The goal of this study is to examine Medicaid long-term medical care eligibility criteria across states, and in particular, how the nursing facility level of care (LOC) criteria affect access to care through home and community-based services (HCBS). The researchers will compare LOC policies across four states that have adopted a standardized, comprehensive assessment instrument, the interRAI Home Care instrument. They will apply state-specific algorithms to data from a fifth state to measure each state’s relative degree of access to HBCS.