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A Series on Advancing Transformation in Long-Term Services and Supports

About the Series

AARP Public Policy Institute has launched LTSS Choices—a multifaceted project with an overarching mission to catalyze the transformation and modernization of the nation’s long-term care system into one that meets the dynamic needs and preferences of consumers and their families.

This series of reports, blogs, videos, podcasts, and virtual convenings seeks to spark ideas for immediate, intermediate, and long-term options for reforming LTSS.  It will showcase current models that could be ramped up now as well as potential innovative models that may take time to fully create. It will emphasize evidence-based solutions and identify regulatory and funding barriers that limit the widespread use of promising practices.

About the LTSS Choices Team

Paying Family Caregivers to Reduce Reliance on Nursing Homes


Spotlight Reports

This is an action-oriented series. We aim to stimulate systems-level change to transform and modernize the delivery of LTSS.

Older Asian woman in nursing home wearing a mask


International Review of Innovations to Protect Nursing Home Residents from Infectious Diseases such as COVID-19

This report reviews the international community’s experience with the COVID-19 pandemic in nursing homes, which has varied substantially across different countries.


Woman giving informal care to a 91 year old man in a home


Presumptive Eligibility for Medicaid Home and Community-Based Services Can Expand Consumer Choice

This report explores how presumptive eligibility can empower consumers to access publicly funded home- and community-based services (HCBS) without lengthy determination delays.


LTSS Nursing Home


Adult Family Care - A Viable Alternative to Nursing Homes

People who need long-term services and supports want alternatives to nursing homes as living options.  Adult Family Care (AFC), which is not as well known among consumers as home care and assisted living, gives older adults and people with disabilities a viable alternative.



mother and daughter

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Paying Family Caregivers to Provide Care During the Pandemic-and Beyond

This Spotlight will demonstrate the critical importance of policies enabling family caregivers to be paid to support older adults and people with physical disabilities in the era of COVID-19 and beyond.



St. John's Green Home in Rochester NY

Courtesy of St. John's Green Home, Rochester, N.Y.

Small House Nursing Homes 

We will look at the evidence on small-house nursing homes, with a particular focus on the model known as Green House homes. We will examine key features of the Green House (housing, services, workforce, and community integration) and discuss challenges and opportunities for expanding availability to Green House homes and other small-house nursing homes. 




Nursing Homes and COVID-19

This Spotlight report will highlight insights from a comprehensive synthesis of the current state and federal reports on nursing homes in light of COVID-19, with a specific focus on alternative recommendations and solutions regarding current nursing home infrastructure and policies.




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Advancing Transformation in Long-Term Services and Supports

This Spotlight lays out the framework guiding AARP's exploration of LTSS Choices, focusing on the four pillars of housing, services, workforce and community integration. In addition, it describes the systemic features and the driving and restraining forces that impact the success and replicability of different models.



More from AARP

AARP Nursing Home COVID-19 Dashboard

AARP fought for public reporting of nursing home COVID-19 cases and deaths. Using this data, the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the AARP Nursing Home COVID-19 Dashboard.



Long-Term Services and Supports Scorecard

A project of AARP, the Commonwealth Fund and the SCAN Foundation, the Long-Term Services and Supports Scorecard provides data on five key dimensions of state LTSS system performance: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and effective transitions. It assesses each state’s performance as a whole and on 26 individual indicators.

Livability Index

How livable is your community?

Contact Us

We invite ideas and opportunities to collaborate. For all questions and inquiries, please contact us at