Long-Term Care

Residential care facilities, such as assisted living facilities and personal care homes provide housing & supportive services to persons who cannot live independently but do not require the level of care provided by nursing homes. RCFs are not federally regulated; state approaches to regulation vary. Using data from the first nationally representative survey of RCFs with four or more beds, this report presents national estimates of RCFs comparing characteristics and services by facility size.

Risk factors associated with the incidence of recipient injuries, bedsores and contractures, and health care use among aged and non-aged adult personal care recipients are investigated. Data are from a statewide survey of aged and non-aged adult personal assistance service (PAS) recipients in California's In-Home Supportive Services (IHSS) program. Outcomes among recipients using relatives as paid providers are compared with those of recipients having non-relatives as providers.

Person- and family-centered care (PFCC) has gained attention in recent years as a mechanism for transforming health care and long-term services & supports (LTSS). Research shows that PFCC improves quality of care & quality of life. The current shift in payment reform & service delivery away from disease or provider-focused models and toward incentives that reward better coordination, communication, and continuity of care, is likely to promote wider adoption and effective implementation of PFCC.

How many people have participated in federally supported evidence-based health promotion programs in your state—and who is involved in these efforts? Find out in our new state profiles compiled by NCOA’s Center for Healthy Aging. The downloadable profiles provide facts about health challenges facing seniors, as well as state efforts to improve older adult health.

The Money Follows the Person (MFP) Demonstration supports state efforts to help Medicaid beneficiaries living in long-term care facilities transition back to community-based residences and to make community-based long-term care services and supports more accessible. This report uses aggregate data from annual financial reports and service claims records submitted by grantees to examine the costs and types of community-based services received by participants in the MFP program.

This manual is meant to help community-based programs assess their individual needs, plan & implement volunteer respite programs and assist state Lifespan Respite programs as they address the requirements in the Lifespan Respite Care Act to build respite capacity through volunteer training & recruitment. Review text boxes throughout the document with resources for reading further, highlights of National Volunteer Respite Initiatives plus examples of local volunteer respite programs.

Review the data products and publications from a new survey about Residential Care Facilities. Included are residential care facilities; assisted living residences; board & care homes; congregate care; enriched housing programs; homes for the aged; personal care homes; & shared housing establishments that are licensed, registered, listed, certified, or otherwise regulated by a state. NSRCF is designed to produce national estimates of facilities and their residents.

States serve a large number of people with dementia & caregivers in their Aging Networks & LTSS systems. This involves accommodating the needs of a population experiencing a variety of physical, cognitive, & behavioral symptoms from dementia, along with other medical conditions. This brief discusses why states should be concerned about dementia capability in their LTSS systems, describes the components of model dementia-capable systems, & reports how states have addressed dementia capability.

When assessing the needs of persons with dementia and caregivers in the community, it is important to understand the number of persons affected and their unique needs for services and programs. This toolkit complements the issue brief titled Making the Long-Term Services and Supports System Work for People With Dementia and Their Caregivers by identifying resources that states and communities can use to design initiatives to ensure that programs are dementia-capable.

In the context of “rebalancing” efforts, the authors describe flexible accounting as budgeting practices and contractual language that incentivize the use of less expensive noninstitutional programs and use savings to expand lower-cost services to further reduce the state’s use of institutional care. The authors offer recommendations for California and pay special attention to flexible accounting in Medicaid managed LTSS and identify examples of flexible accounting practices.