Encompassing coronary heart disease, myocardial infarctions, and heart failure, cardiovascular diseases are the leading cause of death in the United States, accounting for approximately 1 in every 4 deaths1,2. Coronary heart disease (CHD) is caused by atherosclerosis which occurs when the build-up of cholesterol in the arterial wall limits the travel of oxygen-rich blood in the body3. This can lead to serious problems, including heart attack, stroke, or death. CHD is a chronic and potentially fatal condition. The consequences of the disease affect the lifestyle of individuals diagnosed and greatly impact the health care system at large. As of 2010, the estimated direct and indirect cost of CHD in the US exceeded $108 billion annually4. CHD results in substantial healthcare needs and may affect where people choose to live as they age.
Residential care facilities (RCF) have been an important component of housing and long-term care for older adults since the 1990s. They emerged as an alternative to nursing homes for people who do not require 24 hour nursing care, but are unable to live fully independently. These facilities may provide assistance with medication, personal care, and activities of daily living (ADLs). Assisted-living within RCFs has emerged as an important long-term care option, with over >30,000 RCFs and a total capacity of 971,900 beds by 20105. However, this sector of care receives little assistance form government financing. Medicare does not pay for assisted-living, but Medicaid uses waivers in many states to cover some services in residential care settings, excluding room and board. As of 2007, about 115,000 Medicaid beneficiaries received services in a RCF6. Due to the fact that Medicaid will not cover the cost of room and board, most expenses for services in assisted-living are paid for by the resident from private funds, which may include payments from social security, proceeds from the sale of property, pensions, or other family contributions. The 2012 MetLife Market Survey of Nursing Home, Assisted-living, Adult Day Services, and Homecare costs reports the average daily rates for nursing homes, assisted-living communities, and home health aides7. The national average base rate in assisted-living communities was $42,600 per year in 2012 whereas a private room in a nursing home costs approximately 47% more, at $90,520 annually6,8.
RCFs are expected to continue to grow as the baby boomer population ages. The CDC estimates that by 2050, nearly 27 million people will need long-term care4,9. The Balancing Incentive Program (BIP) encourages the shift of Medicaid spending from more expensive institutional care to home or community-based care which has been shown to be less expensive and provide a better quality of life10. As the number of RCFs increases due to the aging population and federal policy, more data are needed to describe the communities and their residents’ characteristics.
The 2010 National Survey of...