Home Health’s Main Appeal to Assisted Living Facilities

Although it’s often delivered in the private residences of older adults, home health care can also offer several benefits to assisted living providers, especially as their residents become older and more medically complex. In fact, by leveraging home health services, assisted living operators may be able to keep residents in their facilities longer.

That’s according to a recent study conducted by researchers from Brown University and supported by the National Institute on Aging.

“Previous work conducted by colleagues has suggested that individuals who moved to assisted living prefer to remain in that setting rather than transition to a higher level of care,” Kali Thomas — co-author of the study and associate professor of health, services, policy and practice at Brown University — told Home Health Care News. “It may be the case that the delivery of home health services in [assisted living] settings may enable these residents to continue to remain in what is essentially their home. It could perhaps prevent the transition to a higher level of care.”


For the study, recently published in Medical Care Research and Review, researchers compared Medicare beneficiaries who received home health services in assisted living settings to those who received home health services in their own residences between 2012 and 2014.

During those two years, the number of all home health care recipients also residing in assisted living facilities increased slightly, climbing from 9.6% to 10.1%. Those beneficiaries were more likely to be white, female and 85 or older.

Meanwhile, close to 40% of all assisted living residents may be receiving home health services, Thomas said.


The study found that assisted living residents receiving home health care were more likely to have cognitive and activities of daily living impairments. They were also less likely to have been recently discharged from an acute care setting — a key finding researchers touted as a motivator to combine assisted living and home health.

“This finding potentially alludes to assisted living residents utilizing [home health agency] services more so for health maintenance than for post-acute care services and corroborates the assumption that [home health agencies] may allow individuals with increasing care needs to reside in AL longer,” the authors wrote.

About half of all assisted living residents suffer from two to three chronic conditions.

The assisted living market presents a huge opportunity for home health providers. In 2017, there were about 32,200 assisted living facilities operating inside the United States, combining to care for close to 1 million residents annually.

The share of home health services delivered in assisted living facilities varied widely across states between 2012 and 2014, researchers found. Home health agencies disproportionately provided services in the assisted living setting in Oregon, Washington, Alaska, Minnesota and Idaho.

Future research is needed to understand the impact of receiving home health care in assisted living settings, the Brown University researchers noted. Their study is one of the few — if not the only — looking at how home health care and assisted living interact.

While the study highlights home health care opportunities in assisted living, potential partnerships also exist for non-medical home care providers.

In these arrangements, communication and specialized programs are often cited as keys to success, Jacqueline Sander, executive director and partner of The Birches Assisted Living in Clarendon Hills, Illinois, said last year during a private duty symposium covered by HHCN.

The symposium was organized by LeadingAge Illinois, Illinois HomeCare & Hospice Council and the Home Care Association of America’s Illinois chapter.

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