community-based elderly, dually eligible, medicare and medicaid, nursing home placement, risk index, waiver program




Nursing home placement (NHP) is costly, and the majority of older adults prefer to remain living in the community. The purpose of this research was to examine NHP among a cohort of participants in a home and community-based waiver program during 2002 to 2007 to develop a risk model for predicting who may transition to a nursing home. Methods: This longitudinal study was conducted on data from the minimum data set-home for care linked with medicaid claim files and death certificates. The sample included 6525 participants who had two assessments and survived through 2007 or had NHP. A risk index was developed to identify participants who had NHP. Results: Using the risk index, the probability of NHP was 50%, with sensitivity of 0.4 and specificity of 0.9. Forty percent of participants who had NHP were correctly identified. Conclusion: This NHP risk index may inform waiver agency personnel as to when participants may need more intense interventions, and consequently provide additional care to delay or prevent NHP when possible.

Original Citation

Spoelstra, S. L., & Given, C. W. (2015). Development of an index to predict risk of nursing home placement for home and community-based waiver participants. Edorium Journal of Aging Research, 1, 1–11.

Included in

Nursing Commons