Background The demand of long-term care facilities has increased because of the geriatric population growing up rapidly. How to reduce the frequency of the nursing home residents¡¦ being hospitalized is one of the most important indicators for the quality of long-term care. Objective To understand the characteristics of facilities and nursing home residents. To test the effect of the characteristics on the probability of hospitalization of nursing home residents and to analyze the predictors of readmission in order to improve the quality of nursing care and the life quality of their residents. Methods We collected 329 residents of a hospital-based nursing home in southern Taiwan before March 31, 2011 and who stayed more than 90 days at the facility. The medical records were reviewed retrospectively. Data were analyzed using descriptive statistics (correlation and one way ANOVA) to test the effect of the resident¡¦s and facility¡¦s characteristics on the probability of hospitalization. Multiple linear regression was used to study the risk factors and the predictors of readmission frequency. Results Of the 29 residents, 141(42.9%) were male. The average age was 78.06. 33.7% of the residents died in the facility. The total individual admissions were from 0 to 18. The hospitalized frequency was 0.42 in each 90-day period. Infectious disease was the majority diagnosis of admission. The three leading causes of admission were pneumonia(45.5%), urinary tract infection (20.0%) and upper gastrointestinal bleeding(10.3%). Correlation analysis showed the age had a positive correlation with the frequency of readmission. The hemoglobin level, serum albumin level, serum cholesterol level, body mass index, mini-nutritional assessment score and mini-mental status evaluation score disclosed a negative correlation with the frequency of readmission. Multiple linear regression showed the male gender, age, lung diseases, complete bed-ridden and mini-nutritional assessment score were significant predictors of readmission frequency. Conclusion The evaluation of the risk factors and predictors might help to identify the nursing home residents who are likely to be readmitted. It is hoped that the hospitalizations from nursing home may be prevented and the results of this study might contribute to the quality of long-term care facilities.

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Neisseria meningitidis infection in humans usually manifests as meningitis and septicemia with skin manifestations. Infections of the respiratory tract with N meningitidis have been documented in the past, but often this organism is not routinely considered in the differential diagnosis of pneumonia. The pathogenic role of N meningitidis in lower respiratory tract infections may be underestimated because its isolation is difficult, particularly when oropharyngeal flora are present. We profile 2 elderly patients with primary meningococcal pneumonia to show the importance of Gram stain and culture in early diagnosis. These modalities helped guide treatment and prophylactic measures.