Transcript National Study of Long-Term Care Providers (NSLTCP) A New Resource to Support Research, Policy, and Practice Lauren Harris-Kojetin, PhD [email protected] Eunice Park-Lee, PhD [email protected] Long-Term Care Statistics.

National Study of
Long-Term Care Providers (NSLTCP)
A New Resource to Support Research, Policy, and Practice
Lauren Harris-Kojetin, PhD
[email protected]
Eunice Park-Lee, PhD
[email protected]
Long-Term Care Statistics Branch
The Long Term Care Discussion Group
February 24, 2015
Contributors to this Presentation
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Christine Caffrey
Lisa Dwyer
Lauren Harris-Kojetin
Eunice Park-Lee
Vincent Rome
Manisha Sengupta
Roberto Valverde
National Center for Health Statistics—
Long-Term Care Statistics Program
• National Health Care Surveys’ Mission
 To collect, analyze, and disseminate data on…
• use, access, quality, and cost of health care provided in the United
States and
• health care organizations and professionals who deliver that care
• Long-Term Care Services Providers Surveyed
 National Nursing Home Survey (NNHS)
• National Nursing Assistant Survey (NNAS) supplement
 National Home and Hospice Care Survey (NHHCS)
• National Home Health Aide Survey (NHHAS) supplement
 National Survey of Residential Care Facilities (NSRCF)
 National Study of Long-Term Care Providers (NSLTCP)
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Overview
• Sponsored by CDC’s National
Center for Health Statistics
• Integrated initiative to monitor
trends in paid, regulated longterm care
• Five sectors
 adult day services centers and
participants
 home health agencies and
patients
 hospices and patients
 nursing homes and residents
 residential care communities
and residents
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Primary Goals
1. Estimate supply and use of paid, regulated long-term
care services
2. Estimate key policy-relevant characteristics of providers
and users, and practices of providers
3. Produce national and state-level estimates, where
possible
4. Compare within and between sectors
5. Examine trends over time
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Topics about Providers
Bolded topics are available for all five sectors
• Basic operating characteristics—Ownership, chain status,
capacity, number served, Medicaid participation, part of
a CCRC, years in operation, dementia special care unit
• Services offered and how—Dental, hospice, social work,
case management, medication management, mental
health, therapeutic, pharmacy, podiatry, skilled nursing,
transportation
• Staffing—Nursing, social workers, activities staff
• Practices—Depression screening, disease management
programming, EHR, person-centered practices
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Topics about Users (Aggregate distributions)
Bolded topics are available for all five sectors
• Demographics—Age, Race, Ethnicity, Sex, Medicaid use
• Selected medical conditions—Alzheimer’s disease or
other dementias, developmental disability, severe mental
illness, depression
• Physical and Cognitive Functioning—Need any ADL
assistance (transferring, eating, dressing, bathing,
toileting, locomotion), wheelchair/scooter use
• Health care use—Overnight hospitalizations, rehospitalizations, ED use
• Other characteristics—Move-ins, move-outs and where
went, left because of cost
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Provider Sectors and Data Sources
PROVIDER SECTORS
Hospices
Nursing
Homes
Home
Health Care
Agencies
Residential
Care
Communities
Adult Day
Services
Centers
DATA SOURCES
Administrative records
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Survey questionnaire
Products Using 2012 Data
Published in 2013
• Survey restricted data files for adult day and residential care available
through NCHS Research Data Center—10/2013
• First overview report on all 5 sectors—12/2013
Published in 2014
• Adult day data briefs with link to state web tables—10/2014
• Residential care data briefs with link to state web tables—11/2014
• Quickstats—varied topics and dates
To be published in 2015
• State web tables to complement first overview report—2/2015
• Weighted national estimates document—by 4/2015
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http://www.cdc.gov/nchs/nsltcp.htm
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http://www.cdc.gov/nchs/nsltcp/nsltcp_products.htm
Selected National Results Across Sectors
As of 2012 in the United States…
• about 58,500 paid, regulated long-term care services providers
served about 8 M people.
 4,800 adult day services centers had 273,200 participants
enrolled on a typical day
 12,200 home health agencies served over 4.7 M patients
annually
 3,700 hospices served over 1.2 M patients annually
 15,700 nursing homes served almost 1.4 M residents on a
typical day
 22,200 residential care communities housed 713,300
residents on a typical day
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Percent Distribution of Long-Term Care Providers, by Type of Provider and
Region: United States, 2012
(4,800)
(12,200)
(3,700)
NOTE: Percentages are based on the unrounded numbers.
