Improving the Quality of Care in Nursing Homes


Book Description

As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.




Stewardship of Federal Facilities


Book Description

The federal government has invested more than $300 billion in 500,000 buildings and other facilities worldwide to support the provision of government services. Evidence is mounting that the physical condition, functionality, and quality of federal facilities are deteriorating. Stewardship of Federal Facilities identifies factors and processes contributing to this deterioration and recommends a framework of methods, practices, and strategies to foster accountability for the stewardship of federal facilities and to allocate resources for their maintenance and repair.




Guiding Principles for Sustainable Federal Buildings and Associated Instructions


Book Description

In 2006, Federal agencies owning and operating more than 90% of all Federal facilities signed the Memorandum of Understanding for Federal Leadership in High Performance and Sustainable Buildings (2006 Guiding Principles). The Memorandum contained the first set of Guiding Principles - overarching environmental performance goals - for new Federal buildings. The 2006 Guiding Principles addressed reducing energy and water use, conserving resources, minimizing waste, protecting indoor air quality, and requiring the use of integrated teams during the design, construction, and operation of new Federal facilities. An updated set of Guiding Principles, called "High Performance and Sustainable Buildings Guidance," December 2008, contained "Guiding Principles for Sustainable New Construction and Major Renovation" and "Guiding Principles for Sustainable Existing Buildings." Previous Executive Orders (E.O.) 13423 (2006) and 13514 (2009) recognized green buildings as a key component in efforts to reduce environmental impacts, cut greenhouse gas (GHG) emissions, and lower the operating costs at Federal facilities. E.O. 13693, Planning for Federal Sustainability in the Next Decade, March 19, 2015, reaffirmed Federal green building efforts and called for revised Guiding Principles to reflect progress in green building design, construction, and operation practices; broaden considerations around protecting occupant health, wellness, and productivity; and address climate change risks.




Standards for Internal Control in the Federal Government


Book Description

Policymakers and program managers are continually seeking ways to improve accountability in achieving an entity's mission. A key factor in improving accountability in achieving an entity's mission is to implement an effective internal control system. An effective internal control system helps an entity adapt to shifting environments, evolving demands, changing risks, and new priorities. As programs change and entities strive to improve operational processes and implement new technology, management continually evaluates its internal control system so that it is effective and updated when necessary. Section 3512 (c) and (d) of Title 31 of the United States Code (commonly known as the Federal Managers' Financial Integrity Act (FMFIA)) requires the Comptroller General to issue standards for internal control in the federal government.




Achieving High-Performance Federal Facilities


Book Description

The design, construction, operation, and retrofit of buildings is evolving in response to ever-increasing knowledge about the impact of indoor environments on people and the impact of buildings on the environment. Research has shown that the quality of indoor environments can affect the health, safety, and productivity of the people who occupy them. Buildings are also resource intensive, accounting for 40 percent of primary energy use in the United States, 12 percent of water consumption, and 60 percent of all non-industrial waste. The processes for producing electricity at power plants and delivering it for use in buildings account for 40 percent of U.S. greenhouse gas emissions. The U.S. federal government manages approximately 429,000 buildings of many types with a total square footage of 3.34 billion worldwide, of which about 80 percent is owned space. More than 30 individual departments and agencies are responsible for managing these buildings. The characteristics of each agency's portfolio of facilities are determined by its mission and its programs. In 2010, GSA's Office of Federal High-Performance Green Buildings asked the National Academies to appoint an ad hoc committee of experts to conduct a public workshop and prepare a report that identified strategies and approaches for achieving a range of objectives associated with high-performance green federal buildings. Achieving High-Performance Federal Facilities identifies examples of important initiatives taking place and available resources. The report explores how these examples could be used to help make sustainability the preferred choice at all levels of decision making. Achieving High-Performance Federal Facilities can serve as a valuable guide federal agencies with differing missions, types of facilities, and operating procedures.




Risk Assessment in the Federal Government


Book Description

The regulation of potentially hazardous substances has become a controversial issue. This volume evaluates past efforts to develop and use risk assessment guidelines, reviews the experience of regulatory agencies with different administrative arrangements for risk assessment, and evaluates various proposals to modify procedures. The book's conclusions and recommendations can be applied across the entire field of environmental health.




Key Performance Indicators for Federal Facilities Portfolios


Book Description

More than 30 federal departments and agencies with a wide range of missions and programs manage large inventories of facilities, also called portfolios. These portfolios range in size from a few hundred to more than a hundred thousand individual structures, buildings, and their supporting infrastructure. They are diverse in terms of facility types, mix of types, and geographic dispersal. For federal senior executives, facilities portfolio-related decisions revolve around the allocation of resources (staff, funding, time) for acquisition, renovation, operation, repair, and disposition of facilities. To make informed decisions, senior executives require information that will allow them to answer such questions as: What facilities do we have? What condition are they in? What facilities are needed to support the organization's missions? This study lays out a framework for developing and evaluating trends in facilities portfolio conditions, investments, and costs and identifies a set of key indicators that can be used to track performance over time. Some of the indicators are currently in use in some federal agencies; others will need to be developed.










Federal Contract Compliance Manual


Book Description