Infection Control Policies and Practices in Residential Care Communities by Selected Organizational and Geographic Characteristics: United States, 2020.

Objectives-Emergency operations plans that are specific to or include response to pandemics, approaches to implement the plans, and related infection control policies and practices vary among residential care communities (RCCs). This report presents nationally representative percentages of RCCs with infection control programs by selected characteristics. Methods-Data are from the RCC component of the 2020 National Post-acute and Long-term Care Study, conducted biennially by the National Center for Health Statistics. The study asked four binary questions, including whether the RCC had a written Emergency Operations Plan that was specific to or included pandemic response, had a designated staff member or consultant responsible for coordinating the infection control program, offered annual influenza vaccination to residents, and offered annual influenza vaccination to all employees or contract staff. RCC characteristics presented in this report are bed size, chain affiliation, ownership status, and provision of dementia-specific care (RCCs that only served residents with dementia or had a dementia wing). Metropolitan statistical area (MSA) was used to characterize geographic location. Results-Most RCCs reported having a written Emergency Operations Plan that was specific to or included pandemic response. A higher percentage of RCCs with more than 26 beds and those with a designated space for dementia care reported having a written Emergency Operations Plan and a designated staff to coordinate an infection control program. The largest differences were observed in the provision of annual influenza vaccination to residents and to all employees or contract staff by MSA status, bed size, and presence of a designated space for dementia care. A higher percentage of RCCs in non-MSAs (83.4%), RCCs with a designated space for dementia care (95.0%), those with more than 50 beds (93.9%), those with 26-50 beds (93.3%), and those with nonprofit ownership (85.8%) offered annual influenza vaccination to all employees or contract staff.

Metro-Nonmetro Differences in Adverse Events in Residential Care Communities: Results From the National Post-Acute and Long-Term Care Study.

More than 1 in 5 older Americans live in rural areas (10.6 million of the 46.2 million aged 65 and older). Long-term care for aging rural populations is a growing challenge in the United States. Research on long-term care services in nonmetro areas has focused almost exclusively on nursing home care, despite growth of residential care alternatives. This paper uses unique facility-level data from the 2020 National Post-acute and Long-term Care Study (NPALS) to examine the relationship of residential care community (RCC) features in metro and nonmetro settings with adverse outcomes (emergency department visits, overnight hospital stays, and falls). Nationally, in 2020, about 13.5% of RCC residents made visits to the emergency department, 8.6% had overnight hospital stays, and 21.3% had falls. Controlling for facility characteristics, RCCs in metro areas had higher risks of overnight hospital stays (p < .001) but lower risks of falls (p = .06).

Home health care and discharged hospice care patients: United States, 2000 and 2007.

OBJECTIVES: This report presents national estimates on home health care patients and discharged hospice care patients. Information on characteristics, length of service, medical diagnoses, functional limitations, service use, advance care planning, and emergent and hospital care use are presented for home health care patients and hospice care discharges. A comparison of selected characteristics for 2000 and 2007 is also provided to highlight changes. METHODS: Estimates are based on data collected on agencies from the 2000 and 2007 National Home and Hospice Care Survey, conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. Estimates are derived from data collected during interviews with administrators and staff designated by the administrators. RESULTS: Each day in 2007, there were an estimated 1,459,900 home health care patients. They were predominantly aged 65 years or over, female, and white. Their mean length of service was 315 days, and their most common primary diagnosis at admission was diabetes mellitus. About one-fourth of them had advance care planning and one-fifth had at least one overnight hospital stay since admission to the home health care agency. In 2007, there were 1,045,100 discharged hospice care patients. The majority of discharged patients were aged 65 or over, female, and white, and most were discharged deceased. Their mean length of service was 65 days, and the most common primary diagnosis at admission was malignant neoplasm. Most of them had advance care planning, and about one-fourth had three or more types of advance care planning instruments.