KEY POINTS: * New research reveals an association between an increase in assisted living options and declines in nursing home occupants. * Assisted living, often financed by private resources, offers alternatives to nursing home care for some individuals. * As more people utilize assisted living options, nursing homes may see negative financial effects.

By Katherine Kahn, Contributing Writer Research Source: Health Services Research Health Behavior News Service

Newswise — A new study finds an association between an increase in assisted living options, which provide older adults with an array of services such as help with everyday tasks in homelike settings, and a decline in nursing home occupancy. This shift in delivery of care has both positive and negative implications for seniors.

The study appears in the upcoming issue of Health Services Research.

Data on assisted living is patchy, primarily because the assisted living industry is not widely regulated and receives little government financing. Additionally, what constitutes assisted living is poorly defined and typically includes a broad range of housing options with varying levels of care.

“Assisted living has, in general, not been very well understood or studied in its role in the broader long-term care marketplace,” said the study’s lead researcher, David Grabowski, Ph.D., professor of health care policy at Harvard Medical School.

To collect data on assisted living, Grabowski and his colleagues contacted each state; however, only 13 states had long-term data available, from 1993 to 2007. Data for nursing homes was gathered from the Centers for Medicare and Medicaid Services, which represents over 95 percent of all nursing home facilities in the U.S., and from Brown University’s Minimum Data Set (MDS) on long term care.

“We found that a 10 percent increase in assisted living capacity led to a 1.4 percent decline in private-pay nursing home occupancy,” Grabowski said. “It’s not a huge effect and it’s not a one-to-one substitution, but I think this is a pretty sizable relationship.”

Since most individuals in assisted living are private-paying residents, researchers accurately predicted that assisted living expansion would have little impact on occupancy of Medicaid nursing home residents or Medicare-eligible patients who were in nursing homes for short-term care after a hospitalization.

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