Medical Foster Homes: Can the Adult Foster Care Model Substitute for Nursing Home Care?

Abstract

MFHs served a distinct subset of veterans with levels of comorbidity and frailty similar to those of veterans cared for in CLCs and CNHs at costs that were comparable to or lower than those of the VHA. Propensity-matched comparisons will be necessary to confirm these findings.

Medical foster home is less costly than traditional nursing home care

“…The propensity score was estimated using a logistic regression in a stepwise iterative fashion . Initial covariate selection for the propensity score model was based on prior research and clinical knowledge about factors that lead to selection of MFH and CNH . Next, other covariates, as well as quadratic and interaction terms, were selected based on likelihood ratio testing.…”

“…Up to three Veterans who cannot live independently because of physical or mental disabilities (these eligibility criteria are identical for CNH Veterans) live in each MFH. These Veterans are unable to participate in the traditional HBPC program because they cannot care for themselves at home and do not have a familial caregiver to provide 24‐7 care …”

“…Veterans pay out‐of‐pocket for MFH room and board, while the VA pays for and provides medical care coordinated by the home care team. Veterans are paired with a community caregiver who typically has prior experience working in a NH, caring for loved ones, or other caregiving experience . Potential MFH caregivers are initially interviewed by the MFH coordinator who is a senior‐level social worker.…”

“…These Veterans are unable to participate in the traditional HBPC program because they cannot care for themselves at home and do not have a familial caregiver to provide 24-7 care. 6 The VA MFH program provides primary care to the Veteran through HBPC interdisciplinary staff. The HBPC care team provides caregiver training tailored to the VA plan of care, home assessment, and patient care.…”

“…Veterans are paired with a community caregiver who typically has prior experience working in a NH, caring for loved ones, or other caregiving experience. 6 Potential MFH caregivers are initially interviewed by the MFH coordinator who is a seniorlevel social worker. A HBPC occupational therapist also visits the home to assess suitability of the home for the MFH program in terms safety and any needed home modifications.…”