Question

Healthcare Basics

Are assisted living facilities regulated by the federal government?

A Answers (4)

  • AAnthony Cirillo, Gerontology, answered

    Assisted living regulations are not as well known or as prevalent as nursing home regulations. Assisted living facilities are regulated at a state level so that can mean that there is no consistency in regulations across states.

    Thankfully, the American Health Care Association National Center for Assisted Living publishes an annual report that offers a state-by-state summary of assisted living regulations. It covers 21 categories, provides contact information for state agencies that oversee assisted living activities, and includes each agency's website address.

    At least 18 states reported making statutory, regulatory, or policy changes in 2010 or January 2011 impacting assisted living/residential care communities. At least six states made major changes including Idaho, Kentucky, Oregon, Pennsylvania, South Carolina, and Texas.

    Focal points of state-assisted living policy include

    • life safety
    • disclosure of information
    • Alzheimer's/dementia standards
    • medication management
    • background checks
    • regulatory enforcement

    Other areas of change include move-in/move-out requirements, resident assessment, protection from exploitation, staff training, and tuberculosis testing standards.

    The AHCA/NCAL publication not only serves as a good reference but by checking in on other states, you may get a glimpse of what might be coming down the pike for your state.

    http://www.ahcancal.org/ncal/resources/Documents/2010SummaryRegulatoryChanges.pdf

  • AF. Michael Gloth, III, Gerontology, answered

    Fortunately, the excessive federal and state regulatory environment for nursing homes has not yet infected assisted living facilities. This isn't to say that some additional oversight may not be warranted, however. Currently, Assisted Living Facilities are regulated by individual states. In part, this is because a federal reimbursement program, e.g. Medicare, doesn't pay for residence in Assisted Living Facilities.

    While certain federal laws associated with abuse, housing and HIPAA do apply to Assisted Living Facilities, there has been a call for greater involvement on a national front to regulate these facilities to a greater degree. This effort not only is related to safety and resident protection, but also as a means of assisting consumers and establishing standards. A reality to be considered is that each new regulation incurs additional costs and many people have difficulty affording such levels of housing and assistance as it is.

    Regulation certainly helped the nursing home industry improve care at the outset, but now that same regulation has grown to a stifling degree. Today, many would argue, that the nursing home regulatory process actually impairs good care as good facilities struggle with the cost and time to complete documentation and prepare for surveys that steal time from resident care. Many state surveyors are lacking in a sufficient comprehension of clinical issues and fighting unwarranted citations has proven costly and difficult for nursing facilities.

    The challenge is to have sufficient oversight in Assisted Living Facilities without creating an environment that ultimately brings down the good players. For now, the issue of regulation primarily resides with state government.

  • AAARP answered

    No. Assisted living residences are not defined or regulated by the federal government. Each state decides how they’re licensed. Be sure to find out from your state or local Area Agency on Aging or state health department how the state where you are searching handles this. Make sure all the residences on your list are appropriately licensed—if one of them isn’t, cross it off and move on.

    Check, too, with the state licensing agency and your state’s long-term care ombudsman’s office to see if there have been complaints filed against the facilities on the list. Do not assume that a state license ensures quality care.

  • ASharine Forbes, Gerontology, answered

    Due to great variances and constant changes in laws and regulations, assisted living facilities are regulated at the state level. However, funding can received from federal resources. Information regarding the laws and regulations of each state can be found at: http://www.assistedlivingfacilities.org/directory/. 

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