Relationships Between Residential Care Community Characteristics and Overnight Hospital Stays and Readmissions: Results From the National Study of Long-Term Care Providers.

The Problem: Hospitalizations and subsequent readmissions can produce significant challenges when trying to reduce costs and improve quality of care. This study describes hospitalizations and readmissions using residential care community data from the 2012 National Study of Long-Term Care Providers.

The Resolution: About 61.

Variation in Licensed Nurse Staffing Characteristics by State Requirements in Residential Care.

Research on licensed nurses in assisted living and residential care communities (RCCs) is sparse compared to that on licensed nurses in nursing homes. RCCs are state-regulated; thus, staffing requirements vary considerably. The current study analyzed variation in characteristics of licensed nurses by state-specific requirements for licensed nurses in RCCs.

Long-Term Care Providers and services users in the United States: data from the National Study of Long-Term Care Providers, 2013-2014.

Long-term care services provided by paid, regulated providers are an important component of personal health care spending in the United States. This report presents the most current national descriptive results from the National Study of Long-Term Care Providers (NSLTCP), which is conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS). Data presented are drawn from multiple sources, primarily NCHS surveys of adult day services centers and residential care communities (covers 2014 data year); and administrative records obtained from the Centers for Medicare and Medicare Services (CMS) on home health agencies, hospices, and nursing homes (covers 2013 and 2014 data years).

Variation in Residential Care Community Nurse and Aide Staffing Levels: United States, 2014.

Objectives: This report presents national and state estimates of staffing levels in residential care communities for registered nurses, licensed practical or vocational nurses, and aides in the United States for 2014.

Methods: Data were drawn from the residential care community component of the 2014 wave of the biennial National Study of Long-Term Care Providers, conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics. For each staff type, the "staffing level" measure is presented as average hours per resident per day, defined as the total number of hours worked divided by the total number of residents, which does not necessarily reflect the amount of care given to a specific resident.

Variation in Adult Day Services Center Participant Characteristics, by Center Ownership: United States, 2014.

More than one-quarter million participants were enrolled in adult day services centers in the United States on the day of data collection in 2014. The number of for-profit adult day services centers has grown in recent years. In 2012, 40% of adult day services centers were for-profit, serving more than one-half of all participants.

Variation in Operating Characteristics of Adult Day Services Centers, by Center Ownership: United States, 2014.

More than one-quarter of a million participants were enrolled in 4,800 adult day services centers in the United States in 2014. Unlike other long-term care providers, such as nursing homes, home health agencies, hospices, and residential care communities, the majority of adult day services centers are nonprofit. However, for-profit ownership of adult day services centers has increased, from 27% in 2010 to 40% in 2012, and more recently to 44% in 2014.

Variation in Residential Care Community Resident Characteristics, by Size of Community: United States, 2014.

Residents of residential care communities are persons who cannot live independently but generally do not require the skilled care provided by nursing homes. There were 835,200 current residents in residential care communities in 2014 (1,2). "Current residents" refers to those who were living in the community on the day of data collection (as opposed to the total number of residents who lived in the community at some time during the calendar year).

Variation in Operating Characteristics of Residential Care Communities, by Size of Community: United States, 2014.

Assisted living and similar residential care communities provide services to individuals who cannot live independently but generally do not require the skilled level of care provided by nursing homes. In 2014, there were 30,200 residential care communities nationwide (1). This report presents the most current national estimates of residential care community operating characteristics and compares these characteristics by community bed size.

Characteristics of residents living in residential care communities, by community bed size: United States, 2012.

In 2012, there was a higher percentage of older, female residents in communities with more than 25 beds compared with communities with 4–25 beds. Residents in communities with 4–25 beds were more racially diverse than residents in larger communities. The percentage of Medicaid beneficiaries was higher in communities with 4–25 beds than it was in communities with 26–50 and more than 50 beds.

Operating characteristics of residential care communities, by community bed size: United States, 2012.

In 2012, the majority of residential care communities had 4–25 beds, yet 71% of residents lived in communities with more than 50 beds. A lower percentage of communities with 4–25 beds were chain-affiliated, nonprofit, and in operation 10 years or more, compared with communities with 26–50 and more than 50 beds. Dementia-exclusive care or dementia care units were more common as community size increased.

Differences in adult day services center characteristics by center ownership: United States, 2012.

Data from the National Study of Long-Term Care Providers. In 2012, 40% of the 4,800 adult day services centers were for-profit entities, serving nearly one-half of the 272,300 center participants. About 60% of adult day services centers used a standardized tool to screen for cognitive impairment, and about 20% used a standardized tool for depression screening.

Differences in adult day services center participant characteristics by center ownership: United States, 2012.

Data from the National Study of Long-Term Care Providers. In 2012, more than one-third of participants in adult day services centers were younger than 65. A higher percentage of participants in nonprofit centers than in for-profit centers were younger than 65.