SOURCE: CDC/NCHS, National Study of Long-Term Care Providers
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(15,700)
(22,200)
Percentage of Long-Term Care Services Providers with Any Full-Time
Equivalent Employees, by Type of Provider and Staff Type: United States,
2012
NOTE: Percentages are based on the unrounded numbers.
SOURCE: CDC/NCHS, National Study of Long-Term Care Providers
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Percent Distribution of Users of Long-Term Care Services, by Type of
Provider and Age Group: United States, 2011 and 2012
<65
16.9
65-74
75-84
85+
25.5
46.8
42.3
50.5
27.2
32.2
19.4
27.9
31.3
32.4
24.6
14.9
36.5
17.6
16.4
5.5
Adult day services
centers
Home health
agencies
Hospices
10.4
6.7
14.9
Nursing homes
Residential care
communities
NOTE: Percentages may not add to 100 because of rounding. Percentages are based on the unrounded numbers.
SOURCE: CDC/NCHS, National Study of Long-Term Care Providers
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Percent Distribution of Users of Long-Term Care Services, by Type of
Provider and Race and Hispanic Origin: United States, 2011 and 2012
Hispanic
4.7
8.4
Non-Hispanic White
3.0
15.7
14.1
Non-Hispanic Black
2.1
8.1
Non-Hispanic Other
2.3
14.0
6.3
4.0
87.3
16.8
80.0
47.3
74.5
85.3
78.7
8.4
4.6
5.1
Home health
agencies
Hospices
20.2
6.9
Population 65
Adult day
and older
services centers
2.4
Nursing homes Residential care
communities
NOTE: Percentages may not add to 100 because of rounding. Percentages are based on the unrounded numbers.
SOURCE: CDC/NCHS, National Study of Long-Term Care Providers
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Percentage of Users of Long-Term Care Services Needing Any Assistance
with Activities of Daily Living, by Type of Provider and Activity: United
States, 2011 and 2012
Bathing
Dressing
Toileting
Eating
96.1
95.1
90.9
83.8
86.6
64.6
61.4
56
51.2
44.9
39.6 37.8
36.2
36.8
25.3
17.7
Adult day services centers
Home health agencies
NOTE: Percentages are based on the unrounded numbers.
SOURCE: CDC/NCHS, National Study of Long-Term Care Providers
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Nursing homes
Residential care communities
Percentage of Users of Long-Term Care Services with a Diagnosis of
Alzheimer’s Disease or Other Dementias and with a Diagnosis of Depression,
by Type of Provider: United States, 2011 and 2012
Alzheimer's disease or other dementias
Depression
48.5 48.5
44.3
39.6
34.7
31.9
30.1
23.5
Adult day services
centers
22.2
Home health
agencies
Hospices
NOTE: Percentages are based on the unrounded numbers.
SOURCE: CDC/NCHS, National Study of Long-Term Care Providers
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24.8
Nursing homes
Residential care
communities
Percentage of Long-Term Care Services Providers that Used Electronic Health
Records and with Computerized Support for Electronic Health Information
Exchange with Physicians and Pharmacies, by Provider Type: United States, 2012
Used electronic health records
With computerized support for electronic health information exchange with pharmacies
With computerized support for electronic health information exchange with physicians
20.0
20.0
20.3
13.3
7.5
5.9
Adult day services centers
NOTE: Percentages are based on the unrounded numbers.
SOURCE: CDC/NCHS, National Study of Long-Term Care Providers
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Residential care communities
Selected State Results for Adult Day or Residential Care
Eunice add depression screening for adult day centers
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Next Steps
• 2012 wave provides a baseline to examine trends in future
waves
• Infrastructure in place to collect data for adult day services
centers and assisted living and similar residential care
communities
• Potential to add sectors, collect primary data on other sectors,
or add content to current surveys
• Exploring feasibility of person-level sampling and data
collection
• Just completed 2nd wave of survey data collection
• Aim to start publishing results using 2014 data by end of 2015
• Working to produce public-use survey files
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Thank you!
Questions?
Supplemental Information
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Residential Care Community Definition
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4 or more beds;
primarily an adult population;
at least 1 resident at time of interview;
licensed, registered, listed, certified, or otherwise
•regulated by the state to…
• provide room and board with at least 2 meals a day;
• provide around-the-clock on-site supervision; and
• offer help with personal care OR health care-related
services.
•Exclusions: Nursing homes and providers exclusively
serving adults with severe mental illness or ID/DD.