Emily Rosenoff

Centers for Disease Control and Prevention, Druid Hills, GA, United States

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Publications (5)3.21 Total impact

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    ABSTRACT: In 2010, residential care residents were mostly female, non-Hispanic white, and aged 85 and over, and had a median length of stay of about 22 months. For about 20% of residents—or 137,700 persons—Medicaid paid for at least some long-term care services provided by the RCF. This estimate is similar to that found in a recent study (3). Almost 40% of all residential care residents received assistance with three or more ADL limitations, and over 40% had Alzheimer’s disease or other dementias. These findings suggest a vulnerable population with a high burden of functional and cognitive impairment. Residential care is an important component of the U.S. long-term care system. This report presents national estimates of people living in RCFs, using data from the first-ever national probability sample survey of RCFs with four or more beds. This brief profile of residential care residents may provide useful information to policymakers, providers, and consumer advocates as they plan for the future long-term care needs of older as well as younger adults. In addition, these findings serve as baseline national estimates as researchers continue to track the growth of and changes in the residential care industry.
    No preview · Article · Apr 2012 · NCHS data brief
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    ABSTRACT: RCFs in the United States totaled 31,100 in 2010, with 971,900 state-licensed, certified, or registered residential care beds. About one-half of RCFs were small facilities which served one-tenth of all RCF residents. The remaining RCFs were medium-sized facilities (16%) which served about one-tenth of all RCF residents, large facilities (28%) which served about one-half of all RCF residents, and extra large facilities (7%) which housed about three-tenths of all RCF residents. RCFs were predominantly for profit (82%), not part of a chain (62%), and located in an MSA (81%). Small RCFs were more likely to be for profit than larger RCFs. The proportion of chain-affiliated RCFs grew with increasing facility size. Small and extra large RCFs were most likely to be located in an MSA, while medium RCFs were least likely to be in an MSA. RCFs were most commonly located in the West. The mix of facility sizes varied by region. The West had almost twice as many residential care beds per 1,000 persons aged 85 and over as the Northeast (245 to 131). Comparing the supply of RCF beds with nursing home beds (data compiled by Centers for Medicare & Medicaid Services) shows that the supply of RCF beds (245) and nursing home beds (203) per 1,000 persons aged 85 and over was relatively comparable in the West, but nursing home beds far outnumbered RCF beds in all other regions. There were about twice as many nursing home beds as RCF beds per 1,000 persons aged 85 and over in the South (325 to 164), Midwest (390 to 177), and Northeast (303 to 131). More research is needed to identify and examine factors that may explain these regional differences in both the supply of residential care beds, including variations in state regulation and financing of different types of LTC providers, and in consumer preferences for different kinds of long-term services and support. RCFs serve primarily a private-pay adult population (6). However, the use of Medicaid financing for services in residential care settings has gradually increased in recent years (7). About 4 out of 10 RCFs had at least one resident who had some or all of their LTC services paid by Medicaid. The percentage of facilities having residents who received LTC services paid by Medicaid varied by facility size. Although nearly all RCFs provided basic health monitoring (96%) and incontinence care (93%), larger RCFs were more likely than smaller RCFs to offer occupational and physical therapy. Larger RCFs were also more likely than small RCFs to provide social services counseling and case management. The provision of skilled nursing services did not vary by facility size. This report presents national estimates of RCFs using data from the first-ever national probability sample survey of RCFs with four or more beds. Findings on differences in selected characteristics and services offered by facility size and on regional variations in the supply of beds provide useful information to policymakers, LTC providers, and consumer advocates as they plan to meet the needs of an aging population. Moreover, these findings establish baseline national estimates as researchers continue to track growth and changes in the residential care industry.
    No preview · Article · Dec 2011 · NCHS data brief
