Each year, the National Center for Assisted Living releases the “Assisted Living State Regulation Review”, which provides a record of states’ requirements and regulations for licensing or certification for their assisted living facilities. Some of the requirements include the state agencies in charge of licensing assisted living, requirements for residency, admission and discharge regulations, scope of care, staffing, training, and procedure for Alzheimer’s and dementia. There are federal regulations for assisted living facilities, but state-level regulation is important because it allows facilities across the state to be unified in their procedures and systems, and it allows states to test different methods of assisted living.
The 2017 report, which has just been released, provides a current record of all states’ assisted living policies, in addition to the District of Columbia. Seventeen states have updated their regulations in the time since the 2016 report, and, according to the report’s author and NCAL’s Senior Policy Director Lilly Hummel, “Over time, states are generally increasing the regulatory requirements for assisted living communities.”
More specifically, it seems that states are choosing to increase their oversight requirements for assisted living and increase civil monetary penalty maximums. Other, less common changes included updating requirements for things such as background checks, medication distribution, training, and administrator licensing.
In addition, these four states chose to create legislation to increase oversight and penalties:
- Oregon – The report states that the Department of Human Services will develop an evidence-based framework to assess compliance with regulations and to measure facilities’ degree of compliance versus non-compliance. In addition, the department will establish a program to provide positive and negative consequences to facilities with respective effective and poor performance.
- Virginia – Legislation was passed that will increase the aggregate number of civil penalties that Virginia’s Department of Social Services may assess per assisted living facility.
- Rhode Island – The state licensing agency is now required to conduct random onsite inspections of all licensed assisted living facilities every two years, with at least 10% of inspections occurring at night and during the weekend; in addition, the agency must conduct additional on-site inspections if it is called for.
- California – This state’s legislature increased civil penalties for licensing violations and required California’s Department of Social Services to work with licensed facilities to pinpoint weaknesses and prevent future and repeat violations.
With these new changes being implemented, the affected states will ideally see a decrease in their facilities’ potential liabilities as they tighten up their requirements and standard procedures. The most prevalent source of claims against assisted living facilities is negligence, whether it is negligence in maintaining the facility or negligence on staff members’ part leading to resident injury, illness, or death. As assisted living facilities are relatively new compared to nursing homes, they are still working on developing their standard policies and procedures, and ideally this rise in jurisprudence will see a reduction in professional and general liability claims.
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