Best at Home: Assuring Quality Long-Term Care in Home and Community-Based Settings

Excerpt

Millions of Americans—both old and young—currently receive some type of long-term care (LTC) in their own homes or in residential care settings other than nursing facilities. For many—if not the majority—this embodies their emphatic choice to stay in their own homes and communities for as long as possible. Equally compelling to lawmakers and the general public eager to cut skyrocketing health care costs is the potential for home and community-based care to be a cost-effective alternative to institutional LTC. Yet concerns abound about the quality of service provided in all the settings that make up the LTC system. The quality of care in nursing facilities has long been questioned, resulting in numerous studies and regulatory efforts. This report, however, focuses on the quality of care provided within individuals' homes— however they define home—whether it is an apartment in a residential care facility, a room in their adult child's home, or the single family dwelling they have lived in for years. This report also briefly examines how the quality of that care is currently assured and improved, and presents a study plan for a much more thorough examination of these issues to be done by the Institute of Medicine (IOM).