An analysis of the effect of admission and transfer policies on nursing care use patterns in continuing care retirement communities

The major thesis of this work is that management policies affect nursing home utilization at Continuing Care Retirement Communities (CCRCs). The research examines the relationships between nursing home utilization patterns and admission and transfer policies and resident and CCRC characteristics.;As organizations that do not rely on public funding for their residents' social and health needs, CCRCs provide a finance and delivery system with special factors that influence the use of nursing home care. Understanding how policies may affect the utilization of nursing care provides insight into the financing and delivery of long-term care services in general.;Using data from the 1989 National Continuing Care Data Base, the study includes analysis of resident, CCRC and management information as well as predictions of nursing home use by CCRC residents.;The research builds upon theoretical and practical research in CCRCs that has examined the relationships between nursing home utilization and characteristics of CCRCs. After a review of the literature, hypotheses are developed for examination and discussion.;The analyses indicate that CCRCs that deny admission to applicants with organic brain syndrome and use standardized transfer policies tend to have a higher proportion of their residents using nursing home care. In addition, the analyses of the patterns of use indicate that differences are observed according to the health guarantee, the age of the community, and the extent of use of assisted living services by residents.