1. 1 National Surveys of Long-Term Care Providers: Recent Findings and Plans for the Future Lauren Harris-Kojetin NCHS Emily Rosenoff ASPE Long-Term Care Discussion Group February 23, 2012 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics and the Office of the Assistant Secretary for Planning and Evaluation

2. 2 NSRCF Partners CDC’s National Center for Health Statistics (NCHS) HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) Contributing agencies and departments CDC’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) CDC’s National Center for Immunization and Respiratory Diseases (NCIRD) Agency for Healthcare Research and Quality (AHRQ) U.S. Department of Veterans Affairs (VA)

3. 3 NSRCF Supporters

4. 4 NSRCF Primary Goals 1.Estimate the size of the U.S. industry Number of facilities and residents 2.Determine the characteristics of facilities Geographic distribution, physical environment, staff, services offered, admission and discharge policies 3.Determine the characteristics of residents Demographics, health status, physical functioning, cognitive impairment, service use, involvement in activities, charges

5. 5 NSRCF Eligibility Definition have 4 or more beds; serve primarily an adult population; are licensed, registered, listed, certified, or otherwise regulated by the state; provide room and board with at least 2 meals a day; provide around-the-clock on-site supervision; offer help with personal care (e.g., bathing and dressing) OR health care-related services (e.g., medication management); and have at least 1 resident at time of interview. Facilities exclusively serving adults with severe mental illness or ID/DD are excluded.

6. NSRCF Data Collection Conducted interviews April – November 2010 Collected data on 2,302 facilities and 8,094 current residents Weighted response rates – Facility-level: 81% and Resident-level: 99% Design and Operation of the 2010 National Survey of Residential Care Facilities http://www.cdc.gov/nchs/data/series/sr_01/sr01_054.pdf 6

7. 7 Upcoming NSRCF Products NCHS Facility Data Brief, December 15 NCHS Resident Data Brief, March 2012 ASPE Policy Briefs, Spring and Summer 2012 – Impact of the April 15, 2011 Proposed Rule on Medicaid HCBS Waivers – Medicaid in Residential Care – Resident Health Conditions/Functional States and Services NCHS/ASPE NSRCF Chart Book, 2013

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11. Use of Medicaid for long-term care services in residential care facilities: United States, 2010 11 Percent NOTE: Figure excludes cases with missing data. SOURCE: CDC/NCHS, National Survey of Residential Care Facilities, 2010.

12. 12 Percent Selected demographic characteristics of residents in residential care facilities: United States, 2010 NOTE: Figure excludes cases with missing data. SOURCE: CDC/NCHS, National Survey of Residential Care Facilities, 2010.

13. 13 Receiving assistance in activities of daily living (ADLs) and common chronic conditions of residents in residential care facilities: United States, 2010 NOTE: Figure excludes cases with missing data. SOURCE: CDC/NCHS, National Survey of Residential Care Facilities, 2010.

14. 14 NOTE: Figure excludes cases with missing data. SOURCE: CDC/NCHS, National Survey of Residential Care Facilities, 2010. Selected services offered by facilities and used by residents in residential care facilities: United States, 2010 Percent

15. 15 http://www.cdc.gov/nchs/nsrcf.htm

16. Plans for the Future: NSLTCP Primary Goals 1.Estimate the U.S. national supply of paid, regulated LTC providers 2.Estimate key policy-relevant characteristics and practices of these providers 3.Estimate the national use of these providers 4.Estimate key policy-relevant characteristics of these users  Provider state estimates for a subset of measures as feasible within confidentiality and reliability standards 16

17. NSLTCP Provider Association Supporters 17

18. NSLTCP Core Products Overview report on supply and use of paid, regulated LTC in the United States Public-use files for providers for which core survey data collected Surveys fielded and report updated every other year 18

19. NSLTCP Provider Types and Data Sources Hospices Nursing Homes Home Health Care Agencies Residential Care Facilities Adult Day Services Centers PROVIDER TYPES Administrative records Survey data DATA SOURCES 19

20. NSLTCP Core Domains About providers Basic characteristics Services Staffing Practices (includes EHR functionalities) About users—Aggregate-level distributions Demographics Physical functioning Cognitive functioning 20

21. http://www.cdc.gov/nchs/nsltcp.htm 21

22. 22 NSLTCP or NSRCF: Lauren Harris-Kojetin National Center for Health Statistics fti3@cdc.gov fti3@cdc.gov 301-458-4369 NSRCF: Emily Rosenoff Assistant Secretary for Planning and Evaluation Emily.Rosenoff@HHS.GOV 202-690-5740