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Federal government needs to take closer look at assisted living facilities
November 02, 2006Over the last 20 years, a housing industry has sprung up to handle elderly citizens who cannot live independently but do not require around-the-clock nursing.
Known as assisted living facilities or ALFs, the industry offers seniors a range of housing possibilities from two-bedroom suites with access to golf and tennis in ritzy vacation spas to small rooms in dilapidated motels and former hospitals.
ALFs have become the fastest growing segment of residential care for the elderly. And along with their rise have come a host of health and care issues that need to be addressed by the federal government, according to an article in the Elder Law Journal published by the Illinois College of Law.
By law, ALFs are not considered medical or mental health facilities and are viewed as residential only. In addition to a private or semi-private room, they typically offer meals for residents, housekeeping services, assistance for taking medications and provisions for social activities.
About half report having a registered nurse on staff either full- or part-time. But a number of differences exist between ALFs and nursing homes, Patrick A. Bruce, a former editor at the journal, noted in the article.
"In contrast to assisted living facilities, nursing homes are subject to federal guidelines because they rely on Medicaid and Medicare funds. A second major difference between assisted living facilities and nursing homes is their respective costs. Assisted living facilities typically cost less than nursing homes. However, this cost is misleading because assisted living residents use private funds to pay for their expenses while eligible persons can use Medicaid to cover nursing home costs."
Surveying the regulation of ALFs by state agencies, Bruce found lax rules and inconsistent inspections. Lack of staff training is a major shortcoming in many states. Maryland, for example, requires only three hours of training to work in an ALF, and inspections have found residents with untreated bedsores, hypothermia and other signs of neglect.
As a result of a budget crisis, California announced in 2003 that it would cut back its inspections of ALFs from yearly to once every five years. In Alabama, regulators spent $5.5 million to inspect 244 nursing homes in 2002, but only $500,000 to inspect 330 ALFs.
The federal 1987 Nursing Home Reform Act requires operators to provide a minimal level of service and established a resident's bill of rights.
Despite enforcement loopholes and shortcomings in inspections, the law has tangibly improved the quality of life for many nursing home residents. "Inappropriate use of physical and chemical restraints, rates of urinary incontinence and catheterization and, most importantly, hospitalization rates have all declined," Bruce wrote.
Similarly, federal standards that set norms for staff training, scope of care, and disclosure of coverage at ALFs would "provide a predictable setting for consumers, providers and payers," according to the article.
It is estimated that about 1 million people are housed in more than 36,000 ALFs nationwide. This compares with about 600,000 seniors housed in 11,500 ALFs in 1998.
The industry reported charging an average monthly fee of $2,627 for private units in 2006, although this figure varies widely depending on the size of the unit, services provided and location.
By 2020, the number of elderly Americans needing long-term residential care is expected to double from 7 million to 14 million.
University of Illinois at Urbana-Champaign
By law, ALFs are not considered medical or mental health facilities and are viewed as residential only. In addition to a private or semi-private room, they typically offer meals for residents, housekeeping services, assistance for taking medications and provisions for social activities.
About half report having a registered nurse on staff either full- or part-time. But a number of differences exist between ALFs and nursing homes, Patrick A. Bruce, a former editor at the journal, noted in the article.
"In contrast to assisted living facilities, nursing homes are subject to federal guidelines because they rely on Medicaid and Medicare funds. A second major difference between assisted living facilities and nursing homes is their respective costs. Assisted living facilities typically cost less than nursing homes. However, this cost is misleading because assisted living residents use private funds to pay for their expenses while eligible persons can use Medicaid to cover nursing home costs."
Surveying the regulation of ALFs by state agencies, Bruce found lax rules and inconsistent inspections. Lack of staff training is a major shortcoming in many states. Maryland, for example, requires only three hours of training to work in an ALF, and inspections have found residents with untreated bedsores, hypothermia and other signs of neglect.
As a result of a budget crisis, California announced in 2003 that it would cut back its inspections of ALFs from yearly to once every five years. In Alabama, regulators spent $5.5 million to inspect 244 nursing homes in 2002, but only $500,000 to inspect 330 ALFs.
The federal 1987 Nursing Home Reform Act requires operators to provide a minimal level of service and established a resident's bill of rights.
Despite enforcement loopholes and shortcomings in inspections, the law has tangibly improved the quality of life for many nursing home residents. "Inappropriate use of physical and chemical restraints, rates of urinary incontinence and catheterization and, most importantly, hospitalization rates have all declined," Bruce wrote.
Similarly, federal standards that set norms for staff training, scope of care, and disclosure of coverage at ALFs would "provide a predictable setting for consumers, providers and payers," according to the article.
It is estimated that about 1 million people are housed in more than 36,000 ALFs nationwide. This compares with about 600,000 seniors housed in 11,500 ALFs in 1998.
The industry reported charging an average monthly fee of $2,627 for private units in 2006, although this figure varies widely depending on the size of the unit, services provided and location.
By 2020, the number of elderly Americans needing long-term residential care is expected to double from 7 million to 14 million.
University of Illinois at Urbana-Champaign
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Houseplants increase quality of life for retirement community residents
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Center for the Study of Traumatic Encephalopathy announces new findings
Leading medical experts at the Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University School of Medicine (BUSM) reported today that nine-year NFL veteran, former Tampa Bay Buccaneer Tom McHale was suffering from chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by head trauma, when he died in 2008 at the age of 45.
Long-term care fraught with uncertainties for elderly baby boomers
The continued decline of the nursing home - once the mainstay care for the frail elderly - and an upsurge in popularity of assisted living will lead to many dramatic changes in long-term care, according to a University of Florida expert and editor of a new book on the subject.
Vaccine for stomach flu may be possible, UNC research shows
Every year, millions of people are infected with noroviruses - commonly called "stomach flu" - often resulting in up to 72 hours of vomiting and diarrhea. While most people recover in a few days, the symptoms can lead to dehydration and - in rare cases, especially among the elderly and infants - death.
Where's the beef? Not enough of it is on elders' plates, muscle-metabolism study suggests
Scientists at the University of Texas Medical Branch at Galveston have good news for people who want to stay strong in their old age: older bodies are just as good as young ones at turning protein-rich food into muscle.
Antipsychotic medications used to treat Alzheimer's patients found lacking
Commonly prescribed antipsychotic medications used to treat Alzheimer's patients with delusions, aggression, hallucinations, and other similar symptoms can benefit some patients, but they appear to be no more effective than a placebo when adverse side effects are considered.
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