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. 2018 Feb;56(2):e10-e15.
doi: 10.1097/MLR.0000000000000659.

A Methodology to Identify a Cohort of Medicare Beneficiaries Residing in Large Assisted Living Facilities Using Administrative Data

Kali S Thomas  1   2 , David Dosa  1   2 , Pedro L Gozalo  1 , David C Grabowski  3 , Jennifer Nazareno  1 , Rajesh Makineni  1 , Vincent Mor  1   2
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A Methodology to Identify a Cohort of Medicare Beneficiaries Residing in Large Assisted Living Facilities Using Administrative Data

Kali S Thomas et al. Med Care. 2018 Feb.

Abstract

Background: Assisted living is a popular option for housing and long-term care.

Objective: To develop and test a methodology to identify Medicare beneficiaries residing in assisted living facilities (ALFs).

Research design: We compiled a finder file of 9-digit ZIP codes representing large ALFs (25+ beds) by matching Outcome and Assessment Information Set (OASIS) assessments and Medicare Part B Claims to the Medicare enrollment records and addresses of 11,751 ALFs. Using this finder file, we identified 738,567 beneficiaries residing in validated ALF ZIP codes in 2007-2009. We compared characteristics of this cohort to those of ALF residents in the National Survey of Residential Care Facilities (n=3009), a sample of community-dwelling Medicare beneficiaries (n=33,025,690), and long-stay nursing home residents (n=1,287,572).

Data sources: A national list of licensed ALFs, Medicare enrollment records, and administrative health care databases.

Results: The ALF cohort we identified had good construct validity based on their demographic characteristics, health, and health care utilization when compared with ALF residents in the National Survey of Residential Care Facilities, community-dwelling Medicare beneficiaries, and long-stay nursing home residents.

Conclusions: Our finder file of 9-digit ZIP codes enables identification of ALF residents using administrative data. This approach will allow researchers to examine questions related to the quality of care, health care utilization, and outcomes of residents in this growing sector of long-term care.

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Conflict of interest statement

Conflicts of Interest:

Authors Kali Thomas, David Dosa, Jennifer Nazareno, David Grabowski, Rajesh Makenini and Pedro Gozalo have no potential conflicts of interest to declare. Vincent Mor, Ph.D. is a founder and on the board of directors of PointRight, Inc. an information services company serving nursing homes on quality measurement and improvement. Dr. Mor is also a stock holder for PointRight, Inc. and Navi Health. Dr. Mor receives no research funding, data or consultation on his research from PointRight or NaviHealth. Dr. Mor also received honoraria from the Alliance for Health Care Quality. Dr. Nazareno is a co-owner of an assisted living facility in California.

Figures

Figure 1
Figure 1
Method of Compiling an Assisted Living Facility Resident Finder File and Identifying Medicare Beneficiaries Residing in Large (25+ Beds) Assisted Living Facilities
See this image and copyright information in PMC

References

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    1. Phillips CD, Holan S, Sherman M, et al. Medicare expenditures for residents in assisted living: data from a national study. Health Serv Res. 2005;40:373–388. - PMC - PubMed

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