Caring for persons with disabilities in the least restrictive setting is a major long-term policy objective. It is therefore important to understand why people are in nursing homes, and to identify those who could be discharged to the community if appropriate home and community-based services were available. This study analyzed data from the Resident Assessment Instrument’s Minimum Data Set (MDS) on 750,000 nursing facility residents in nine states from 1994 to 1996. Residents were categorized within chronological age group (0-4, 5-14, etc.) and their functional status, chronic conditions and treatments were compared. Factor analysis was used to derive a chronic conditions hierarchy classification. This classification provides a method for identifying the primary reason for nursing home. Major findings include: (1) pediatric residents appear substantially more physically and cognitively impaired than young adult residents; (2) the primary diagnoses of young adult residents were related to mental retardation and other developmental disabilities while older residents were typified by increasing prevalence of neurological diagnoses and more co-morbid conditions; (3) non-elderly adult residents have the highest prevalence of chronic mental health and terminal illnesses; and (5) fifteen diagnostic factors provide a chronic care hierarchy (MDS-CCH) that classifies nearly 85% of all nursing home residents and highlights differences between age groups.
PIC ID: 6275; Agency Sponsor: ASPE-ODALTCP, Office of Disability, Aging, and Long-Term Care Policy; Federal Contact: Drabek, John, 202-690-6443; Performer: Hebrew Rehabilitation Center for the Aged, Boston, MA