title: Community Discharge of Nursing Home Residents: The Role of Facility Characteristics.
abstract: OBJECTIVE
  Using a socio-ecological model, this study examines the influence of facility characteristics on the transition of nursing home residents to the community after a short stay (within 90 days of admission) or long stay (365 days of admission) across states with different long-term services and supports systems.
  
  
  METHODS
  Data were drawn from the Minimum Data Set, the federal Online Survey, Certification, and Reporting (OSCAR) database, the Area Health Resource File, and the LTCFocUs.org database for all free-standing, certified nursing homes in California (n = 1,127) and Florida (n = 657) from July 2007 to June 2008.
  
  
  METHODS
  Hierarchical generalized linear models were used to examine the impact of facility characteristics on the probability of transitioning to the community.
  
  
  RESULTS
  Facility characteristics, including size, occupancy, ownership, average length of stay, proportion of Medicare and Medicaid residents, and the proportion of residents admitted from acute care facilities are associated with discharge but differed by state and whether the discharge occurred after a short or long stay.
  
  
  CONCLUSIONS
  Short- and long-stay nursing home discharge to the community is affected by resident, facility, and sometimes market characteristics, with Medicaid consistently influencing discharge in both states.
authors.affiliation: Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, FL.
authors.forename: Amanda A
authors.initials: AA
authors.lastname: Holup
authors.affiliation: Davis School of Gerontology, University of Southern California, Los Angeles, CA.
authors.forename: Zachary D
authors.initials: ZD
authors.lastname: Gassoumis
authors.affiliation: Davis School of Gerontology, University of Southern California, Los Angeles, CA.
authors.forename: Kathleen H
authors.initials: KH
authors.lastname: Wilber
authors.affiliation: Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, FL.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hyer
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D003072:Cognition Disorders / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008484:Medicaid / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010067:Ownership; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States
keywords: Rebalancing; home- and community-based care; long-term services and supports; nursing home