface. ... ...

Abstract	The phylogenetic position of Homo habilis is central to debates over the origin and early evolution of the genus Homo. A large portion of the species hypodigm consists of dental remains, but they have only been studied at the often worn enamel surface. We investigate the morphology of the H. habilis enamel-dentine junction (EDJ), which is preserved in cases of moderate tooth wear and known to carry a strong taxonomic signal. Geometric morphometrics is used to characterise dentine crown shape and size across the entire mandibular and maxillary tooth rows, compared with a broad comparative sample (n = 712). We find that EDJ morphology in H. habilis is for the most part remarkably primitive, supporting the hypothesis that the H. habilis hypodigm has more in common with Australopithecus than later Homo. Additionally, the chronologically younger specimen OH 16 displays a suite of derived features; its inclusion in H. habilis leads to excessive levels of variation.
MeSH term(s)	Animals ; Hominidae/anatomy & histology ; Phylogeny ; Fossils ; Mandible/anatomy & histology ; Biological Evolution
Language	English
Publishing date	2024-01-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-023-44375-9
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Article ; Online: Dental morphology in Homo habilis and its implications for the evolution of early Homo

Thomas W. Davies / Philipp Gunz / Fred Spoor / Zeresenay Alemseged / Agness Gidna / Jean-Jacques Hublin / William H. Kimbel / Ottmar Kullmer / William P. Plummer / Clément Zanolli / Matthew M. Skinner

Nature Communications, Vol 15, Iss 1, Pp 1-

2024 Volume 16

Abstract: Abstract The phylogenetic position of Homo habilis is central to debates over the origin and early evolution of the genus Homo. A large portion of the species hypodigm consists of dental remains, but they have only been studied at the often worn enamel ... ...

Abstract	Abstract The phylogenetic position of Homo habilis is central to debates over the origin and early evolution of the genus Homo. A large portion of the species hypodigm consists of dental remains, but they have only been studied at the often worn enamel surface. We investigate the morphology of the H. habilis enamel-dentine junction (EDJ), which is preserved in cases of moderate tooth wear and known to carry a strong taxonomic signal. Geometric morphometrics is used to characterise dentine crown shape and size across the entire mandibular and maxillary tooth rows, compared with a broad comparative sample (n = 712). We find that EDJ morphology in H. habilis is for the most part remarkably primitive, supporting the hypothesis that the H. habilis hypodigm has more in common with Australopithecus than later Homo. Additionally, the chronologically younger specimen OH 16 displays a suite of derived features; its inclusion in H. habilis leads to excessive levels of variation.
Keywords	Science ; Q
Subject code	590
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Temporal modelling of the biofilm lifecycle (TMBL) establishes kinetic analysis of plate-based bacterial biofilm dynamics.

Enriquez, Kyle T / Plummer, W Dale / Neufer, Preston D / Chazin, Walter J / Dupont, William D / Skaar, Eric P

Journal of microbiological methods

2023 Volume 212, Page(s) 106808

Abstract: Bacterial biofilms are critical to pathogenesis and infection. They are associated with rising rates of antimicrobial resistance. Biofilms are correlated with worse clinical outcomes, making them important to infectious diseases research. There is a gap ... ...

Abstract	Bacterial biofilms are critical to pathogenesis and infection. They are associated with rising rates of antimicrobial resistance. Biofilms are correlated with worse clinical outcomes, making them important to infectious diseases research. There is a gap in knowledge surrounding biofilm kinetics and dynamics which makes biofilm research difficult to translate from bench to bedside. To address this gap, this work employs a well-characterized crystal violet biomass accrual and planktonic cell density assay across a clinically relevant time course and expands statistical analysis to include kinetic information in a protocol termed the TMBL (Temporal Mapping of the Biofilm Lifecycle) assay. TMBL's statistical framework quantitatively compares biofilm communities across time, species, and media conditions in a 96-well format. Measurements from TMBL can reliably be condensed into response features that inform the time-dependent behavior of adherent biomass and planktonic cell populations. Staphylococcus aureus and Pseudomonas aeruginosa biofilms were grown in conditions of metal starvation in nutrient-variable media to demonstrate the rigor and translational potential of this strategy. Significant differences in single-species biofilm formation are seen in metal-deplete conditions as compared to their controls which is consistent with the consensus literature on nutritional immunity that metal availability drives transcriptomic and metabolomic changes in numerous pathogens. Taken together, these results suggest that kinetic analysis of biofilm by TMBL represents a statistically and biologically rigorous approach to studying the biofilm lifecycle as a time-dependent process. In addition to current methods to study the impact of microbe and environmental factors on the biofilm lifecycle, this kinetic assay can inform biological discovery in biofilm formation and maintenance.
MeSH term(s)	Kinetics ; Biofilms ; Biological Assay ; Biomass ; Gene Expression Profiling
Language	English
Publishing date	2023-08-17
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	604916-3
ISSN	1872-8359 ; 0167-7012
ISSN (online)	1872-8359
ISSN	0167-7012
DOI	10.1016/j.mimet.2023.106808
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Article: Dynamical Network Models From EEG and MEG for Epilepsy Surgery-A Quantitative Approach.

Cao, Miao / Vogrin, Simon J / Peterson, Andre D H / Woods, William / Cook, Mark J / Plummer, Chris

Frontiers in neurology

2022 Volume 13, Page(s) 837893

Abstract: There is an urgent need for more informative quantitative techniques that non-invasively and objectively assess strategies for epilepsy surgery. Invasive intracranial electroencephalography (iEEG) remains the clinical gold standard to investigate the ... ...

