National Post-acute and Long-term Care Study

About NPALS

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The National Study of Long-Term Care Providers (NSLTCP) is now called the National Post-acute and Long-term Care Study (NPALS). The new name reflects the addition of more post-acute sectors (i.e. inpatient rehabilitation facilities and long-term care hospitals), while keeping the same sectors that have been in the study since it launched in 2012 (adult day services centers, assisted living and similar residential care communities, home health agencies, hospices, and nursing homes). The information NCHS plans to collect about adult day services centers and participants and residential care communities and residents will not change. Please contact us at ltcsbfeedback@cdc.gov with your questions about this exciting change.

Primary Study Goals

The main goals of NPALS are to:

  1. Estimate the supply and use of paid, regulated post-acute and long-term care services providers.
  2. Estimate key policy-relevant characteristics and practices.
  3. Produce national and state-level estimates, where feasible.
  4. Compare estimates among sectors.
  5. Monitor trends over time.

NPALS expands NSLTCP, which replaced NCHS’ previous National Nursing Home Survey, National Home and Hospice Care Survey, and National Survey of Residential Care Facilities. NPALS was designed to be responsive to multiple factors: NCHS’ 2009 Board of Scientific Counselors external review panel’s key recommendation to integrate all existing and future long-term care provider surveys into a unified study that can provide an overall picture of the long-term care spectrum at the same point in time; uncertainties and challenges in getting back into the field after periodic and infrequent data collection as with NCHS’ previous long-term care provider surveys; and NCHS’ goal to monitor the diverse post-acute and long-term care fields, and fill the gaps in coverage of long-term care providers and recipients.

NPALS:

  • Provides information on seven major sectors of paid, regulated post-acute and long-term care services providers and services users.
  • Uses existing administrative data on nursing homes, home health agencies, hospices, inpatient rehabilitation facilities, and long-term care hospitals.
  • Collects primary data on adult day services centers and residential care communities via national and state representative surveys because national administrative data are not available on these providers.
  • Allows comparisons among sectors at a similar point in time and over time.

Survey Fielding Update

NCHS ended fielding of the 2022 Adult Day Services Center and Resident Care Community in March 2023. All adult day services centers and a sample of residential care communities that received a survey were invited to participate.

Published Reports and Survey Documentation

Findings from the 2012, 2014, 2016, 2018, and 2020 survey waves are available from the Study Results and Publications pages. Please sign up for the Long-term Care Listserv to be notified when new products are published. Questionnaires from the 2012, 2014, 2016, 2018, 2020, and 2022 survey waves can be found on the Questionnaires, Data Sets, and Related Documentation page.

Public Use and Restricted Data Files

Restricted data files for the 2012, 2014, 2016, 2018, 2020, and 2022 adult day services center and residential care community surveys are available through NCHS’ Research Data Center (RDC) for a fee. Public use files (PUF) from the 2018 adult day and residential care surveys are available to download from the NPALS website. Potentially identifiable information about providers and users were removed from the PUFs to ensure the confidentiality of respondents.

These included survey responses from 1,660 eligible ADSCs from a census of 5,137 centers, and 2,088 eligible RCCs from a sample of 6,049 RCCs. The data files include weights that can be used to get nationally representative estimates.

For more information and announcements: