Nursing homes experienced unprecedented financial challenges during the COVID-19 pandemic, raising concerns about a potential increase in nursing home closures.
Long-Term Services & Supports, Long-Term Care
ASPE conducts research, analysis, and evaluation of policies related to the long-term care and personal assistance needs of people of all ages with chronic disabilities. ASPE’s work also highlights the financing, delivery, organization, and quality of long-term services and supports, including those supported or financed by private insurers, Medicaid, Medicare, and the Administration for Community Living (ACL). This includes assessing the interaction between health care, post-acute care, chronic care, long-term care, and supportive services needs of persons with disabilities across the age spectrum; determining service use and program participation patterns; and coordinating the development of long-term care data and policies that affect the characteristics, circumstances, and needs of people with long-term care needs, including older adults and people with disabilities.
Noteworthy
Most Older Adults Are Likely to Need and Use Long-Term Services and Supports
More than one-half of older adults, regardless of their lifetime earnings, are projected to experience serious LTSS needs and use some paid LTSS after turning 65.
Older adults with limited lifetime earnings are more likely to develop serious LTSS needs than those with more earnings.
However, fifty-six percent of older adults in the top lifetime earnings quintile receive some paid LTSS, and the likelihood of nursing home care does not vary much by lifetime earnings. Learn more.
Reports
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Advanced SearchASPE Issue Brief
Nursing Home Closures Did Not Increase in 2020 and 2021, Despite Financial Challenges Caused by the COVID-19 Pandemic Issue Brief
Research Brief
Racial, Ethnic, and Socioeconomic Differences in COVID-19 Diagnosis and Mortality Among Nursing Home Residents
Nursing homes have been disproportionately impacted by COVID-19. The purpose of this study was to examine whether there were racial, ethnic, and socioeconomic differences in COVID-19 infection and mortality rates at both the nursing home resident and nursing home facility levels. The study includes national data on COVID-19 outcomes for nursing home residents through the end of June 2021.
ASPE Issue Brief
Barriers and Opportunities for Improving Interstate Licensure Portability for Behavioral Health Practitioners: Technical Expert Panel Findings Issue Brief
In October 2022, ASPE convened a virtual technical expert panel (TEP) to discuss policy options that encourage interstate licensure among behavioral health providers.
Environmental Scan
Impact of COVID-19 on Clinical Trials Costs to Patients
This environmental scan, conducted by Mathematica and funded by ASPE, examines the types of direct and direct costs to patients associated with clinical trial participation. It also explores the effect of COVID-19 on costs to patients, including cost implications of clinical trial innovations widely implemented during COVID-19 and other efforts to increase diversity of clinical trials.
ASPE Issue Brief, Report
Transformation of the Clinical Trial Enterprise: Lessons Learned from the COVID-19 Pandemic
In 2023, ASPE launched a research project to understand the impacts of COVID-19 on the clinical trial enterprise and identify key lessons learned.
ASPE Data Point
Nurse Staffing Estimates in US Nursing Homes, May 2024
In April 2024, CMS issued the Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting final rule which established new minimum nurse staffing requirements for nursing homes by nurse type.
ASPE Issue Brief
Medicaid Home and Community-Based Services Section 1915(c) Waiver Policy Flexibilities During the COVID-19 Public Health Emergency: State Agency, Provider, and Consumer Experiences Issue Brief
States may use Appendix K to modify their existing Medicaid home and community-based services (HCBS) 1915(c) waiver programs during emergency situations. During the COVID-19 public health emergency, states used Appendix K to make temporary changes to access and eligibility, payment, services, and other aspects of their waiver programs.
Research Brief
Changes in Ownership of Skilled Nursing Facilities from 2016 to 2021: Variations by Size, Occupancy Rate, Penalty Amount, and Type of Ownership
Stakeholders, researchers, and policymakers have identified varying nursing home ownership structures and ownership transactions as potentially influencing the quality of care delivered to vulnerable residents.
Report
Medicare Advantage Coverage Among Individuals Receiving Federal Housing Assistance
Prior research from the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) and U.S. Department of Housing and Urban Development (HUD) Office of Policy Development and Research (PD&R) show older adults receiving federal housing assistance face disproportionately high rates of chronic conditions and health care utilization.
ASPE Issue Brief
Trends and Disparities in Pandemic Telehealth Use among People with Disabilities
This Issue Brief explores telehealth use for people and Medicare beneficiaries with disabilities and examines questions on the use of audio-only telehealth during the second and third years of the coronavirus disease 2019 (COVID-19) pandemic.