In 2008, in an effort to provide helpful information to consumers and improve provider quality, the Centers for Medicare & Medicaid Services (CMS) developed and implemented the Five-Star Quality Rating System (Five-Star System). The Five-Star System assigns each nursing home an overall rating and three component ratingshealth inspections, staffing, and quality measuresbased on the extent to which the nursing home meets CMSs quality standards and other measures. The rating scale ranges from one to five stars, with more stars indicating higher quality. This book examines how CMS developed and implemented the Five-Star System and what key methodological decisions were made during development; the circumstances under which CMS considers modifying the Five-Star System; and the extent to which CMS has established plans to help ensure it achieves its goals for the Five-Star System.

Well child care is designed to promote optimal health status for children, including school and life success. This preventive care includes anticipatory guidance; continuity of care; assessment of growth and development; screening procedures for vision, hearing, dental, and cognitive development; and immunizations. Anticipatory guidance provides parental health education, counseling, and reassurance. The vast majority of Medicaid-insured children receive fewer than the American Academy of Pediatrics (AAP) recommended number of well child visits in the preschool years, and a disproportionate number of children have poor health and lack school readiness. With little empirical data available indicating clinical effectiveness other than for immunizations, the AAP recommendations for well child care were originally based on consensus expert opinion, and more than three decades later, documentation of effectiveness remained unavailable. This information gap led policymakers to question the value of well child care and limited incentive to correct its underuse. Only in the last five years have experimental findings indicated an association between well child care and both more cost efficient health care and increased school readiness. Awareness of these findings by insurance company and Medicaid administrators is limited. The purpose for this book is to increase awareness by all stakeholders of the empirically determined clinical effectiveness of well child care. The short-term goal is to facilitate increased utilization of well child care, with a longer term goal of improved child health and life success.

Solution Focused Brief Therapy (SFBT) promotes collaborative work and positive outcomes. It is an approach that can be used with individuals, families and groups in acute hospitals as well as with clients who are seen as outpatients or in the community. Written in an accessible style with over seventy case examples, this new edition of 'Focus on Solutions' shows how SFBT can help people who are suffering from voice or memory difficulties, a stammer, a stroke, HIV, traumatic brain injury or illness such as cancer or Parkinson's disease. Two new full session transcripts show clients beginning to shift from focusing on the problems in their lives towards a clear description of how they want their lives to be different. Recent outcomes are included on solution focused supervision within the NHS and examples of ways to help clients monitor progress and give feedback. 'Focus on Solutions' contains many useful ideas for experienced practitioners and those new to solution focused work, which is of growing importance in the health service as well as business and education. Therapists, doctors, nurses and psychologists will find this book an invaluable contribution to the field of reflective practice. 'Focus on Solutions' is a clear and inspiring application of the solution-focused approach in a medical and community setting . . . Bonus content includes how to be solution-focused in supervision, training new practitioners and measuring client outcomes. The varying and updated case examples brings the approach to life, demonstrates its practical nature and how it can be incorporated into existing speech and language therapy frameworks.