During the past decade the United States and other post industrial nations have witnessed unprecedented growth in their population's need for long-term care services. Originally viewed as institutional care for those with chronic illness, long-term care now characterizes a variety of health and social services including those provided in community centers, participants' homes, a variety of residential care settings, rehabilitative settings, and sub-acute care. Long-term care is increasingly viewed even more expansively to include the range of acute, primary, skilled nursing, and custodial care services required by persons with chronic illnesses. About 70% of health care dollars in the United States are spent on chronic illnesses.

About two thirds of those who need long term care are older persons. Although on any given day only about 4% of persons age 65 and over are in long term care facilities, about one in seven older adults require functional assistance of some type. Trends such as population aging technological advances, restructuring of health care services towards less hospital based care, managed care, and alternative delivery systems are transforming the field of long term care resulting in increased demand for services and expanded efforts to identify and apply effective innovations in a variety of settings.

The purpose of this course is to acquaint students pursuing a career in health care management with the dynamic and increasingly important field of long term care. The course provides a comprehensive overview of programs, policies, and services and examines the issues, challenges and dilemmas confronting long term care management and others in the field of health services.

The course is divided into three sections.

During the first section, we will explore the history and the context of current long-term care programs, and examine some of the developments that have led to the current configuration of services.

The second section will discuss the economic, political, regulatory, and social conditions that confront managers. Using these issues as background we will examine a number of issues including organizational design, strategic management and planning, managing change and innovation, quality assurance, measures of effectiveness, leadership and staff management.

The third section will focus on financing long term care, efforts to develop organized delivery systems, managed care and managers' strategic responses to these issues. We will discuss ethical issues and the conflicting missions managers face to ensure that services comply with regulatory requirements, address organizational and corporate goals, and maintain a client centered focus. Two case studies will be analyzed that incorporate issues from both sessions. In addition, students will be asked to make a presentation of their research on innovations in long tern care to the class.

The class will consist of online lectures, cyber-class discussions, email responses to course questions, self-directed site visits to innovative long-term care programs, case study team presentations, and a final paper.