{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T03:43:30Z","timestamp":1774064610702,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR001870"],"award-info":[{"award-number":["KL2TR001870"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P01 AG066605"],"award-info":[{"award-number":["P01 AG066605"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30 AG044281"],"award-info":[{"award-number":["P30 AG044281"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R03 AG074038\u201001A1"],"award-info":[{"award-number":["R03 AG074038\u201001A1"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent long\u2010term care facility (LTCF) policy has focused on transitioning nursing home (NH) residents back to community settings, yet we lack recent descriptions of this phenomenon and how it compares in assisted living (AL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the National Health and Aging Trends Study, we studied adults over age 65 who had moved from community living into an LTCF between 2011 and 2018. Persons or their proxies reported residence in annual interviews. NH was defined by facility staff. ALs were multi\u2010unit buildings helping with activities of daily living. We excluded temporary short\u2010stay NH patients and independent AL residents. Our primary outcome was cumulative incidence of return to community living, with death as co\u2010primary outcome and modeled as a competing risk, stratified by NH versus AL entry. We identified covariates (age, gender, race\/ethnicity, dementia, activity limitations, and prior living arrangement) associated with return to community living through bivariate and multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 739 participants, weighted mean age was 84\u2009years (SD 7.5), 66% were women, 13% were non\u2010White, 57% had dementia, and 41% entered NH. At 1, 2, and 4\u2009years, the cumulative incidence of return to community living was 2.9% (95% CIs: 1.9%\u20134.3%), 6.4% (4.7%\u20138.4%), and 7.4% (5.5%\u20139.8%); the cumulative incidence of death was 28% (95% CIs: 24%\u201331%), 44% (40%\u201348%) and 66% (61%\u201370%). Outcomes were similar in persons entering NH versus AL. Older persons (aOR 0.88, 95% CI 0.83\u20130.94), those with dementia (aOR 0.33, 95% CI 0.12\u20130.88), and those previously living alone (aOR 0.39, 95% CI 0.17\u20130.89) were less likely to return.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Few returned to community living after entering either NH or AL. Mortality was similar. Results highlight limits in transitioning persons out of LTCFs and the need to observe AL use to ensure policies do not merely displace persons between institutional care sectors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18144","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T08:46:10Z","timestamp":1669279570000},"page":"569-576","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Return to community living and mortality after moving to a long\u2010term care facility: A nationally representative cohort study"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8148-2421","authenticated-orcid":false,"given":"Kenneth","family":"Lam","sequence":"first","affiliation":[{"name":"Division of Geriatrics, Department of Medicine University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irena","family":"Cenzer","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Medicine University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth E.","family":"Covinsky","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Medicine University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,24]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Money Follows the Person Demonstration: Overview of State Grantee Progress","author":"Coughlin R","year":"2016"},{"key":"e_1_2_11_3_1","volume-title":"Money Follows the Person: Updated State Transitions as of December 31, 2020","author":"Peebles V","year":"2022"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001281"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.13118"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.12.004"},{"key":"e_1_2_11_7_1","volume-title":"Long\u2010Term Care Providers and Services Users in the United States, 2015\u20132016","year":"2019"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.10.014"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.33877"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/10775587211050189"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.33872"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010017\u20102571\u2010y"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gby131"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16127"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15131"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/43.5.690"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz109"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532\u20105415.2003.51060.x"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.13411"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.01053"},{"key":"e_1_2_11_21_1","unstructured":"KasperJD FreedmanVA SpillmanBC.Classification of persons by dementia status in the National Health and aging trends study. 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