Choosing the right assisted living and residential care facility goes beyond evaluating the environment; its cost, types of food served, activities offered, and apartment or room amenities. When searching for a senior housing location, dig deep into the facility’s state violations, citations and inspection reports. It’s not difficult to do and these reports will shed some very important and interesting light on the facility under your review and consideration. In the long run, you’ll be grateful you did.
What is Assisted Living?
Assisted living residences provide older adults and people living with a disability, a mixture of housing and supportive services. Generally, it’s for people who don’t need round-the-clock nursing and medical care (skilled nursing homes) but do need help with daily living help like personal care and health services.
It is important to know that residential care homes like assisted living facilities are not regulated and defined by the federal government, so the states have developed their own definitions and regulations.
Assisted living residences vary in small home to big apartment buildings. There are stand-alone residences, and others that connect to a full continuum of care like independent living, memory care, and skilled nursing facilities.
Services offered in a residential care facility vary and are limited to meals, housekeeping and personal care, like bathing and dressing. Other assisted living facilities offer physical therapy or transportation.
Every state in the U.S. requires assisted living facilities to be licensed by the state agency that oversees the regulation of long term care facilities. Penalties for failure to obtain a license range from monetary sanctions to criminal liability.
The licensure and regulation of assisted living and residential care facilities are overseen by the state department of health, department of social services, or a combined department of each. In most states, the department in charge of issuing licenses is in charge of performing inspections. However, in a few states more than one agency may be involved in conducting inspections or a different agency than the licensing agency may conduct inspections.
How often are assisted living facilities inspected?
Most states require that facilities be inspected annually, semiannually, or at specified times between one and two years. An assisted living residence must also be inspected when a resident, family member or a concerned party submits a complaint.
State licensing and survey teams are usually made up of nurses, social workers, sanitarians and public health officials. The state department in charge of licensure and regulation usually provides short training sessions from a few days to a week. The number of surveyors per team is between one and five.
Assisted living surveys include interviews with residents, staff, and family members; review of resident, staff, and facility records and direct observation. Surveyors provide on-site consultation to facility staff on compliance and quality improvement issues.
Survey teams look to make sure that the resident has been informed of his or her rights and that a resident assessment has been performed and a care plan developed. They also check facility records and that the facility has retained appropriate licensure documentation.
When Visiting a Facility
Assisted living is a promising option for seniors because it promotes residents’ independence, and their rights to make decisions about their lives.
It is important you have an understanding of the philosophy of each community you visit and how each will enable you to live your life the way you want.
In order to remain safe living in an assisted living facility, its highly recommended that you check for the latest violations and inspections before choosing to live in one.
Where to Check for Latest Violations and/or Inspections
We’ve compiled the state regulating bodies that inspect and issue violations to assisted living facilities in their respective states. Use this resource to conduct research on assisted living facilities that you are considering, review any publicly available inspections or violation reports from the state licensing bodies.
How to File a Complaint against a Residential Care Facility (A prevalent question of consumers)
Assisted living, the fastest growing type of senior housing for older adults, fills the space between nursing homes and board and care homes.
Assisted living is tremendously appealing to consumers because it meets the need of older individuals receiving necessary care and services in a home-like environment.
In the event that a loved one comes across a problem while living in a residential care facility, be sure to report the problem to the facility management. It’s imperative that you should also report the problem to the state licensing agencies that oversee assisted living.
For example, if you see evidence of neglect or abuse, contact Adult Protective Services (APS) or the state’s licensing agency and the Long-Term Care Ombudsman in your area immediately. In some states, APS are responsible for investigating complaints. The long-term care ombudsman is authorized by federal law to “investigate and resolve complaints made by or on behalf of older individuals who are residents of long-term care facilities.”
- Physical abuse
- Verbal abuse
- Sexual Abuse
- Absence of financial management
It’s vital that details of the complaint are recorded. The more information you write down and record, the better chances of getting the grievance handled.
Record details of a grievance:
- What happened?
- To whom did it happen?
- When did it happen?
- Where did it happen?
- Who did the abuse?
- Who was responsible for the neglect?
More information on reporting complaints to the state’s licensing agency
More Issues of Concern
A growing problem in the assisted living industry: State assisted living laws increasingly allow assisted living facilities to admit or retain residents with significant health care needs.
Some residential care homes and assisted living facilities believe that the facility has the right but not the obligation to accept residents with the specified health care needs. Under the ADA, (Americans with Disabilities Act) it is illegal for a facility to use a specific health care need as an ineligibility for residence, if state law allows for that health care need to be met in an assisted living facility.
The most prominent feature about assisted living discharge laws is the discretion that facility operators are granted. Most states allow involuntary discharge when a facility cannot meet a resident’s needs, and anticipate that the facility has a right to decide whether particular needs can be met
By allowing this discretion to facilities, state law creates two potential problems:
- a resident will be discharged too soon
- or too late
If a resident is discharged too soon, a facility has the right due to a resident’s needs are too expensive or inconvenient. If you loved one should come up against a discharge due to care issues, a resident may receive more protection from the ADA than from state assisted living law.
The too-late discharge is the source of many serious assisted living problems. The most horrific incidents are the result of a facility retaining a resident that a facility is incapable of providing care.
Assisted living regulations differ greatly from state to state and even within a state, with individual assisted living facilities often bearing little resemblance to each other.
Before selecting and moving into an assisted living facility, research your state’s violations and view all complaints made against the home or facility.
Carol Marak is a contributor for the senior living and health care market. She advocates for older adults and family caregivers by writing on tough topics like chronic issues, senior care and housing. Her work is found on AssistedLivingFacilities.org and HomeHealthcareAgencies.com. Find Carol on LinkedIn and contact her at Carebuzz@gmail.com.