Dementia special care units in residential care communities: United States, 2010.

In 2010, 17% of residential care communities had dementia special care units. Beds in dementia special care units accounted for 13% of all residential care beds. Residential care communities with dementia special care units were more likely than those without to have more beds, be chain-affiliated, and be purposely built as a residential care community, and less likely to be certified or registered to participate in Medicaid.

Long-Term Care Services in the United States: 2013 Overview.

Long-term care services include a broad range of services that meet the needs of frail older people and other adults with functional limitations. Long-Term care services provided by paid, regulated providers are a significant component of personal health care spending in the United States. This report presents descriptive results from the first wave of the National Study of Long-Term Care Providers (NSLTCP), which was conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

Infections in long-term care populations in the United States.

Objectives: To estimate infection prevalence and explore associated risk factors in nursing home (NH) residents, individuals receiving home health care (HHC), and individuals receiving hospice care.

Design: Cross-sectional.

Setting: Nationally representative samples of 1,174 U.

Training of home health aides and nurse aides: findings from national data.

Training and satisfaction with training were examined using data from nationally representative samples of 2,897 certified nursing assistants (CNAs) from the National Nursing Assistant Survey and 3,377 home health aides (HHAs) from the National Home Health Aide Survey conducted in 2004 and 2007, respectively. This article focuses on the commonalities and differences in the perceptions of CNAs and HHAs regarding the initial and continuing education they received to prepare them for their job. More than 80% of HHAs and all CNAs received some initial training.

Characteristics and use of home health care by men and women aged 65 and over.

Objective: This report presents national estimates on differences in the use of home health care between men and women aged 65 years and over.

Methods: Estimates are based on data from the 2007 National Home and Hospice Care Survey, conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics.

Results: In the United States, men aged 65 years and over used home health care at a lower rate than women.

Residential care facilities: a key sector in the spectrum of long-term care providers in the United States.

RCFs in the United States totaled 31,100 in 2010, with 971,900 state-licensed, certified, or registered residential care beds. About one-half of RCFs were small facilities which served one-tenth of all RCF residents. The remaining RCFs were medium-sized facilities (16%) which served about one-tenth of all RCF residents, large facilities (28%) which served about one-half of all RCF residents, and extra large facilities (7%) which housed about three-tenths of all RCF residents.

Residents living in residential care facilities: United States, 2010.

In 2010, residential care residents were mostly female, non-Hispanic white, and aged 85 and over, and had a median length of stay of about 22 months. For about 20% of residents—or 137,700 persons—Medicaid paid for at least some long-term care services provided by the RCF. This estimate is similar to that found in a recent study (3).

Design and operation of the 2010 National Survey of Residential Care Facilities.

Objectives: This methods report provides an overview of the National Survey of Residential Care Facilities (NSRCF) conducted in 2010. NSRCF is a first-ever national probability sample survey that collects data on U.S.

Racial differences in dementia care among nursing home residents.

Objectives: This article aims to describe potential racial differences in dementia care among nursing home residents with dementia.

Methods: Using data from the 2004 National Nursing Home Survey (NNHS) in regression models, the authors examine whether non-Whites are less likely than Whites to receive special dementia care--defined as receiving special dementia care services or being in a dementia special care unit (SCU)--and whether this difference derives from differences in resident or facility characteristics.

Results: The authors find that non-Whites are 4.

An overview of home health aides: United States, 2007.

Objectives: This report presents national estimates of home health aides providing assistance in activities of daily living (ADLs) and employed by agencies providing home health and hospice care in 2007. Data are presented on demographics, training, work environment, pay and benefits, use of public benefits, and injuries.

Methods: Estimates are based on data collected in the 2007 National Home Health Aide Survey.

Home health care and discharged hospice care patients: United States, 2000 and 2007.

Objectives: This report presents national estimates on home health care patients and discharged hospice care patients. Information on characteristics, length of service, medical diagnoses, functional limitations, service use, advance care planning, and emergent and hospital care use are presented for home health care patients and hospice care discharges. A comparison of selected characteristics for 2000 and 2007 is also provided to highlight changes.

Complementary and alternative therapies in hospice: The national home and hospice care survey: United States, 2007.

Objective-This report presents national estimates on the provision and use of complementary and alternative therapies (CAT) in hospice. Comparisons of organizational characteristics of hospice care providers are presented by whether the provider offered CAT. Comparisons of selected characteristics of patients discharged from hospice are presented by whether they received care from a provider that offered CAT, and whether they received a CAT service.

Use of advance directives in long-term care populations.

An advance directive (AD) allows a patient to communicate health care preferences in the event that he or she is no longer able to make these decisions. Many view advance care planning (ACP)—a process that includes discussing values and goals of care among the patient, family, and physician, and determining or executing treatment directives—as a way to help ensure that wishes about end-of-life care are honored. Ideally, ADs are part of the ACP process.