1. A New Resource to Support Research, Policy, and Practice Lauren Harris-Kojetin, PhD LHarrisKojetin@cdc.gov Eunice Park-Lee, PhD EParkLee@cdc.gov Long-Term Care Statistics Branch The Long Term Care Discussion Group January 27, 2015 National Study of Long-Term Care Providers (NSLTCP)

2. Christine Caffrey Lisa Dwyer Lauren Harris-Kojetin Eunice Park-Lee Vincent Rome Manisha Sengupta Roberto Valverde 2 Contributors to this Presentation

3. 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) 3

4. Overview 4 Sponsored by CDC’s National Center for Health Statistics Integrated initiative to monitor trends in paid, regulated long- term 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

5. 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 5

6. 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 6

7. 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, re- hospitalizations, ED use Other characteristics—Move-ins, move-outs and where went, left because of cost 7

8. Provider Sectors and Data Sources 8 Hospices Nursing Homes Home Health Care Agencies Residential Care Communities Adult Day Services Centers PROVIDER SECTORS Administrative records Survey questionnaire DATA SOURCES

9. 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 Products Using 2012 Data 9

10. http://www.cdc.gov/nchs/nsltcp.htm 10

11. 11

12. http://www.cdc.gov/nchs/nsltcp/nsltcp_products.htm

13. Selected National Results Across Sectors

14. 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 14

15. Percent Distribution of Long-Term Care Providers, by Type of Provider and Region: United States, 2012 NOTE: Percentages are based on the unrounded numbers. SOURCE: CDC/NCHS, National Study of Long-Term Care Providers 15 (4,800)(12,200)(3,700) (15,700) (22,200)

16. Percentage of Long-Term Care Services Providers with Any Full-Time Equivalent Employees, by Type of Provider and Staff Type: United States, 2012 16 NOTE: Percentages are based on the unrounded numbers. SOURCE: CDC/NCHS, National Study of Long-Term Care Providers

17. Percent Distribution of Users of Long-Term Care Services, by Type of Provider and Age Group: United States, 2011 and 2012 17 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

18. Percent Distribution of Users of Long-Term Care Services, by Type of Provider and Race and Hispanic Origin: United States, 2011 and 2012 18 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

19. 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 19 NOTE: Percentages are based on the unrounded numbers. SOURCE: CDC/NCHS, National Study of Long-Term Care Providers

20. 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 20 NOTE: Percentages are based on the unrounded numbers. SOURCE: CDC/NCHS, National Study of Long-Term Care Providers

21. 21 NOTE: Percentages are based on the unrounded numbers. SOURCE: CDC/NCHS, National Study of Long-Term Care Providers 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

22. Selected State Results for Adult Day or Residential Care

23. Eunice add depression screening for adult day centers 23

27. 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 2 nd wave of survey data collection Aim to start publishing results using 2014 data by end of 2015 Working to produce public-use survey files 27

28. Thank you! Questions?

29. Supplemental Information 29

30. Residential Care Community Definition 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.