Measures and Primary Study Outcome
To examine feasibility, we tracked enrollment, examined baseline characteristics between the randomized arms, monitored participants’ fidelity to the intervention, measured the proportion of participants who we were able to link with CMS data, and analyzed the primary study outcome. Participants’ demographics (ie, age, race and ethnicity, sex, and living arrangement) were obtained by the programs during the usual intake assessment process and shared with the research team. Racial and ethnic groups were self-reported or proxy-reported and included participants who were Black, Latino or Hispanic, White, and other race and ethnicity, which included Asian, multiracial, and “other,” as reported by the programs. Results for those categorized as other were combined because the small numbers could result in participant identification. Fidelity (eg, received meals for 6 months, discontinued meals, and reasons for discontinuing meals) came from the programs’ administrative data. The primary study outcome was the number of days from randomization to nursing home admission, ascertained using a Minimum Data Set admission assessment (completed for all new nursing home residents regardless of payer or intent of stay), within 6 months of randomization.