The assisted living concept has boomed over the last few decades, not only in Kentucky, but throughout the country. It is now a multi-billion dollar industry that provides housing for people who aren’t physically capable of living on their own, but aren’t yet ready for a nursing home.
Unfortunately, as with any industry that is early in its development, there are few regulations that protect consumers and residents. A Frontline episode highlighted the fact that while some 750,000 seniors live in assisted living facilities, many states have minimal regulations for these institutions.
For anyone in a facility, or with loved ones in assisted living, you should recognize that it is essentially a buyer beware business. Take these three actions before you choose a facility:
Review Staff Training and Experience
It may be shocking to know that most states require little education or training for assisted living employees. Some states don’t even require them to have a licensed nurse on staff. When you visit a home, inquire about the medical training of supervisors and aides.
Check Staff-Resident Ratios
It may also be surprising that some states don’t have staff ratio requirements; those states that do have ratios vary widely. For example, Mississippi requires a 1:25 staff/resident ratio at night, while California requires only 1:100 at night!
Review Complaint Files
Always review complaint files – which can be harder to do for assisted living facilities than for nursing home records. While all nursing home complaints are available from an online database, only about half of the states maintain online assisted living records. In states that don’t, this means a trip to state offices or possibly having to file public records requests.
Also, beware that while all states can shut down facilities, most will only do so after years of complaints. This means you may want to thoroughly inspect the facility yourself before you move in, and keep aware throughout the stay.
Sadly, patients or relatives can’t even rely on states to fully and routinely inspect assisted living facilities. While federal rules require nursing homes to be inspected at least once every 15 months, states are able to set their own standards for assisted living. Six states have no inspection requirements for assisted living. For those that do, the time period between inspections can be as long as five years.
The lack of rules can all be credited to the assisted living providers. The industry employed a strategy in D.C. to convince Congress that states are better suited to regulate; then they worked both ends by aggressively lobbying state legislature to keep regulations at a minimum.
The Frontline special pointed out that the nursing home industry is highly regulated because the federal government pays many of the bills, via Medicare. In contrast, most residents in assisted living pay for themselves.
In response to some of these problems, the assisted living industry asserts that “91 percent of the country that has a mom or dad in an assisted living facility would recommend that facility to someone else.”
Nevertheless, anyone who has a chance to view the Frontline episode will likely conclude the best approach is still buyer beware.