The Effects of Housing Costs on Nursing Home Diversion

Anguelov, Nikolay; Frank, Adam

doi:10.1080/01488376.2018.1532944

Cited by 3 publications

(3 citation statements)

References 47 publications

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“…28,29 The striking contrast between Hispanic older Housing challenges significantly predict closure only for older adults, but strongly relate to longer transition periods for all groups, adding over 4 months on average. Recent research that found housing not to be a barrier involved either short-stay private pay residents, 7 with higher socioeconomic status, or options counseling clients, 20 who may not have lost their housing. For long-stay Medicaid residents, housing remains a prominent challenge to timely transitions and should be a primary focus of transition program resources.…”

Section: Discussionmentioning

confidence: 99%

“…Additional factors, particularly within 90 days of admission, include a supportive facility, availability and funding of HCBS, and supplemental community supports . Lack of affordable or accessible housing reduces the odds of transition, although two recent studies did not confirm the relationship between housing and successful transition . Other factors inhibiting transition include cognitive impairment, mental health diagnoses and substance use disorders, and greater functional impairment or medical complexity …”

Section: Introductionmentioning

confidence: 99%

“…4 Lack of affordable or accessible housing reduces the odds of transition, 4,[17][18][19] although two recent studies did not confirm the relationship between housing and successful transition. 7,20 Other factors inhibiting transition include cognitive impairment, 12,13,16 mental health diagnoses and substance use disorders, 21,22 and greater functional impairment or medical complexity. 12,13,19 Fewer predictors of community discharge have been identified for long-stay residents.…”

Section: Introductionmentioning

confidence: 99%

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Challenges to community transitions through Money Follows the Person

Robison

Shugrue

Porter

et al. 2020

Health Services Research

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Objective: To examine the effects of transition challenges on the success and timeliness of transitions from institutions to community living for long-stay participants in the Money Follows the Person (MFP) Rebalancing Demonstration and determine whether outcomes vary by age and disability. Data Source: Secondary data on transition challenges for individuals enrolled in Connecticut's MFP program between December 2008 and December 2017. Study Design: Challenges were analyzed for older adults, people with mental health disability, and people with physical disability. Bivariate and multivariate analyses investigated which transition challenges and selected demographic variables predict transition versus closure and length of transition period for each group. Data Extraction Methods: The sample includes 3506 persons who attempted transition from institutions to community living and whose case concluded with transition or closure from 2015 to 2017.Principal Findings: The association between most transition challenges and the ability of long-stay institutional residents to return to the community, and to do so in a timely manner, varies significantly among older adults and younger persons with physical or mental health disabilities. For all groups, however, consumer engagement challenges predicted closure without transition (OR: 1.3-3.9) and housing challenges predicted longer transition periods (84-132 days). Length of institutional stay was associated with both outcomes for older adults and persons with physical disability. Other challenges, such as issues with services and supports, differed among the three groups on both outcomes. Conclusions: Knowledge of the effects of transition challenges on success and timeliness of transition for each group allows program managers and health and service providers to focus resources on addressing the most serious challenges. Particular emphasis should be placed on consumer engagement and housing challenges, and on targeting persons for transition early in their institutional stay. Federal and state transition programs can benefit by individualizing supports for residents to yield successful outcomes. Health Services Research ROBISON et al.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Challenges to community transitions through Money Follows the Person

Robison

Shugrue

Porter

et al. 2020

Health Services Research

View full text Add to dashboard Cite

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Comparative analysis of the determinants of fees charged by fee-based homes for the elderly in urban and suburban areas

Takahashi

Sato

Yabe

2021

J Hous and the Built Environ

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The Effects of Housing Cost Burden and Housing Tenure on Moves to a Nursing Home Among Low- and Moderate-Income Older Adults

Morales

Robert

2020

The Gerontologist

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Background and Objectives In the United States, a growing number of older adults struggle to find affordable housing that can adapt to their changing needs. Research suggests that access to affordable housing is a significant barrier to reducing unnecessary nursing home admissions. This is the first empirical study we know of to examine whether housing cost burden (HCB) is associated with moves to nursing homes among older adults. Research Design and Methods Data include low- and moderate-income community-dwelling older adults (N = 3,403) from the nationally representative 2015 National Health and Aging Trends Study. HCB (≥30% of income spent on mortgage/rent) and housing tenure (owner/renter) are combined to create a 4-category housing typology. Multinomial logistic regression models test (a) if renters with HCB are most likely (compared with other housing types) to move to a nursing home over 3 years (2015–2018) and (b) if housing type interacts with health and functioning to predict moves to a nursing home. Results Across all models, renters with HCB had the greatest likelihood of moving to a nursing home. Moreover, self-rated health, physical capacity, and mental health were weaker predictors of nursing home moves for renters with HCB. Discussion and Implications Results suggest that older renters with HCB are most likely to experience unnecessary nursing home placement. The growing population of older renters experiencing HCB may not only signal a housing crisis, but may also challenge national efforts to shift long-term care away from nursing homes and toward community-based alternatives.

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The Effects of Housing Costs on Nursing Home Diversion

Cited by 3 publications

References 47 publications

Challenges to community transitions through Money Follows the Person

Challenges to community transitions through Money Follows the Person

Comparative analysis of the determinants of fees charged by fee-based homes for the elderly in urban and suburban areas

The Effects of Housing Cost Burden and Housing Tenure on Moves to a Nursing Home Among Low- and Moderate-Income Older Adults

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