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. 2017 Jun;39(5):597-611.
doi: 10.1177/0164027515622244. Epub 2015 Dec 17.

Rebalance Without the Balance: A Research Note on the Availability of Community-Based Services in Areas Where Nursing Homes Have Closed

Denise A Tyler  1   2 , Mary L Fennell  1   3
Affiliations

Rebalance Without the Balance: A Research Note on the Availability of Community-Based Services in Areas Where Nursing Homes Have Closed

Denise A Tyler et al. Res Aging. 2017 Jun.

Abstract

Policies to "rebalance" funding away from nursing homes and toward home and community-based services (HCBS) have encouraged national trends of nursing home closure and an expansion of the HCBS industry. These changes are unfolding without a clear understanding of what services are available at the local level. The purpose of this study was: (1) to describe the current distribution of community-based services (CBS) in areas where nursing homes have closed and (2) to examine differences in availability of CBS using local market and population characteristics as regressors in a multinomial logistic model. We collected data on and geocoded CBS facilities and then used ArcGIS to define a 5-mile radius around all nursing homes that closed between 2006 and 2010 and compared these local market areas. In rural areas, availability of CBS does not appear to compensate for nursing home closures. Policies encouraging HCBS may be outpacing availability of CBS, especially in rural areas.

Keywords: community-based services; long-term care; nursing homes; rural access.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Community-based services available in urban versus rural local market areas. Note. Dot in the center of the circle represents the closed nursing home, the circle represents the local market area (i.e. the 5 mile radius around the closed nursing home), other dots in the circle are open nursing homes, stars are ALFs and triangles are ADSCs.
See this image and copyright information in PMC

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