The Value of Senior Housing Plus Services

A research effort by the LeadingAge Center for Housing Plus Services explored whether service-enriched housing helps low-income older adults meet their health and long-term care needs. The project included analysis of the connection between on-site services and residents’ healthcare utilization and spending, a survey on the availability of on-site services at 2,017 HUD-assisted senior housing developments (a non-representative sample), a policy brief on the potential expansion of service-enriched senior housing based on interviews with state policymakers, and a set of case studies of affordable senior housing developments that added on-site services.

Major findings:

• In federally-subsidized senior housing, an on-site service coordinator reduced hospital admissions among residents by 18%.
• On-site service coordinators were associated with higher average Medicaid payments, perhaps by assisting residents in identifying programs that they need.
• Health education services were associated with an increase in emergency department visits and a decrease in Medicare Part D payments. Case study interviewees indicated that health education and screening programs identified urgent medical issues for which residents were encouraged to seek treatment.
• Approximately two-thirds of the HUD-assisted senior housing properties in the survey have an on-site service coordinator. HUD was the primary source of service coordinator funding. Coordinators were typically available 30 hours per week.
• One third of properties conducted formal needs assessments with residents.
• 74 percent of properties offered social and recreational activities. 66 percent offered health education programs, and 64 percent offered health screenings. Health education and screenings, however, were available on an infrequent basis.
• Based on state policymaker interviews, several states have created a housing coordinator role as part of their Money Follows the Person programs.
• California, Connecticut, Massachusetts, Ohio, and Oregon received HUD rental subsidies for Money Follows the Person participants.