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The Gerontologist 42:462-474 (2002)
© 2002 The Gerontological Society of America

A Screening System for Michigan's Home- and Community-Based Long-Term Care Programs

Brant E. Fries, PhDa, Lisa R. Shugarman, PhDb, John N. Morris, PhDc, Samuel E. Simon, MAc and Mary James, MAd

a Institute of Gerontology and School of Public Health, University of Michigan, Ann Arbor, and Ann Arbor VA Medical Center, MI
b RAND Corporation, Santa Monica, CA
c Research and Training Institute, Hebrew Rehabilitation Center for Aged, Boston, MA
d Medical Services Administration, Long Term Care Health Plan Division, Michigan Department of Community Health, Lansing

Correspondence: Brant E. Fries, PhD, Institute of Gerontology, University of Michigan, 300 North Ingalls, Ann Arbor, MI 48109-2007. E-mail: bfries{at}

Decision Editor: Laurence G. Branch, PhD

Purpose: To develop a screening system for Michigan's MI Choice publicly funded home- and community-based services programs, to aid in identifying both individuals eligible for services and their most appropriate level of care (LOC). Design and Methods: Identify assessment items from the Minimum Data Set for Home Care (MDS-HC) assessment instrument that are predictive of five LOCs determined by expert care managers: nursing home, home care, intermittent personal care, homemaker, and information and referral (without services). Results: The algorithm based on approximately 30 client characteristics agrees with expert opinions substantially better ({kappa} = .62) than systems based on activities of daily living and instrumental activities of daily living only ({kappa} < .40). Implications: The screening algorithm can be used both over the telephone to identify clients who will not be fully assessed (as they are unlikely to receive services) and in person to recommend the appropriate LOC.

Key Words: Long-term care • Screening • Home care • Nursing home eligibility

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Copyright © 2002 by The Gerontological Society of America.