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MOUD Support in Long-term Care Facilities


  • Long-term care facilities express concerns about admitting residents with OUD.
  • Abt supported facility staff caring for residents receiving MOUD.
  • Post-training assessments indicated significant increases in understanding OUD and MOUD.
The Challenge

In 2016, Massachusetts announced that long-term care facilities (LTCFs) are expected to admit individuals with opioid use disorder (OUD), provided it is not a primary diagnosis, and to provide prescribed medication for OUD (MOUD). Failure to do so violates the Americans with Disability Act. Yet, many facilities still do not admit residents with OUD. The purpose of this program is to provide training and technical support to staff caring for residents with OUD and improve continuity of MOUD care.

The Approach

The Abt Team recruited 42 LTCFs in five communities of practice (CoP), with geographic spread across the Commonwealth. We conducted pre-program staff interviews, one in-person learning session offered in each CoP, virtual site visits, a series of six ECHO® learning sessions, and post-program web-based staff surveys. The team developed and disseminated a MOUD in LTC Toolkit to help facilities comply with state and federal policies and provide evidence-based care to residents on MOUD.

The Results

Pre-training data indicated that only six of 42 recruited LTCFs had admitted residents with OUD. Although licensed LTCF practitioners can obtain a waiver to prescribe certain MOUD, only 4 of the 28 LTCF medical directors interviewed had done so. Almost all who attended the first learning session agreed that the session met the objectives of understanding OUD as a chronic disease, recognizing the stigma of OUD, gaining knowledge of MOUD treatments, and obtaining strategies to enhance best practices across the continuum of care. All items on the pre/post-session assessments indicated a significant increase in understanding (37% versus 60%).