The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65943

Robert E Burke, PhD and Justin Klotz, BA. Wertlieb Educational Institute for Long Term Care Management, The George Washington University, 2175 K Street, NW, Suite 700, Washington, DC 20037, 202 416 0492, hsmreb@gwumc.edu

With the continually growing alphabet soup laws and requirements that control nursing homes, i.e., OBRA'87, HIPAA, BBA, BBRA, the post-acute provider report they just try to survive. As long-term providers enter and some successfully exit bankruptcy, have issues of survival become more necessary than planning for the future? Based on publicly available population and health service data, this paper presents paradigms as to how the post-acute care services and nursing homes may look in 2030. In post-acute care there are several populations that are not always mutually exclusive. They are: short stayers who are over 65 and who have just been released from an acute hospital, the very old for whom the nursing home has become their last resort, the under 65 who are disabled, and some, usually older people with chronic mental illness. Since the 1980s, we have seen dramatic changes in the numbers of older Americans who use assisted-living facilities instead of nursing homes, an increase in the number of under 65 year old disabled, and more use of hospice as a palliative alternative. We document that there is a tremendous amount of admissions and discharges to all types of health care providers. This suggests that there is more flow between and among services such that the model that one nursing home is the last for resort and final home is true only for a few.

Using these data and models, we demonstrate the need for planners and providers to plan for the future. Our analyses propose that post-acute care in 2020 will be very different.

Learning Objectives:

• At the conclusion of the session, the particpant will be able to:
• Discuss how nursing home care has evolved over the past twenty years.
• Describe the increase in service options for post acute care.
• Articulate the changes in the use of post-acute care services.
• Identify the changing post-acute care demographic

Keywords: Long-Term Care, Disability Policy

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.