Relations Among Home- and Community-Based Services Investment and Nursing Home Rates of Use for Working-Age and Older Adults: A State-Level Analysis

Nursing home use declined among older adults (65+) in more than 2/3 of states but increased among older working-age adults (31-64) in all but 2 states. This article examines the associations between programmatic characteristics and rates of use. Although greater investment in Medicaid HCBS coupled with reduced nursing home capacity was associated with reduced rates of nursing home care for adults aged 65+, neither characteristic was associated among older working-age adults.