1. Characteristics of Residential Care Consumers While the prevalence of chronic conditions is similar, 38% of residential care consumers need assistance with 3 or more activities of daily living (ADLs), compared to just 3% of Medicare beneficiaries living in the community? DataBrief Series ● October 2012 ● No. 31

2. Demographics of Residential Care Consumers • “Residential care” is an umbrella term for facilities that provide apartment-style housing and support services for persons who cannot live independently, but generally do not require the skilled level of care provided in nursing homes. Residential care facilities include assisted living facilities, board and care homes, and other settings.1 • Common support services provided in residential care settings include managing medications and assistance with activities of daily living (ADLs) like bathing and dressing. • In 2010, there were 656,091 seniors age 65 and older living in residential care facilities.2 • Older residential care consumers are more likely to be white, female, and older than senior Medicare beneficiaries living in the community. They are also much more likely to be widowed or otherwise unmarried.2 • The prevalence of chronic conditions is similar among older residential care consumers and similar Medicare beneficiaries living in the community.2 • However, in terms of functional impairment care needs, older residential care residents are much more likely to require assistance with ADLs than older Medicare beneficiaries who live in the community.2 1 Centers for Disease Control and Prevention. “Residents Living in Residential Care Facilities: United States, 2010.” 2012. http://www.cdc.gov/nchs/data/databriefs/db91.htm#definitions 2Avalere analysis of the 2010 National Survey of Residential Care Facilities and the 2010 Medicare Current Beneficiary Survey (Access to Care file). DataBrief (2012) ● No. 31

3. Presence of Functional Impairment and Lack of Spousal Support May Be Tied to Use of Residential Care Characteristics of Residential Care Consumers Compared to Medicare Beneficiaries Living in the Community Age 65 and Over, 2010 Source: Avalere Health LLC analysis of the 2010 National Survey of Residential Care Facilities and the 2010 Medicare Current Beneficiary Survey. 1 N = 656,091 residential care residents age 65 and older. 2 N = 33,030,236 community residents age 65 and older. 3 Low-income individuals are those dually eligible for Medicare and Medicaid. DataBrief (2012) ● No. 31

4. A Clear Policy Connection Residential care facilities offer assistance with ADLs and other key supports in a community setting. New data suggest that older adults may seek residential care when they develop functional limitations, but lack the spousal support that enables them to live independently. While the prevalence of chronic conditions is similar among residential care consumers and their counterparts living in the community, residential care consumers today have more functional impairment on average. Residential care can potentially offer a level of care in between what can be delivered in the community and in nursing facilities. States are responsible for licensure and regulation of residential care facilities and define what rights consumers have, what services facilities must provide, and how facilities will be held accountable. States should consider how the residential care industry can be a part of ongoing plans to increase access to community-based services and supports. Residential care facilities are an important part of the continuum of care for older adults and younger individuals who need long-term services and supports. • Data on community residents is based on the Medicare Current Beneficiary Survey (MCBS), Access to Care file, 2010. The MCBS includes information on demographics, health status, and functional limitations. • Data on residential care is based on the National Survey of Residential Care Facilities (NSRCF) 2010, published by the National Center for Health Statistics. The NSRCF collects information on demographics, health status and functional limitations for residential care residents. To be included in the NSRCF sample, facilities had to provide at least 24-hour supervision of residents, two meals a day, and help with ADLs. • In both surveys, individuals indicated if they had any of the following chronic conditions: Alzheimer’s disease or other dementia, arthritis, asthma, cancer, chronic obstructive pulmonary disease, emphysema, heart failure, depression, myocardial infarction or heart attack, hypertension, osteoporosis, stroke, heart disease, or mental illness. • Analyses of both datasets were limited to respondents age 65 and older. DataBrief (2012) ● No. 31