Pilot Study of Assisted Living Facilities in Florida

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The specific aim of the project is to pilot test data collection instrument that will enable investigation pf variations in residents' income, race/ethnicity, gender and other individual characteristics (including physical and cognitive status) in assisted living facilities by key characteristics of the facility (size, public/private admission rates, rural/urban location, ownership type). Prior research indicates that ALF placement may be an appropriate substitute for nursing home admission,, for at least some frail elderly people. In efforts to contain the costs of long-term care to the frail elder population, the federal government and state governments have implemented policies that have expanded access to ALFs for low-income frail elders though public subsidies for placement in ALFs. A recent national study, the HHS sponsored National Study of Assisted Living Facilities (NSALF), gathered data only for large (11 or more residents) facilities. These facilities served predominantly affluent, white, women residents who paid privately for their own care. Yet the pilot study investigators preliminary analysis of Florida ALF administrative data indicates that publicly-funded ALF resident admissions are concentrated mainly in small (fewer than 10 residents) facilities. Consequently, high quality empirical data that permits comparison across types of ALFs and residents is important. Because research shows that ALFs placements are appropriate for some frail elders at risk of nursing home admission, and because the public sector funds for long-term care are increasing in the ALF sector, the implications for serving different vulnerable sub-groups of the frail elder populations in different types of ALFs need to be investigated. The pilot will provide the foundation for data collection in a larger study which will provide the empirical basis for investigation of differences among ALF types and the populations they serve. The size and diversity of Florida's elder population and its ALF sector and the significant role that Florida public policy plays in subsidizing ALF admissions make Florida an appropriate site for this pilot study of the interaction between research and public policy.