Over the past two decades, assisted living has rapidly emerged as a housing and long-term care option for older adults. In 2012, assisted living facilities provided a home to over 710,000 older Americans. However, given that assisted living facilities do not routinely submit Medicare claims for services or resident assessments as are required for nursing home residents, rehabilitation patients, and home health recipients, researchers and policy-makers have no reliable methodology for studying the health and health care utilization of assisted living facility residents.
[Photo: Dr. Kali Thomas]
The purpose of this study, led by Dr. Kali Thomas, Assistant Professor of Health Services, Policy and Practice, and faculty member in the Center for Gerontology and Healthcare Research, was to develop and test a novel methodology to identify residents in large assisted living facilities using secondary data sources, specifically the 9-digit ZIP code reported in Medicare enrollment records.
With the help of her colleagues at the Brown University School of Public Health, Dr. Thomas compiled a finder file of 9-digit ZIP codes representing assisted living facilities of 25 beds or larger, by matching Outcome and Assessment Information Set (OASIS) assessments and Medicare Part B Claims to the Medicare enrollment records and addresses of 11,751 assisted living facilities. Under this finder file, the researchers identified 783,567 beneficiaries residing in validated assisted living facility ZIP codes in 2007-2009. They then compared characteristics of this cohort to those of assisted living facility residents in the National Survey of Residential Care Facilities, a sample of community-dwelling Medicare beneficiaries, and long-stay nursing home residents. The assisted living facility cohort identified by Dr. Thomas and her colleagues had good construct validity based on their demographic characteristics, health, and health care utilization when compared with assisted living residents in the comparison cohorts.
This study provides a first of its kind methodology to capture data on a growing long-term care industry. As more federal and state dollars are spent on providing care in this sector of long-term care, it is important that we have sound research to understand the quality of these facilities and the health and health outcomes of Medicare beneficiaries residing in assisted living facilities. The development of this innovative methodology sets the stage for important future work in this area.
This study was published in Medical Care, 2016 (ahead of print).
To read more: https://www.ncbi.nlm.nih.gov/pubmed/27820597