The interRAI Long Term Care Facility (interRAI LTCF) is a comprehensive, standardized instrument for evaluating the needs, strengths, and preferences of those in chronic care and nursing home institutional settings. The interRAI LTCF has been designed to be compatible with other internationally used interRAI instruments for home care, community mental health, in-patient mental health, acute care, palliative care, and post-acute care. The compatibility of assessment elements improves the continuity of care through a seamless health assessment system across multiple settings, and promotes a person-centered approach to care. The interRAI LTCF consists of an assessment form, item-by-item instructions, and a series of care planning protocols. The assessment form enables a health care provider to assess key domains of function, mental and physical health, social support, and service use.
Background
The first assessment system created by members of interRAI is the Long Term Care Facility Resident Assessment Instrument, which consists of a core screening and assessment instrument, known as the Minimum Data Set (MDS), and 18 Resident Assessment Protocols (RAPs). The instrument and its related training materials provide a standardized approach to assessing the health, functional and psychosocial needs and strengths of individuals living in nursing homes or receiving short-term post-acute care in skilled nursing facilities.
The interRAI LTCF was originally developed in 1988-90 under a US Health Care Financing Administration (HCFA, now Centers for Medicare and Medicaid Services) contract with a consortium of researchers from Research Triangle Institute, Hebrew Rehabilitation Center for Aged, Brown University, and the University of Michigan. The development of the MDS/RAI was mandated by the 1987 Nursing Home Reform Law, which also required that it be implemented in all US nursing homes. The LTCF was originally implemented in approximately 17,000 US nursing homes in 1990-91. It was revised (Version 2.0) in 1994-95, and items were dropped, modified or added to enhance clinical utility, item reliability, and streamline the care planning process. Version 2 was implemented across US nursing homes in 1996, and later in several countries including Canadian provinces and European countires. The latest version (interRAI LTCF) was developed by interRAI to be compatible with the interRAI Suite of instruments.
Target Population
Frail elderly and disabled adults in institutional long-term care settings.
Domains
Adoption and Use
The LTCF and previous versions are currently used in several countries for one or more of the following purposes: care planning, facility management, needs assessment, policy development, quality improvement and benchmarking, reimbursement, research, or service eligibility. It is used in North America (U.S. and Canada), Europe (Belgium, England, Finland, France, Germany, Iceland, Italy, Netherlands, Norway, Spain, Sweden, Switzerland), Asia (Hong Kong, Korea, and Japan), and Pacific Rim (Australia, New Zealand).
Applications
A comprehensive User's Manual which contains item-by-item instructions for using the form, suggested assessment processes, procedures for completing the 27 CAPs (for interRAI LTCF version) and techniques for linking the assessment to individualized care planning is available.
- Validated scales to measure ADLs, cognitive performance, pain, depression, communication, etc.
- A quality monitoring system (validated Quality Indicators)
- A case-mix system that can be used for reimbursement and other purposes (RUG-III)
For more information, please contact:
John Morris
Co-Director, Institute for Aging Research
Hebrew Senior Life
1200 Centre St.
Boston, MA USA 02131
Email: jnm@hrca.harvard.edu
