# Staffing characteristics and injury-related emergency department use among assisted living residents with Alzheimer's Disease and Related Dementias (ADRD)

> **NIH NIH R03** · BROWN UNIVERSITY · 2022 · $122,677

## Abstract

Project Summary
Injuries are a leading cause of emergency department visits among older adults. Individuals with Alzheimer's
disease and related dementias (ADRD) are at particular risk of injuries, primarily due to falls. Lower levels of
direct care staffing are related to injuries in nursing homes. Currently, nothing is known regarding the
relationship between direct care staffing levels and injury-related emergency department (ED) use in assisted
living (AL) communities. Approximately 40% of the 800,000 individuals in AL communities have ADRD.
Although AL communities provide housing, personal care, at least two meals a day, and oversight 24 hours a
day, they are not required to provide round-the-clock nursing services. Also unlike nursing homes, AL
communities are regulated at the state level rather than the federal level. As a result, direct care staffing levels
and policies are variable among and within states. The goal of the proposed project is to examine whether
direct care staffing levels and policies are associated with injury-related ED use among AL residents with
ADRD. For the first aim, we will examine whether AL direct care staffing levels are associated with injury-
related ED visits among AL residents with ADRD. Specifically, using 2007 to 2019 of Ohio's Biennial Survey of
Long-Term Care Facilities linked to Medicare claims, we will examine the relationship between changes in
direct care staffing levels and injury-related ED use among AL residents with ADRD in the state of Ohio. For
the second aim, using a database of state staffing regulations, we will examine how states' changes in policies
related to minimum direct care staffing levels affect injury-related ED use among Medicare-enrolled AL
residents with ADRD between 2007 and 2019.The project is expected to improve the delivery of care to the
residents who live in AL communities with ADRD. States and AL communities can use the information gained
from this study to inform policies and practices related to direct care staffing levels.

## Key facts

- **NIH application ID:** 10461984
- **Project number:** 5R03AG073805-02
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Cassandra L Hua
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $122,677
- **Award type:** 5
- **Project period:** 2021-08-15 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10461984

## Citation

> US National Institutes of Health, RePORTER application 10461984, Staffing characteristics and injury-related emergency department use among assisted living residents with Alzheimer's Disease and Related Dementias (ADRD) (5R03AG073805-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10461984. Licensed CC0.

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