Relationships between Acute Care and Nursing Unit Use in Two Continuing Care Retirement Communities

The likelihood of nursing home use among Continuing Care Retirement Community (CCRC) residents is substantially affected by temporary placements. CCRC residents are more likely to use a nursing unit after a hospital stay or outpatient surgery than are community residents. On the other hand, CCRC residents have a lower rate of hospital admissions and a higher rate of outpatient surgery. There is an apparent substitution between the use of on-site personal care and nursing services among the CCRCs studied. The interrelationships between acute care and nursing unit use suggest implications for managed care, insurance coverage, and the measurement of outcomes of care in assisted living facilities.