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The Aging in Place Project Assuring Quality At-Home Services for Seniors

The Aging in Place Project Assuring Quality At-Home Services for Seniors. Marilyn Rantz, PhD, RN, FAAN Curator’s Professor, Sinclair School of Nursing University of Missouri, Columbia, MO. www.agingmo.com. AIP Vision, Foundation, Goal.

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The Aging in Place Project Assuring Quality At-Home Services for Seniors

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  1. The Aging in Place ProjectAssuring Quality At-Home Servicesfor Seniors Marilyn Rantz, PhD, RN, FAAN Curator’s Professor, Sinclair School of Nursing University of Missouri, Columbia, MO www.agingmo.com

  2. AIP Vision, Foundation, Goal • Dramatically change the way long-term care is provided in this country through a new approach • RN Care Coordination/Community Case Management • Getting people the right services at the right time to maximize regaining or maintaining health and independence • Provide research and education opportunities

  3. AIP tested in community, private and public housing, now at TigerPlace • CMS grant 1999-2003, wellness center focused, licensed home health agency for Medicare, Medicaid, private insurance, private pay, served over a hundred monthly 2006 • TigerPlace opened 2004, expanded in 2009 and 2011, serving 65 daily in housing and now 85 in rehabilitation

  4. Key Clinical and Financial Outcomes • RN care coordination reduces adverse health events, improves care outcomes, nursing home utilization, and costs less • Clinical outcomes better (ADL performance, less depressed and better cognition, continence, pain and shortness of breath) • Cost savings $1,591 per month (nursing home comparison) $483 (community comparison) • Costs for any TigerPlace participant (even through end of life) has not approached nursing home care (average annual care cost for 2008 was $7,331 for those nursing home eligible and $2591 for those not eligible, plus housing cost) • Over $10.1 million in grants; hundreds student experiences

  5. Challenges • Building and operating TigerPlace required legislation in Missouri (1999 and 2001) • Continuing regulation interpretation and concerns from traditional nursing homes • Medicare referrals from our health system • Melding for-profit partner with University • Medicare and Medicaid funding stream for RN care coordination, change federal regulations • Explaining new approach to services and billing to consumer

  6. Policy Implications • Medicare and Medicaid funding for RN care coordination • Bundling services so RN can order the needed community services (PT, DME) • Incentives for consumer health promotion and independence

  7. Leadership Implications • Communicating the vision and practice in day to day activities • Grant writing and journal publications • Team building, for practice, for research, for education • Keeping the vision and outcomes alive at the University • Translating outcomes into public policy messages and strategically targeting the messages for change

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