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Date:  August 28, 1995
For Release:  Immediately
Contact:  HHS Press Office (202) 690-6343

Although families continue to be the major source of long-term care, a variety of residential settings with supportive services has emerged to supplement their efforts. These arrangements support families whose members need more care than the family can provide, and those elderly and disabled who have no family.

Other than nursing homes, the most common form of residential setting with services for people with disabilities is board and care homes. There are approximately 34,000 licensed board and care homes with more than 613,000 beds. Some estimates indicate that there are similar numbers of unlicensed homes putting the total number of persons living in board and care homes as high as 1 million.

Regulation of board and care homes varies from state to state, and the study found several factors suggesting that broad regulation and licensure requirements result in homes that are better prepared to cope with the disability levels and potentially changing needs of residents who are elderly and disabled. These include:

• greater availability of supportive services in licensed homes than in unlicensed homes;

• greater operator training in the care of the elderly and disabled in states with more regulation; and

• lower use of psychotropic drugs and medications contraindicated for use in the elderly in homes in more regulated states.

The study also found that requiring licensure made it more likely that homes would have in place a wider array of the safety features and supportive devices considered important to the well- being of residents.

Extensive regulation and licensure did not appear to have an effect in some areas, notably staff knowledge of basic care procedures and appropriate monitoring of health conditions, the cleanliness and attractiveness of homes, the availability of licensed nurses (LPNs and RNs) on staff and the availability of physical amenities in homes (e.g., comfortable chairs, plants, lamps).

The study, conducted by the Research Triangle Institute under contract with HHS' Office of the Assistant Secretary for Planning and Evaluation, included visits to more than 500 licensed and unlicensed board and care homes and in-person interviews with more than 4,500 residents and staff.

"Compared to results from previous studies, we found board and care residents today to be older, and to have more disabilities, including cognitive impairment and loss of physical function," said Robyn Stone, deputy assistant secretary for the Office of Disability, Aging, and Long-Term Care. "But it was heartening to find that effective regulation can have positive effects on the quality of care the residents are receiving."

Note: Copies of the report are available from: Floyd Brown, (202) 690-6443.