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  • Key Questions About Nursing Home Regulation and Oversight in the Wake of COVID-19

    Issue Brief

    The COVID-19 pandemic has led to renewed interest among policymakers, the media, residents, and their families in nursing home regulation and oversight, as residents and staff are at increased risk of infection due to the highly transmissible nature of the coronavirus, the congregate nature of facility settings, and the close contact that many workers have with patients. This issue brief answers key questions about nursing home oversight under Medicare and Medicaid and explains how federal policy has changed in light of COVID-19.

  • Rising Cases in Long-term Care Facilities Are Cause for Concern

    Issue Brief

    LTC cases in hotspot states are increasing at 4x the rate as LTC cases in non-hotspot states. Media has largely focused on the share of cases attributed to a younger population. However, increased cases in long-term care facilities are cause for concern, given that nearly half of all COVID-19 deaths have been in long-term care facilities. This piece provides state-level data, including data that shows that long-term care cases in Texas and Florida have increased by over 50% in 2 weeks.

  • Voices of Paid and Family Caregivers for Medicaid Enrollees Receiving HCBS

    Issue Brief

    To help inform the ongoing debate, KFF conducted four focus groups in July and August 2021 with direct care workers and unpaid caregivers who provide HCBS, assisting seniors and people with disabilities with daily self-care and household activities. These focus groups are not necessarily generalizable to all caregivers, but can provide insight into their experiences to help inform current policy debates.

  • State Medicaid Home & Community-Based Services (HCBS) Programs Respond to COVID-19: Early Findings from a 50-State Survey

    Issue Brief

    This issue brief presents early findings from the most recent KFF survey of Medicaid HCBS programs in all 50 states and the District of Columbia. It focuses on state policies adopted in response to challenges posed by the pandemic, the pandemic’s impact on Medicaid HCBS enrollees and providers, and states’ initial plans for the new American Rescue Plan Act 10 percentage point temporary increase in federal Medicaid matching funds for HCBS available from April 2021 through March 2022.

  • COVID-19 Cases and Deaths in Long-Term Care Facilities through June 2021

    Issue Brief

    This data note examines state-level data on COVID-19 cases and deaths in long-term care facilities through June prior to the recent rise in cases and deaths nationally linked to the spread of the Delta variant. It finds long-term care deaths down 96% from their peak in December as the nation's vaccination effort began.

  • State Options to Expand Medicaid HCBS: Examples & Evaluations of Section 1115 Waivers

    Issue Brief

    States are currently developing plans to access an increased federal matching rate (“FMAP”) for Medicaid HCBS spending established in the American Rescue Plan Act (ARPA) of 2021. In the future, states may also be able to access increased HCBS funds proposed in the Biden Administration’s American Jobs Plan and the Better Care Better Jobs Act recently introduced in Congress. This brief highlights examples of Medicaid HCBS policy changes authorized through Section 1115 demonstration waivers in seven states (Arizona, Delaware, New Jersey, New York, Rhode Island, Vermont, and Washington). Where available, we discuss waiver evaluation findings and reports that assess the impact of these policy changes.