Abstract	There is an urgent need for more informative quantitative techniques that non-invasively and objectively assess strategies for epilepsy surgery. Invasive intracranial electroencephalography (iEEG) remains the clinical gold standard to investigate the nature of the epileptogenic zone (EZ) before surgical resection. However, there are major limitations of iEEG, such as the limited spatial sampling and the degree of subjectivity inherent in the analysis and clinical interpretation of iEEG data. Recent advances in network analysis and dynamical network modeling provide a novel aspect toward a more objective assessment of the EZ. The advantage of such approaches is that they are data-driven and require less or no human input. Multiple studies have demonstrated success using these approaches when applied to iEEG data in characterizing the EZ and predicting surgical outcomes. However, the limitations of iEEG recordings equally apply to these studies-limited spatial sampling and the implicit assumption that iEEG electrodes, whether strip, grid, depth or stereo EEG (sEEG) arrays, are placed in the correct location. Therefore, it is of interest to clinicians and scientists to see whether the same analysis and modeling techniques can be applied to whole-brain, non-invasive neuroimaging data (from MRI-based techniques) and neurophysiological data (from MEG and scalp EEG recordings), thus removing the limitation of spatial sampling, while safely and objectively characterizing the EZ. This review aims to summarize current state of the art non-invasive methods that inform epilepsy surgery using network analysis and dynamical network models. We also present perspectives on future directions and clinical applications of these promising approaches.
Language	English
Publishing date	2022-03-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2022.837893
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Article: Is metallic glass poised to come of age?

Johnson, William L / Plummer, John

Nature materials

2015 Volume 14, Issue 6, Page(s) 553–555

Language	English
Publishing date	2015-06
Publishing country	England
Document type	Interview
ZDB-ID	2088679-2
ISSN	1476-4660 ; 1476-1122
ISSN (online)	1476-4660
ISSN	1476-1122
DOI	10.1038/nmat4297
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Affordable Care Act's Effects On The Formation, Expansion, And Operation Of Physician-Owned Hospitals.

Plummer, Elizabeth / Wempe, William

Health affairs (Project Hope)

2016 Volume 35, Issue 8, Page(s) 1452–1460

Abstract: The Affordable Care Act (ACA) imposed new restrictions on the formation and expansion of physician-owned hospitals. These restrictions provided incentives for the hospitals and their owners to take preemptive actions before the effective dates of ACA ... ...

Abstract	The Affordable Care Act (ACA) imposed new restrictions on the formation and expansion of physician-owned hospitals. These restrictions provided incentives for the hospitals and their owners to take preemptive actions before the effective dates of ACA provisions and modify their operations thereafter. We studied 106 physician-owned hospitals in Texas to determine how they responded to ACA restrictions. We found that there were significant pre-ACA increases in the formation, physician ownership, and physical capacity of physician-owned hospitals, which suggests that they reacted quickly to the policy changes. After the ACA's provisions took effect, the hospitals improved the use of their assets to generate increased amounts of services, revenue, and profits. We found no evidence that existing physician-owned hospitals stopped accepting Medicare to avoid the ACA restrictions, although some investors adopted a seemingly unsuccessful strategy of not accepting Medicare at physician-owned hospitals formed after implementation of the ACA. We conclude that the ACA restrictions effectively eliminated the formation of new physician-owned hospitals, thus accomplishing what previous legislative efforts had failed to do.
Language	English
Publishing date	2016-08-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	632712-6
ISSN	1544-5208 ; 0278-2715
ISSN (online)	1544-5208
ISSN	0278-2715
DOI	10.1377/hlthaff.2015.1342
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Article ; Online: Extracorporeal photopheresis chargemasters show haphazard billing practices.

Adkins, Brian D / Kneib, Jessica / Plummer, W Dale / Dupont, William D / Booth, Garrett S

Transfusion

2021 Volume 61, Issue 10, Page(s) 2844–2848

Abstract: Background: United States healthcare spending continues to outpace other developed nations although efforts are being made to increase cost-transparency. Recent legislation requires hospitals to publish a chargemaster, a list of all billable procedure ... ...

Abstract	Background: United States healthcare spending continues to outpace other developed nations although efforts are being made to increase cost-transparency. Recent legislation requires hospitals to publish a chargemaster, a list of all billable procedure codes together with prices. Chargemaster prices have been shown to be highly variable, if available, and are not typically paid, but contribute to negotiated rates. Extracorporeal photopheresis (ECP) is performed for a limited number of indications and could serve as a marker of this variability. We investigated the availability of chargemaster documentation for ECP procedures and the variability of pricing as assessed by institutional characteristics. Study design and methods: A list of centers with photopheresis systems was obtained from the device manufacturer and the institutional websites were analyzed for chargemaster list prices. Multivariate linear regressions were performed to compare impact of facility variables on chargemaster pricing. Results: There are 139 locations in the US which are listed as referral centers for ECP; and chargemaster prices were available in 66.2% of these centers. The range was $571.48-183,452.00, maximum price 321 times greater than minimum, and the median price, after outlier exclusion, was $8989.06 (SD = $4361.72). ECP cost did not correlate with hospital size, facility type, ownership, number of hospitals in the referral region, hospital care intensity index, academic status, or region (p ≥ .05). Conclusions: Chargemaster costs for ECP procedures are highly variable and nonuniform, and the current data available for patients undergoing these specialized apheresis procedures is insufficient to afford patients the ability to compare prices.
MeSH term(s)	Costs and Cost Analysis/economics ; Fees and Charges ; Hospitals ; Humans ; Linear Models ; Photopheresis/economics ; United States
Language	English
Publishing date	2021-07-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	208417-x
ISSN	1537-2995 ; 0041-1132
ISSN (online)	1537-2995
ISSN	0041-1132
DOI	10.1111/trf.16602
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