Alzheimer’s Staffing, Services, and Outcomes in Adult Day Health Centers

Growing demands for specialized care for Alzheimer’s Disease and other Dementia (AD/D) and for caregiver respite have resulted in rising use of adult day health centers (ADHCs). Amidst rapidly-rising demand for health care workers, including in occupations commonly found in ADHCs, there is concern about the recruitment and training of adequate numbers of workers for these settings. It is not clear whether staffing needs are different in ADHCs that offer care for those with AD/D. This study evaluates the scope of services and staffing models of Adult Day Health Centers (ADHCs) that provide care to persons with Alzheimer’s Disease and other Dementia (AD/D) compared to ADHCs that do not, and assesses whether or not staffing varies by ADHC-level variables, such as ownership type and region. We use facility-level data from the 2012 and 2014 National Study of Long-Term Care Providers (NSLTCP) Adult Day Services Center module, which collects primary data on ADHCs through a nationally representative survey. The micro-data from the NSLTCP must be accessed through a federal Research Data Center, and this will be one of the first studies focused on the ADHC module of these data. Key outcome variables are measures of ADHC staffing, as well as rates of emergency department visits, hospitalizations, and falls. The first part of the paper focuses on descriptive analysis of staffing patterns within ADHCs, and on bivariate comparisons of staffing in ADHCs that offer AD/D services versus those that do not. We then estimate multivariate regressions to learn whether staffing differences exist holding other ADHC characteristics constant, such as size, region, and other services offered. We also estimate additional regression models to learn whether there are differences in rates of emergency room visits, hospitalizations, and falls based on whether AD/D services are offered, the volume of AD/D patients, and staffing.