Long-Term Services & Supports (LTSS)

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.

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.

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.

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.

This paper provides an overview of Health Information Technology (HIT) adoption and utilization in long-term and post-acute care (LTPAC) settings. This study found that LTPAC have adopted electronic health records (EHRs) to support clinical and business needs. Interoperable exchange of health information however is not routine or widely used.

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.

Home and community-based services (HCBS) are a range of medical and non-medical services provided in the home and community that support individuals with functional limitations, enabling them to reside in the community rather than in institutional settings.

During the COVID-19 public health emergency, states used Appendix K, a standalone appendix available during emergency situations, to modify their existing Medicaid HCBS 1915(c) waiver programs. Using Appendix K, states can make to make temporary changes to access and eligibility, payment, services, and other aspects of their waiver programs.

As the United States population ages, a larger proportion of individuals will likely need and use long-term services and supports (LTSS). Much of this support is provided by informal (i.e., unpaid) caregivers. For those that need paid LTSS, most Americans pay out-of-pocket. Some may do so until their personal resources are exhausted, and then rely on the Medicaid safety net.

This issue brief provides updates on state Medicaid policies regarding delivery of telehealth services by provider types and modalities, as of January 2022. The COVID-19 pandemic substantially accelerated interest in and utilization of telehealth across all payers including Medicaid.