Table 4.
The Association Between Residential Care/Assisted Living Regulation and Potentially Burdensome Transitions Among Residential Care/Assisted Living Decedents (N = 129,153, Adjusted Odds Ratio, 95% Confidence Interval)
| Model 1a | Model 2b | |
|---|---|---|
| Third-party services | ||
| Allow hospice services (ref: silent) | 0.99 (0.95, 1.04) | 0.97 (0.90, 1.06) |
| Allow home health services (ref: silent) | 1.02 (0.98, 1.07) | 1.02 (0.95, 1.09) |
| Allow private care aide services (ref: silent) | 0.96 (0.93, 1.01) | 0.98 (0.93, 1.03) |
| Staffing | ||
| Require RNs (ref: silent) | 0.99 (0.96, 1.03) | 1.04 (0.99, 1.09) |
| Require LPN/LVNs (ref: silent) | 1.02 (0.99, 1.06) | 1.00 (0.94, 1.05) |
| Require minimum ratios/levels for DCWs (ref: other requirements or silent) | 1.05* (1.01, 1.09) | 1.10* (1.04, 1.06) |
| Medication management | ||
| Require regular medication reviews (ref: silent) | 0.92* (0.89, 0.95) | 0.96* (0.92, 0.99) |
| Require RN/LPN/LVNs to administer oral medication | ||
| Require (ref: silent) | 1.13* (1.08, 1.18) | 1.08* (1.02, 1.13) |
| Not require (ref: silent) | 1.10* (1.03, 1.17) | 1.02 (0.91, 1.15) |
| Permit DCWsc to assist with oral medication administration | ||
| Permit (ref: silent) | 0.96 (0.90, 1.02) | 0.93* (0.87, 0.99) |
| Prohibit (ref: silent) | 1.06 (0.97, 1.15) | 0.92 (0.81, 1.05) |
| Require RN/LPN/LVNs to administer injections | ||
| Require (ref: silent) | 1.05* (1.01, 1.09) | 1.12* (1.05, 1.19) |
| Not require (ref: silent) | 1.14* (1.08, 1.21) | 1.19* (1.06, 1.33) |
| Permit DCWs to administer injections | ||
| Permit (ref: silent) | 0.93* (0.89, 0.98) | 0.90* (0.84, 0.96) |
| Prohibit (ref: silent) | 1.03 (0.99, 1.07) | 0.96 (0.91, 1.01) |
Indicates statistical significance lower than 0.05.
Model 1 reports regression model results of the association between each RC/AL regulation and potentially burdensome transitions. Each model included the same set of covariates: RC/AL decedent sociodemographic characteristics (i.e., age, sex, race/ethnicity, dual eligibility), Medicare Advantage enrollment, early hospice enrollment, length of stay in RC/ALs, HSA hospitalization rate, and HSA random intercepts.
Model 2 reports multivariable regression results of all RC/AL regulations and potentially burdensome transitions. The model included the same set of covariates specified above.
DCWs refer to DCWs with minimal training, not including certified nurse aides or medication aides.
HSA, hospital service area.