Center for Excellence in Assisted Living CEAL@UNC

Advancing the well-being of the people who live and work in assisted living through research, practice, and policy.

Journal of the American Geriatrics Society

Likelihood of assisted living residents aging in place as a factor of dual Medicare-Medicaid eligibility at the end of life

May 1, 2023
States vary in their coverage of services in assisted living (AL) settings which may impact whether AL residents can remain in what they consider their home. Previous research found an association between state Medicaid financing and access to AL for beneficiaries dually eligible for Medicare and Medicaid. In addition, research found that among AL residents […]

Likelihood of assisted living residents aging in place as a factor of dual Medicare-Medicaid eligibility at the end of life

by Lea Efird-Green

States vary in their coverage of services in assisted living (AL) settings which may impact whether AL residents can remain in what they consider their home. Previous research found an association between state Medicaid financing and access to AL for beneficiaries dually eligible for Medicare and Medicaid. In addition, research found that among AL residents […]

Are Online Reviews of Assisted Living Communities Associated with Patient-Centered Outcomes?

Dec 1, 2022
WHAT THIS MEANS FOR YOU: Findings from this study suggest that AL's online reviews may signal quality of care issues, offering consumers information to make more informed decisions in their AL selection, and that reviews may offer insight into residents' perspectives. However, ratings should not replace, but rather complement, other traditional ways of assessing resident experiences because of rating system limitations. Additionally, ratings may assist providers in making improvements to their ALs based on resident feedback, and function as a data source for policymakers about AL quality of care.

Are Online Reviews of Assisted Living Communities Associated with Patient-Centered Outcomes?

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: Findings from this study suggest that AL’s online reviews may signal quality of care issues, offering consumers information to make more informed decisions in their AL selection, and that reviews may offer insight into residents’ perspectives. However, ratings should not replace, but rather complement, other traditional ways of assessing resident experiences because of rating system limitations. Additionally, ratings may assist providers in making improvements to their ALs based on resident feedback, and function as a data source for policymakers about AL quality of care.

Injury-Related Emergency Department Use among Assisted Living Residents with Alzheimer’s Disease and Related Dementias

Dec 1, 2022
Background Injuries are a leading cause of emergency department (ED) visits among older adults, and individuals with Alzheimer’s disease and related dementias (ADRD) may be at particular risk. We compared injury-related ED use among assisted living (AL) residents with and without ADRD and assessed differences in the risk of injury-related ED visits among individuals with […]

Injury-Related Emergency Department Use among Assisted Living Residents with Alzheimer’s Disease and Related Dementias

by Lea Efird-Green

Background Injuries are a leading cause of emergency department (ED) visits among older adults, and individuals with Alzheimer’s disease and related dementias (ADRD) may be at particular risk. We compared injury-related ED use among assisted living (AL) residents with and without ADRD and assessed differences in the risk of injury-related ED visits among individuals with […]

Psychotropic Medication Prescribing in Assisted Living and Nursing Home Residents with Dementia after the National Partnership

Dec 1, 2022
BackgroundThe Centers for Medicare & Medicaid Services implemented the National Partnership to Improve Dementia Care in Nursing Homes (the Partnership) to decrease antipsychotic use and improve care for nursing home (NH) residents with dementia. We determined whether the extent of antipsychotic and other psychotropic medication prescribing in AL residents with dementia mirrored that of long-stay […]

Psychotropic Medication Prescribing in Assisted Living and Nursing Home Residents with Dementia after the National Partnership

by Lea Efird-Green

BackgroundThe Centers for Medicare & Medicaid Services implemented the National Partnership to Improve Dementia Care in Nursing Homes (the Partnership) to decrease antipsychotic use and improve care for nursing home (NH) residents with dementia. We determined whether the extent of antipsychotic and other psychotropic medication prescribing in AL residents with dementia mirrored that of long-stay […]

Dementia and COVID-19 Infection Control in Assisted Living in Seven States

Jun 1, 2022
Background Assisted living (AL) is the largest residential long-term care provider in the United States, including for persons with Alzheimer’s disease and related dementias. Despite recognizing the challenge of infection control for persons with dementia, this study of 119 AL communities is the first to describe dementia-relevant COVID-19 infection control across different types of AL […]

Dementia and COVID-19 Infection Control in Assisted Living in Seven States

by Lea Efird-Green

Background Assisted living (AL) is the largest residential long-term care provider in the United States, including for persons with Alzheimer’s disease and related dementias. Despite recognizing the challenge of infection control for persons with dementia, this study of 119 AL communities is the first to describe dementia-relevant COVID-19 infection control across different types of AL […]

Post-Acute Care Transitions and Outcomes among Medicare Beneficiaries in Assisted Living Communities

Jan 1, 2022
Background Despite the rapid growth of assisted living (AL) and frequent hospitalizations among AL residents, little is known about their patterns of post-acute care transitions and outcomes. This study examined the post-acute care transitions among AL residents and their association with outcomes in the first 30 and 60 days after hospital discharge. Methods This study used […]

Post-Acute Care Transitions and Outcomes among Medicare Beneficiaries in Assisted Living Communities

by Lea Efird-Green

Background Despite the rapid growth of assisted living (AL) and frequent hospitalizations among AL residents, little is known about their patterns of post-acute care transitions and outcomes. This study examined the post-acute care transitions among AL residents and their association with outcomes in the first 30 and 60 days after hospital discharge. Methods This study used […]

Prevalence and Persistency of Deficiency Citations in Florida Assisted Living Facilities

Jan 1, 2022
Background Assisted living facilities (ALFs) are plagued with quality issues but there are limited studies on the quality of ALFs. In Florida, state surveyors conduct inspections of ALFs and cite and/or fine facilities that are in violation of regulations. Yet, we do not know the types of quality problems identified and the extent to which […]

Prevalence and Persistency of Deficiency Citations in Florida Assisted Living Facilities

by Lea Efird-Green

Background Assisted living facilities (ALFs) are plagued with quality issues but there are limited studies on the quality of ALFs. In Florida, state surveyors conduct inspections of ALFs and cite and/or fine facilities that are in violation of regulations. Yet, we do not know the types of quality problems identified and the extent to which […]