| In order to examine the characteristics of individuals who transition from nursing homes to the community, a group of 11,560 Medicaid participants aged 65 and older who had a nursing home admission between April 1, 2003, and April 1, 2006, were selected. Overall 231 of them transitioned to community; nearly three quarters of transitioned individuals wished to return to the community and over half had a support person who was positive toward discharge. Compared to all residents in the study, those who transitioned to the community were more likely to be younger, had a much lower average level of care, were in their Medicaid eligibility span for less than one year when they entered the nursing home, and were more likely to need lower levels of assistance with their activities of daily living.;A Heckman selection model was used in order to determine if any factors exist that can identify nursing home residents who are most likely to transition to stable living in the community. The model found that there were several known factors that can predict transition from a nursing home to the community, including age, gender, marital status, level of care, preference to return to the community, and the presence of a support person positive toward discharge. The second stage of the model, however, failed to find any factors significantly associated with an individual being stable in the community, suggesting that post-transition episodes (such as a heart attack or fall), not pre-transition characteristics, are responsible for truncated community living.;Finally, an endogenous switching regression was used to determine how much Medicaid cost savings is associated with transitioning to the community, and how that cost savings is affected by individual characteristics. By comparing transitioned individuals to a matched group of nursing home residents, this study reaffirmed prior findings that transitioning older adults from a nursing home to the community is associated with Medicaid cost savings, in this case of approximately... |
