Male nurse or caregiver doing a finger sugar test to senior woman indoors during home visit.
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Assisted living communities could be the focus of more research into care quality and outcomes in the future now that a new study has provided a methodology for identifying Medicare beneficiaries living in such settings.

The study from the University of Rochester School of Medicine and Dentistry, published in JAMDA, the journal of AMDA–The Society for Post-Acute and Long-Term Care Medicine, developed the alternative methodology through the use of ZIP codes and assisted living community addresses. The researchers said their approach is less expensive, capable of identifying even residents of small assisted living homes, and more sensitive and specific in identifying residents.

Including residents of small assisted living communities is important, the authors said, because such places represent more than half of all such facilities. Residents of these smaller facilities also tend to be younger, minorities and dually eligible for Medicare and Medicaid compared with residents of larger facilities, they said. Studies that use this alternative methodology to identify outcomes and assess care quality in assisted living communities could be beneficial for operators, according to lead author Helena Temkin-Greener, Ph.D., a professor at the University of Rochester School of Medicine.

Assisted living communities, according to the study authors, account for half of all long-term care beds and serve frail and impaired people. With Medicaid long-term care services and supports increasingly funding assisted living as an alternative site to nursing homes via home- and community-based services, the proportions of dually eligible and minority residents in assisted living likely will grow, they added. 

It’s difficult for researchers to address critical research and policy issues because no centralized data collection related to assisted living communities, which primarily are regulated at the state level, exists, the authors said. Providing a low-cost, simple methodology to identify Medicare beneficiaries in assisted living could help both researchers and policymakers study disparities in care, relationships between community size and resident health characteristics, and how care transitions and outcomes vary across providers, they added.

“Given these changes, and the regulatory, financial and workforce complexities increasingly affecting the residential care market, understanding how these factors influence care quality and outcomes and assessing potential disparities in care have become essential,” the authors wrote. 

The study was funded by the Department of Health and Human Services’ Agency for Healthcare Research and Quality.