This research examines the differences between nursing home residents and those who were able to leave nursing homes with the help of the Medicaid Waiver Program in Vermont. Ninety individuals who reentered the community with the aid of such waivers were compared with a random sample of nursing home residents through the use of the Nursing Home Minimum Data Set. The researchers found divergence in four key areas: cognition, continence, treatment categories, and desire to return to the community. Typically, those who left nursing homes for the community were cognitively intact, had moderate continence, received rehabilitative or clinically complex treatments, and expressed a desire to return to the community. Contrary to the prevailing theory, no differences were found between groups in the ability to perform activities of daily living, except for toilet use. This report also found that community-based treatment under the Medicaid waiver was a cost-effective alternative to traditional nursing home care.



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