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This report evaluates the Nursing Home Connection, a demonstration project that tested the use of nurse practitioners (NPs) and physician assistants (PAs) to improve quality of care in nursing homes. The section on methods describes the matched sampling strategy, the quality of the resultant matched samples, the data collection based on nursing home medical records, and a cross-validation exercise that compared the record review data with the combined Medicare and Medicaid claims data on hospitalizations. Other sections discuss findings on functional status outcomes, use of medications, amounts of medical attention, and quality of care; the results of the cost study; and the results of a small survey on program satisfaction collected from nursing home administrators and directors of nursing in participating nursing homes. The evaluation of the Nursing Home Connection demonstration found a modest improvement in both the quality and quantity of care provided to nursing home patients at no additional expense. In addition, the results clearly show that NPs and PAs are adequate as substitutes for physicians within the scope of practice prescribed by the demonstration.

This report is part of the RAND Corporation Joint report series. The joint report was a product of the RAND Corporation from 1988 to 1993 that included documents published jointly with other organizations, which transmitted major research findings and final research.

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