Aging & Society: Eighth Interdisciplinary Conference

Abstract

Quality of life and quality of care are essential issues for older adults receiving long-term care services. Yet, these constructs are difficult to define and measure. This paper describes a mixed-methods examination of quality using data from 124,276 Medicaid enrollees residing in nursing facilities, assisted living communities, and homes across the state of Florida between 2013 and 2016 and interviews with a subsample of enrollees. Following the move of all Medicaid LTC services to a Statewide Medicaid Managed Care program, an interdisciplinary team from the FSU’s Colleges of Medicine and Social Work has conducted an independent assessment. We established quality measures specific to sites of care, using enrollee outcomes as the gold standard and developed a novel measure of unmet need. We interviewed fifty-one enrollees regarding their experiences. Overall, we found that quality had been maintained or improved with the change in implementation. We found anomalies in depression scores across all three sites of care as well as identifying a need for greater interaction with NF enrollees and a deficit in enrollees’ understanding of their rights. This study is unique in presenting findings of a statewide structural change in healthcare delivery and incorporating the voices of enrollees in the findings.