Coronary Heart Disease in Older Adults Living in Residential Care Facilities

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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 cov...

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...Services Utilization of Residents in Assisted Living Communities October 2013 SHESG Meeting Abstract Health Services Utilization of Residents in Assisted Living Com. 1–21 (2013). at
9. Moss, A. J. et al. Design and operation of the 2010 National Survey of Residential Care Facilities. Vital Health Stat. 1. 1–131 (2011). at
10. Balancing Incentive Program | Medicaid.gov. at
11. Shelkey, B. M. & Mason, V. Katz Index of Independence in Activities of Daily Living ( ADL ) Katz Index of Independence in Activities of Daily Living. 185, (2012).

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