Transition from Home Care to Nursing Home: Unmet Needs in a Home- and Community-Based Program for Older Adults |
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| Authors: | Julie Robison PhD Noreen Shugrue JD MBA MA Martha Porter BA Richard H. Fortinsky PhD Leslie A. Curry PhD MPH |
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| Affiliation: | 1. Associate Professor, Center on Aging , University of Connecticut Health Center , Farmington , Connecticut , USA jrobison@uchc.edu;3. Research Associates, Center on Aging , University of Connecticut Health Center , Farmington , Connecticut , USA;4. Professor, Physicians Health Services Endowed Chair in Geriatrics and Gerontology, Center on Aging , University of Connecticut Health Center , Farmington , Connecticut , USA;5. Research Scientist, Division of Health Policy and Administration , Yale School of Public Health , New Haven , Connecticut , USA |
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| Abstract: | A major effort is under way nationally to shift long-term care services from institutional to home- and community-based settings. This article employs quantitative and qualitative methods to identify unmet needs of consumers who transition from a statewide home- and community-based service program for older adults to long-term nursing home residence. Administrative data, care manager notes, and focus group discussions identified program service gaps that inadequately accommodated acute health problems, mental health issues, and stressed family caregivers; additional unmet needs highlighted an inadequate workforce, transportation barriers, and limited supportive housing options. National and state-level policy implications are considered. |
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| Keywords: | HCBS long-term care Medicaid waiver mixed methods rebalancing |
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