Searching for Quality in Assisted Living CarePosted on May 20, 2014 by ECR Louisville in Blog
Josh Lucas, regulatory licensing program manager for A Place for Mom, said the tool grew out of the company’s efforts to make sure all the facilities it works with were properly licensed. (A Place for Mom does not charge clients, but earns fees from participating facilities when they accept those referred for placement.)
The directory ranks all 50 states and the District of Columbia based on the ease with which consumers can gain access to inspection reports and other documents — like notices of complaints, violations or fines — for assisted living centers. Assisted living centers are for older people who need help with activities of daily living, like dressing, bathing or meal preparation. Roughly one million people live in such facilities in the United States, according to a report from the American Society on Aging.
Nursing homes, which are for people who need more intensive medical care, are generally regulated by the federal government because many are certified to participate in the Medicare and Medicaid insurance programs. Consumers can find detailed quality information about them using the federal Nursing Home Compare tool.
Assisted living centers, however, are primarily licensed and regulated by states, and residents often pay out of pocket for services, so the availability of information about them varies. According to a recent report from Genworth Financial, the median rate for assisted living nationally is $3,500 a month.
A Place for Mom’s tool groups states into four categories, based on how easy it is to get inspection reports, for example, Mr. Lucas said. The site based its rankings on a dozen criteria, including availability of data online, the frequency with which records are updated, the publication of inspections and violations, and the scope of information available.
Twenty-nine states were deemed of “exceptional” or “high” rank. Missouri ranked first for its “highly transparent” records: A person can click on a facility’s name online to see its inspection reports, with any deficiencies noted. The state also got high marks for the frequency of its inspections, which are required every six months. Florida and Washington also rank highly.
Eight states, including New York, and the District of Columbia are ranked as “moderate,” while 13 are considered “basic” — a nice way of saying that they could stand some improvement. South Dakota ranked 50th, while Massachusetts ranked 51st; the guide notes that it is “the most difficult state from which to acquire assisted living records.” The state’s list of facilities is available only as a PDF or Word file, and is outdated, according to the directory. (The list says it is current as of February 2013.)
The Massachusetts Executive Office of Elder Affairs did not immediately respond to a request for comment.
Thomas E. Martinec, deputy secretary of the South Dakota Department of Health, said in an email that assisted living survey reports were considered public records, and consumers can request them either by phone, email or mail. The state provides online access to nursing home reports, and intends to offer similar access for other licensed facilities, including assisted living centers, “as time and resources allow.”
Here are some additional questions about assisted living:
■ Where can I find tips for selecting an assisted living center?
■ What if I have to file a Freedom of Information request to obtain inspection reports?
Some states require that a request be submitted by mail or fax; others permit requests over the phone. If you need help, the National Freedom of Information Coalition offers sample letters on its website.
■ Should I rule out an assisted living center if it has had a recent violation?
Violations vary in severity and risk, Mr. Lucas noted, so that should be taken into account. A citation for leaving lids off garbage cans, for instance, may not be as much of a concern as one for having disconnected security alarms at a facility that houses residents with memory disorders. He suggests asking the facility, as well as state regulators, about the details of a violation and how it was fixed.
Mr. Lucas also said that consumers should consider whether the facility has corrected any problems; if it had multiple violations two or three years ago but fixed them, and has remained free of deficiencies, that signals a commitment to improve.
Patricia L. McGinnis, executive director of the California Advocates for Nursing Home Reform, said that since regulations vary by state, consumers should try to familiarize themselves with their states’ rules.
In California, she said, even a “deficiency” notice involving a death may bring only a small fine, so the size of a penalty is not necessarily enough to go by. (The group is campaigning for tougher rules for assisted living facilities, also known as residential care facilities.) “You have to put it in context,” she said. “What is the severity of the complaint?”
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