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Long-Term Care

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More than 12 million Americans depend on long-term care for help with everyday activities such as bathing or dressing. This group includes veterans and people with disabilities, but it is primarily comprised of seniors. Thus, the number will likely soar as the baby boom generation ages. RAND research on long-term care can help health providers and policymakers meet the growing demand for high-quality, affordable care.

Report
Family Caregivers Should Be Integrated into the Health Care Team
The pandemic has produced changes in health care practices, such as shorter hospital stays and more frequent management of chronic illnesses at home. This has shifted the responsibility for many medical tasks to family caregivers. Caregivers have become frontline workers and should be treated as members of the health care team.
Jan 5, 2021
Report
Long-Term Care Policy: Who Should Be at the Table?
The COVID-19 pandemic has underscored that long-term care residents, their families, and staff have limited representation when it comes to facility policies. Recognizing them as stakeholders with perspectives to include in decisionmaking could improve infection control practices and also address residents' health-related quality of life.
Feb 2, 2021

Explore Long-Term Care

Journal Article
Organizational and Geographic Nursing Home Characteristics Associated With Increasing Prevalence of Resident Obesity in the United States
The objective of this study was to examine the associations between nursing home obesity prevalence rate and nursing home organizational, staffing, resident, and geographic factors within a profit maximization framework.
Feb 8, 2022
Journal Article
Nurse Aide Retention in Nursing Homes
The research presented provides information on nurse aide retention in nursing homes as a workforce challenge and its impact on quality.Retention may be an additional staffing characteristic of nursing facilities with policy and practice relevance.
Feb 8, 2022
Journal Article
Nursing Home Patient Safety Culture Perceptions Among US and Immigrant Nurses
This study compared the PSC perceptions of foreign and domestic born and trained nurses working in urban NHs in 5 states to analyze how nurses' patient safety culture perceptions corresponded to their personal and professional characteristics.
Feb 8, 2022
Journal Article
Adjusting for Patient Characteristics to Compare Quality of Care Provided by Serious Illness Programs
To ensure fair comparison of serious illness programs, quality measure scores should be case-mix adjusted for variables that influence patients' reports about care quality, but are not under the control of the program administering care.
Feb 4, 2022
Journal Article
Understanding What Works: Measuring and Monitoring Quality in Medi-Cal's Home and Community-Based Services
This issue brief describes challenges and opportunities related to measuring, reporting, and monitoring the quality of HCBS sponsored by Medi-Cal.
Jan 26, 2022
Report
Evaluating New York's Medicaid Section 1115 Waiver
New York State’s Medicaid Section 1115 Waiver seeks to enroll a majority of Medicaid beneficiaries into managed care, increase access and service quality, and expand coverage to more low-income New Yorkers. RAND researchers examined whether two components of the 1115 Demonstration Waiver have helped achieve the program’s goals.
Dec 2, 2021
Journal Article
Perceived Impacts of a Medicaid Rebalancing Initiative to Increase Home- and Community-Based Services
Stakeholders reported that BIP participation had a range of impacts on the HCBS ecosystem, often beyond the structural reforms. Our findings highlight BIP impacts to monitor over the long term and to consider in evaluations of future rebalancing efforts.
Jul 16, 2021
Blog
RAND Art + Data, 'Gray Market Care,' Supply Chains and Cyberattacks: RAND Weekly Recap
This weekly recap focuses on RAND's new artist residency program, Art + Data; the prevalence of “gray market care” in the United States; supply chains' cyber problem; and more.
Jun 25, 2021
News Release
Nearly a Third of Americans Use Gray Market When Hiring Caregivers for the Elderly and Those with Dementia
Nearly a third of Americans who arranged for paid care for an older person or someone with dementia employed workers who were not hired through a regulated agency.
Jun 21, 2021
Commentary
The Informal Carers Who Help People with MS Need Support More Than Ever
The trend within health care services toward remote care and self-management for people with multiple sclerosis has not included adequate support to carers. Greater investment to support the needs of carers could support the informal care they provide, as well as the carer as an individual.
May 28, 2021
Commentary
Rescue Plan Help for Family Caregivers Is a First Step
Unpaid caregivers have been a critical part of the functioning U.S. economy, serving as the backbone of the health system, since long before the pandemic started. Adding them to the American Rescue Plan was an important step, but even after the pandemic is over, their financial security will need long-term protection.
Apr 5, 2021
Essay
Giving Family Caregivers a Voice
One in every five American adults is caring for a loved one in need. Too often, they have to fight to make their voices heard in a health care system that doesn't always see them as the partners in care they can be. More could be done to integrate them into patients' health care teams.
Mar 10, 2021
Report
Home Care Workers Are Essential Yet Undervalued
Home health and personal care aides are socially isolated and at heightened risk during the COVID-19 pandemic. Journaling is a promising way to give them a voice and reduce stress and anxiety. But policy-level changes are needed to address the issues of low wages and minimal benefits.
Feb 3, 2021
Journal Article
Do Income Supplemental Programs for Older Adults' Help Reduce Primary Caregiver Burden? Evidence from Mexico
This article analyzes the effects of a supplemental income program for older adults on primary caregiver burden, in Yucatan, Mexico.
Dec 15, 2020
Journal Article
Comparative Effectiveness of Long-Term Acute Care Hospital Versus Skilled Nursing Facility Transfer
We conducted a retrospective cohort study of patients hospitalized on a medicine service in a high-LTACH use region and discharged to either an LTACH or SNF and followed for one year.
Nov 17, 2020
Report
Family Caregivers Should Be Included in Health Care Teams
About 53 million family and friends provide care and assistance to loved ones in the United States, but they are often overlooked by health care systems. Integrating them into a patient's health care team can help improve care quality and the quality of life for patients and their families.
Nov 10, 2020
News Release
Efforts Needed to Expand Ability of Family Members to Integrate into Formal Health Care Teams
Integrating family caregivers into a patient's health care team can help improve care quality and the quality of life for both patients and their families, yet family caregivers face significant barriers coordinating their efforts with the formal health care team.
Nov 10, 2020
Journal Article
Factors Explaining State Differences in Applying for a Recent Long-Term Care Program That Promotes Aging in Place: Perspectives of Medicaid Administrators
This article examines the reasons underlying states' decisions regarding their applications to the Balancing Incentive Program.
Aug 4, 2020

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