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Mental Health Needs in Nursing Facilities (2010)

In FY09 the Center for Research on Aging and Disability Options (CRADO) began a study to examine the mental health status and needs, interventions, and discharge patterns of older adults using Medicaid who reside in Kansas nursing facilities (NFs). For mental health status and needs, this study will analyze the characteristics (e.g., demographics, mood, behaviors) associated with NF residents mental health diagnoses and identify potential barriers to addressing mental health needs. When examining interventions, we will investigate the mental health interventions currently in use as well as identify emerging and evidence-based practices and/or interventions, with a focus on interventions that could assist Medicaid residents with mental health needs in discharging from NFs to community-based settings. In order to examine discharge patterns, the mental health status and need, and interventions will be investigated for their relationship to discharge patterns and NF tenure. The findings from this study will provide background information for the future implementation of mental health interventions in nursing facilities and recommendations for the training of NF staff members and CARE assessors.
Mental Health Needs in Nursing Facilities (2009)

The Longitudinal Study of Customers Diverted Through the CARE Program (2003)

The Longitudinal Study of Customers Diverted Through the CARE Program*, or Diversion Study, tracked four cohorts of older adults who had applied for nursing facility admission and were living in a community setting thirty days later. The purpose was to measure how long these diverted older adults were able to maintain community tenure, to explore the level at which they use community-based services, and to identify the differences and similarities between diverted and non-diverted older adults. CRADO has continued to track the original cohort of diverted customers for five years (Report forthcoming). Continued tracking allows the CRADO to establish a complete and accurate measure of the average length of community tenure.

The Examination of the Relationship of the Use of Medicare Home Health Services and Informal Caregiving to Successful Community Tenure project built on the analysis of factors related to long-term community tenure. The purpose of this study was to examine the relationship of the use of Medicare home health services and informal caregiving to community tenure of older adults who were diverted from nursing facility placement.

The Expanded Examination of Factors Related to Diversion and Successful Community Tenure for Medicaid Customers: The Role of Diagnoses and Prescription Drug Use* project also builds on the Diversion Study by examining the affect of different diagnoses and medication use on the likelihood of being diverted and on the length of community tenure. This study will also provide a cost-benefit analysis of HCBS/FE compared to nursing facility care (Report forthcoming). These projects were funded in part through a contract with KDOA and SRS. (PDF)

Reports Available:

Longitudinal Study of Customers Diverted through the Care Program Report: Fiscal Year 2000; (pdf)

Longitudinal Study of Customers Diverted through the CARE Program: Fiscal Year 2001 Report (pdf), and Appendices; (pdf)

Longitudinal Study of Customers Diverted through the CARE Program Report: Fiscal Year 2002: Summary of Key Policy Findings, (pdf) Technical Report (pdf), and Appendices (pdf);

Examination of the Use of Medicare Home Health Services and Informal Caregiving and Their Relationship to Successful Community Tenure (pdf) and Appendices (2003); (pdf)

The Diversion Study Update: Community Tenure Status of Diverted CARE Assessment Customers at 36 months (2005). (pdf)

The Community Tenure Study: Community Tenure Status of CARE Assessment Customers 60 Months after Diversion. (pdf)

Presentations:

Macmillan, K., Chapin, R., Rachlin, R., Zimmerman, M., Baca, B. (2005, November). Community Tenure of Older Adults 36 Months After NF Diversion: Challenging Assumptions with Facts. Gerontological Society of America, Orlando, FL.

Macmillan, K., Chapin, R., Rachlin, R., Zimmerman, M. (January 2005). Length of community tenure following application for nursing facility placement: A prospective study. Paper presented at the annual meeting of the Society for Social Work and Research, Miami, FL.

Publication:

Chapin, R., Baca, B., Macmillan, K., Rachlin, R., Zimmerman, M. (in press). Residential outcomes for nursing facility applicants who have been diverted: Where are they five years later? The Gerontologist.

TLSCDT CARE Program

Older Adult Client Outcome Indicators (2002)

This project was to monitor specific outcomes for adults age 65 and over who are receiving long-term care services and are the mandated responsibility of KDADS, DCF, and KDHE. From 1995-2002, we examined independence and protection indicators at the state, county and Area Agency on Aging Planning and Service Area levels to discern regional variations and longitudinal pattern. Independence indicators relate to rates at which Kansans age 65 and over use nursing facilities and home- and community-based services, discharge from nursing facilities to the community, and are diverted from placement through community-based alternatives. Protection indicators track older Kansans’ rate of abuse, neglect, and exploitation in community and institutional settings. Data for indicators were broke down by age group, allowing more precise tracking for the most vulnerable groups. The annual reports summarized findings, examined trends for previous years, and offered policy strategies for improving home- and community-based service delivery. This project was funded in part through a contract with KDADS and DCF.

Reports available:

Older Adult Client Outcome Indicator Project Report Fiscal Year 2002. (pdf)

Older Adult Client Outcome Indicator Project Report. (pdf)

Older Adult Client Outcome Indicators (2002)

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