title: Early implementation of medicare part D in urban and rural nursing facilities.
abstract: OBJECTIVE
  To determine if differences occurred in the early implementation of Medicare Part D (prescription drug program) between urban and rural nursing facilities.
  
  
  METHODS
  Nursing facility demographic data, obtained from the Nursing Facility Compare Medicare Web site, were used to create matched pairs of rural and urban facilities. On-site interviews were conducted in June and July 2006 with one designated representative from each nursing facility. Details for each prescription drug plan (PDP), identified by the facility representatives, were obtained from the PDP's Web site.
  
  
  METHODS
  A prospective pilot field study of rural and urban nursing facilities was created from among 40 facilities in the 26-county Texas Panhandle. Five rural/urban nursing facilities of identical ownership and of similar perceived quality (number of cited deficiencies) and staffing (total nursing staff time per resident) were used for the pilot study.
  
  
  METHODS
  Nursing facility employees charged with overseeing Part D implementation and trained interviewers.
  
  
  METHODS
  None.
  
  
  METHODS
  Number of PDPs per nursing facility and distribution of persons providing enrollment decision support.
  
  
  RESULTS
  Rural facilities used more PDPs (7.4 +/- 3.9) than did urban facilities (4.6 +/- 3.8, NSS). Independent samples Student's t-test determined that there was a significant difference in the average number of drugs per resident. Rural residents received fewer medications (8.2 +/- 1.9) than urban residents (11.2 +/- 2.2; P = 0.049, t = 2.32).
  
  
  CONCLUSIONS
  These early findings suggest that rural nursing facilities interact with more PDPs than urban facilities and that Medicare Part D enrollment decisions are more likely to be aided by family members in rural facilities than in urban nursing facilities.
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, TX 79106-1712, USA. Raehl@ttuhsc.edu
authors.forename: Cynthia
authors.initials: C
authors.lastname: Raehl
authors.forename: Eric
authors.initials: E
authors.lastname: Maclaughlin
authors.forename: Roland
authors.initials: R
authors.lastname: Patry
authors.forename: Stephanie
authors.initials: S
authors.lastname: Leeper
authors.forename: C A
authors.initials: CA
authors.lastname: Bond
mesh_terms: D001291:Attitude of Health Personnel; D014487:Centers for Medicare and Medicaid Services, U.S.; D006707:Homes for the Aged; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D054524:Medicare Part D / Q000458:organization & administration*; D009735:Nursing Homes; D010865:Pilot Projects; D015397:Program Evaluation; D011446:Prospective Studies; D012424:Rural Population; D014481:United States; D014505:Urban Population