Long-Term Care: The Need for Geriatric Assessment in Publicly Funded Home and Community-Based Programs

Pursuant to a congressional request, GAO discussed geriatric assessments for federally-funded home and community-based long-term care, focusing on: (1) its definition; (2) the extent of its use in public programs; (3) the qualification requirements for geriatric assessment administrators; and (4) the benefits of standardizing the evaluation process. GAO noted that: (1) geriatric assessment is the skillful gathering of information about an elderly person's health, needs, and resources to determine a client's eligibility for services and provide a basis for the client's care plan; (2) a comprehensive, standardized geriatric assessment should be available to all elderly applicants for publicly funded home and community-based long-term care programs; (3) there is support for client screening to identify those clients who are most likely to benefit from comprehensive evaluation; (4) although geriatric assessment procedures are often employed in Medicaid waiver and state-funded community care programs, they vary among states and programs; (5) evaluator's professional qualifications vary from program to program; (6) although standardizing geriatric assessment programs could increase equity, decrease the likelihood of redundant assessments, and promote comprehensive care planning, it could adversely affect program flexibility and alienate some clients; and (7) client screening and improved evaluator training could reduce the negative effects of program standardization.