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    ABSTRACT: This methods report provides an overview of the National Survey of Residential Care Facilities (NSRCF) conducted in 2010. NSRCF is a first-ever national probability sample survey that collects data on U.S. residential care providers, their staffs and services, and their residents. Included are residential care facilities consisting of assisted living residences; board and care homes; congregate care; enriched housing programs; homes for the aged; personal care homes; and shared housing establishments that are licensed, registered, listed, certified, or otherwise regulated by a state. A survey-specific definition was used to select residential care facilities into the study. This report discusses the need for and objectives of the survey, design process, survey methods, and data availability. In 2008, a small pilot study and a pretest were conducted to test and refine the survey protocol, data collection procedures, and questionnaires. NSRCF was conducted between March and November 2010. The survey used a two-stage probability sampling design in which residential care facilities were sampled. Then, depending on facility size, three to six current residents were sampled. In-person interviews were conducted with facility directors and designated staffs; no interviews were conducted with residents. The survey instrument contained a facility screening module, facility- and resident-level modules, a resident sampling module, and a pre-interview worksheet. National data were collected on 2,302 facilities, and 8,094 current residents. The first-stage facility weighted response rate (for differential probabilities of selection) was 81%. The second-stage resident weighted response rate was 99%. Two public-use files will be released. The facility and resident files include sampling weights to generate national estimates, and design variables to calculate accurate standard errors.
    No preview · Article · Nov 2011 · Vital and health statistics. Ser. 1, Programs and collection procedures
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    ABSTRACT: This study introduces the first National Nursing Assistant Survey (NNAS), a major advance in the data available about certified nursing assistants (CNAs) and a rich resource for evidence-based policy, practice, and applied research initiatives. We highlight potential uses of this new survey using select population estimates as examples of how the NNAS can be used to inform new policy directions. The NNAS is a nationally representative survey of 3,017 CNAs working in nursing homes, who were interviewed by phone in 2004-2005. Key survey components are recruitment; education; training and licensure; job history; family life; management and supervision; client relations; organizational commitment and job satisfaction; workplace environment; work-related injuries; and demographics. One in three CNAs received some kind of means-tested public assistance. More than half of CNAs incurred at least 1 work-related injury within the past year and almost one quarter were unable to work for at least 1 day due to the injury. Forty-two percent of uninsured CNAs cite not participating in their employer-sponsored insurance plan because they could not afford the plan. Years of experience do not translate into higher wages; CNAs with 10 or more years of experience averaged just $2/hr more than aides who started working in the field less than 1 year ago. This survey can be used to understand CNA workforce issues and challenges and to plan for sustainable solutions to stabilize this workforce. The NNAS can be linked to other existing data sets to examine more comprehensive and complex relationships among CNA, facility, resident, and community characteristics, thereby expanding its usefulness.
    No preview · Article · May 2009 · The Gerontologist
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    ABSTRACT: This report provides an introduction and overview of the National Nursing Assistant Survey (NNAS),the first national probability survey of nursing assistants working in nursing homes. The NNAS was designed to provide national estimates and to allow for separate estimates to be calculated for nursing assistants by geographic location of the agency and for workers by tenure at the sampled facility. This report includes a description of relevant research that led to federal interest in sponsoring the NNAS, types of data collected, methodology, linkage between the NNAS and the 2004 National Nursing Home Survey (NNHS), advantages of combining establishment and worker surveys, and potential uses of the data. The NNAS was conducted as a supplement to the 2004 National Nursing Home Survey. The design was a stratified, multistage probability survey. Nursing facilities were sampled and then nursing assistants were sampled within the facilities. Telephone interviews were conducted with nursing assistants using Computer-Assisted Telephone Interviews (CATI). The survey instrument consisted of sections on recruitment, training and licensure, job history, family life, management and supervision, client relations, organizational commitment and job satisfaction, workplace environment, work-related injuries, and demographics. A total of 3,017 interviews were completed from September 2004 to February 2005. The overall response rate was 53.4 percent. A public-use data file has been released that contains the interview responses and sampling weights. The file also includes ownership, bed size, and geographic location of the facility where the nursing assistant was sampled. Estimates based on the sampling weights can be used to produce national estimates.
    No preview · Article · Mar 2007 · Vital and health statistics. Ser. 1, Programs and collection procedures