States and the federal government have sought ways to be more flexible in Medicaid programs by using the Medicaid waiver system. These efforts have focused on an expressed desire to reduce nursing facility utilization when possible. He discusses pitfalls including risk, payment rates, accountability, and infrastructure. Wiener, Janis, et al. Multiple Antibiotic-Resistant Klebsiella and Escherichia coli in Nursing Homes.
Nosocomial infections are a problem for a variety of reasons.
First is the increase of antibiotic resistance to these infections. Second, the presence of antibiotic resistance genes on bacterial plasmisds which can be transferred between different species of bacteria. Lastly, is the concern that these drug-resistant bacteria are not only spreading in the hospital setting, but also in the community. This article discusses the spread of antibiotic-resistant bacteria in nursing facilities. The two infections tracked were ceftazidime-resistant Escherichia coli , Klebsiella pneumoniae , or a combination of the two in hospital admissions from nursing facilities between November 1990 and July 1992.