The Relationship Between Older Americans Act In-Home Services and Low-Care Residents in Nursing Homes

Abstract

OBJECTIVE: The aim of the study was to investigate the relationship between supportive services provided under Title III-B of the Older Americans Act (OAA) and the prevalence of low-care residents in nursing homes (NHs). METHOD: State Program Reports (state-level expenditure and utilization data for each OAA service) and NH facility-level data were analyzed using a two-way fixed effects model. RESULTS: Results suggest that every additional 1% of the population age 65+ that receives personal care services is associated with a 0.8% decrease in the proportion of low-care residents in NHs. DISCUSSION: Despite efforts to rebalance long-term care, there are still many NH residents who have the functional capacity to live in a less restrictive environment. This is among the first studies to suggest that states that have invested in their in-home supportive services, particularly personal care services provided through the OAA, have proportionally fewer of these people.