# Telehealth Use in Nursing Homes and the Quality of Care for Long-Stay Residents with Alzheimer's Disease and Related Dementias

> **NIH NIH RF1** · WEILL MEDICAL COLL OF CORNELL UNIV · 2024 · $2,373,964

## Abstract

PROJECT SUMMARY/ABSTRACT
Expansion of Medicare coverage of telehealth services during the COVID-19 public health emergency (PHE) removed
many of the barriers to telehealth provision in nursing homes (NHs). In 2020, 58% of Medicare Advantage (MA) plans
covered additional telehealth benefits in NHs, beyond those reimbursed by Medicare fee-for-service (FFS). Over three
years after the pandemic's onset and given that Medicare waivers supporting telehealth use in NHs will end in December
2024, new evidence is critically needed to assess the impact of telehealth on long-standing gaps in access to specialty
care and overall quality of care for NH residents with Alzheimer's disease or related dementias (ADRD). For long-
stay NH residents with ADRD, who make up over half of all NH residents, increased telehealth provision may allow more
timely access to routine and specialty care, provide clinicians and caregivers with an important layer of audiovisual
information to make more informed patient-centered decisions, and facilitate communication between residents,
providers, and caregivers. While telehealth has the potential to reduce potentially avoidable hospitalizations and
emergency department visits for NH residents through these mechanisms and others, there may be unintended
consequences of broader telehealth use, and challenges to using telehealth for residents with ADRD. The overall
objectives of this study are to leverage the natural experiments surrounding changes in access to telehealth among
Medicare FFS and MA-enrolled long-stay NH residents, to examine how telehealth has been used to supplement or
replace in-person patient care and to measure the relationship between telehealth use and the quality and cost of care. We
will focus on the following specific aims: (1) To examine how telehealth is and has been used for long-stay residents with
ADRD, using qualitative methods to generate nuanced insights into multiple predictors of, barriers to, and constraints on
use. We will conduct semi-structured interviews with NH medical directors and resident caregivers to explore multiple
implementation domains, including NH characteristics associated with telehealth provision.; (2) To characterize the
uptake and patterns of telehealth and in-person care from 2018 through 2024 for long-stay NH residents with ADRD; and
(3) To measure the relationship between access to telehealth among long-stay NH residents with ADRD and the
utilization, quality, and cost of care from 2018 through 2024. This application is innovative because it will be the first to
measure telehealth use for long-stay residents enrolled in both Medicare FFS and in MA. It will also be the first to
quantify the potential benefits of increasing access to telehealth services in NHs for long-stay residents with ADRD. The
findings from our mixed methods approach will provide nuanced qualitative insights on NH leadership decision-making
surrounding telehealth, frontline facilitators and barriers to te...

## Key facts

- **NIH application ID:** 10984740
- **Project number:** 1RF1AG089362-01
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Hye-Young Jung
- **Activity code:** RF1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $2,373,964
- **Award type:** 1
- **Project period:** 2024-09-01 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10984740

## Citation

> US National Institutes of Health, RePORTER application 10984740, Telehealth Use in Nursing Homes and the Quality of Care for Long-Stay Residents with Alzheimer's Disease and Related Dementias (1RF1AG089362-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10984740. Licensed CC0.

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