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University of Missouri

Nursing School Makes MU History

MU’s largest research grant will improve care for older adults.

Marilyn Rantz

The University of Missouri Sinclair School of Nursing today announced a $14.8 million grant from the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS). MU researchers, led by Marilyn Rantz, Curators’€™ Professor of nursing, will use the funds, distributed over four years, to implement a project aimed at reducing avoidable re-hospitalizations among nursing home residents. Insights gained from this project could provide a nationwide model for senior care and significantly reduce national health care spending. Photo by Nicholas Benner.

Marilyn Rantz has been busy. On Nov. 5, 2012, the University of Missouri Sinclair School of Nursing announced MU researchers, led by Rantz, secured a $14.8 million grant from the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) — the largest research award in the history of the university. This comes only three weeks after Rantz, a Curators’ Professor of nursing, was admitted to the Institute of Medicine, one of the highest honors in the field.

Marilyn Rantz has been a virtual ‘force’ in terms of improving care and quality outcomes for older adults,” says Judith Fitzgerald Miller, nursing school dean.

The four-year grant will fund the Missouri Quality Initiative for Nursing Homes, a project aimed at reducing avoidable re-hospitalizations among nursing home residents with the ultimate goal of producing a nationwide model of senior care. According to CMS, nearly half of all hospitalizations among nursing home residents enrolled in Medicare or Medicaid could have been prevented, resulting in health care costs of more than $7 billion in 2011.

With grant support, MU will partner with CMS and state Medicaid programs at 16 nursing facilities in St. Louis. Funds will be used to place an advanced practice registered nurse (APRN) at each location. Each APRN will work with a traveling interdisciplinary team and the nursing home staff to coordinate patient care and improve the recognition, assessment and management of conditions that commonly lead to hospitalizations.

Ten years ago, I was at the Gerontological Society of America, and I said, ‘If I have to measure the impact of an advanced practice nurse in a nursing homes and how effective that is one more time, I think I’m going to throw up,’ ” Rantz recalls. “We’ve done this and measured it over and over again, and it works. So we’re going to do it again, but this time what’s different is we’ve got the attention of CMS. They are behind it. If there was ever a time we could really advance the care for older people in America, it’s now. Now we’ve got the opportunity. We’re going to take this grant and run with it.”

Advanced practice nurses play a key role in adult care because they are trained to recognize the subtle changes in behavior and conditions among older adults, Rantz says, allowing interventions to happen before the condition worsens.

For instance, if pneumonia and other acute infections are caught early, the illness could probably be treated at the nursing home instead of transporting the resident to the hospital.

Our team of nursing faculty pursued this project not because of the size of the funding but because of their passion to improve the health care of older adults,” Dean Miller says, “[This project will] save resources for Medicare and Medicaid.”

Other nursing researchers involved in the project include:

  • Greg Alexander, associate professor
  • Marcia Flesner, clinical instructor
  • Jessica Mueller, program coordinator
  • Lori Popejoy, assistant professor
  • Amy Vogelsmeier, assistant professor

Other MU researchers include:

  • Colleen Galambos, professor in the College of Human Environmental Sciences’ School of Social Work
  • Dr. Richelle Koopman, associate professor of family and community medicine in the School of Medicine
  • Greg Petroski, biostatistician in the Medical Research Office

MU Sinclair School of Nursing Receives Nearly $15 Million for Project to Reduce Re-hospitalizations of Nursing Home Residents from MU News Bureau on Vimeo.