Design of Evaluation Options of the System Change Grants Final rept

摘要

The goal of the Design of Evaluation Options of the System Change Grants was to identify and pilot analyses useful evaluating state's progress in reforming their long-term care systems, in part to evaluate the impact of the Systems Change grant program. Because of the diversity of the grant goals, activities and scope, staggered implementation and a lack of quantitative data, it was not feasible to develop direct measures of the grant program as a whole or even of specific grant types. The challenge was to identify a quantitative approach to evaluate the impact of these activities and reforms that could provide information about how the nation as a whole and individual states are doing in reforming their long-term care systems as well as shedding light on the impact of specific features of state long-term care policy. This report details the use of admission and discharge assessment data from the Nursing Home Minimum Data Set (MDS) to observe state variation and changes over time in the profile of new entrants to nursing facilities and in discharge destinations. The results are used to make inferences about the strength of the home and community based system and states' progress in moving towards long-term care reform.