HHS Grants $15 Million for Nursing Home Aging in Place Project

A Missouri nursing school recently received a nearly $15 million grant from the Department of Health and Human Services (HHS) for a project to reduce rehospitalizations of nursing home residents using advanced practice registered nurses (APRNs).

“Aging in place” is a concept most often applied to independent or assisted living, but it can happen in nursing homes, too, when residents are able to avoid costly hospitalizations that can often further deteriorate their health. 

The $14.8 million in funds will be distributed to The University of Missouri Sinclair School of Nursing during a four-year period for a project led by MU researchers and headed by Marilyn Rantz, professor of nursing at MU. 


The school believes that insights gained from the project could provide a nationwide model for senior care and lead to a significant reduction in national healthcare spending. Its expectations are in line with results hoped for in a similar initiative by Brookdale Senior Living in partnership with the University of North Texas Health Science Center, which also received an HHS grant. 

MU will partner with the Centers for Medicare & Medicaid Services (CMS) and state Medicaid programs to improve care for residents at 16 nursing homes in St. Louis. Many of the residents are dually eligible for Medicare and Medicaid, and research shows that nearly half of all hospitalizations among those enrolled in either program could have been avoided—at a cost of more than $7 billion in 2011. 

The grant will help fund the project, which will be overseen by MU researchers who will recruit and place one advanced practice registered nurse at each of the nursing homes. The APRN will work with each nursing home’s staff and residents’ health providers to coordinate patient care along with help improve the recognition, assessment, and management of conditions that often cause hospitalizations among seniors, says MU. 


“Previous research has shown that every time patients move from nursing homes to hospitals and back to nursing facilities, their conditions deteriorate,” said Rantz. “Older adults have subtle changes in their behaviors and in their health statuses. In nursing homes, improving the observation and assessment processes by advanced practiced nurses can help residents receive treatment earlier and avoid unnecessarily going back to hospitals.”

The INTERACT program, a quality improvement initiative designed to monitor and assess seniors’ health in healthcare facilities, will feature into the project. APRNs at each nursing home will work with a traveling interdisciplinary team that will include a master’s-trained social worker, medical director, an APRN with knowledge of INTERACT II, and an information technology specialist.

“From my perspective as a researcher, clinician and former nursing home administrator, this award is exciting because, for years, I have measured the benefits of APRNs in nursing homes,” Rantz said. “Putting APRNs in nursing homes is the right solution, and if you combine these nurses with the INTERACT II tools, we’ve really got a shot at improving the quality of care and health outcomes of nursing home residents.”  

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Read more at the Sinclair School of Nursing’s website.

Written by Alyssa Gerace