Date of Completion


Embargo Period



Laura Donorfio, Ph.D., Keith Bellizzi, Ph.D., Julie T. Robison, Ph.D.

Field of Study

Human Development and Family Studies


Master of Arts

Open Access

Open Access


Older adults (65+) are a growing and significant population in the United States. Due to medical conditions and other social factors, some older adults may move to institutional settings to receive care. The Money Follows the Person (MFP) Rebalancing Demonstration is a federal initiative that offers Medicaid recipients the opportunity to live independently in the community by facilitating transitions from institutional settings. A secondary data analysis was performed using longitudinal data from a Quality of Life (QoL) survey conducted with 1,577 older adults in Connecticut (CT). The purpose of these analyses was to explore potential differences among rural, suburban and urban dwelling older MFP participants in CT. This study sought to examine potential relationships between rural residence and three domains: health outcomes, community living and life satisfaction. First, health outcomes were assessed using rates of acute care utilization, reinstitutionalization and self-rated health. Next, the study examined differences in transportation and community integration among the sample. Finally, the study examined differences in life satisfaction among participants in the three geographical categories. Overall, there were no differences between groups in any dependent variable at the twenty-four month follow ups. At the six month follow up, rural residents reported greater difficulties with transportation and urban residents reported higher levels of community integration than either rural or suburban residents. At the twelve month follow up, rural residents reported a higher instance of reinstitutionalization and suburban residents reported greater self-rated health. This research has the potential to inform policymakers about the impacts of the MFP program regarding rural, suburban, and urban older adults.

Major Advisor

Laura Donorfio, Ph.D.