Senior citizens need better consumer protection and more quality assurance for assisted-living facilities, according to a General Accounting Office report released last week.
But neither the U.S. Senate Special Committee on Aging, which requested the report on the assisted-living industry, nor the industry itself believes those problems should be resolved with federal legislation.
Assisted-living facilities are designed for elderly residents too frail to live alone but too healthy to need round-the-clock skilled care.
About half of states already regulate assisted-living facilities, and most of the rest are studying the issue or have legislation or regulations pending.
The report found 27% of facilities studied had been cited on five or more occasions in 1996 or 1997 for quality-of-care or consumer-related issues. The GAO looked at 753 facilities in California, Florida, Ohio and Oregon for this part of the study.
The report also found that facilities did not provide consumers with adequate information on services.
Marketing materials for one Florida facility, for instance, promised residents that they could stay in the facility even if their health declined. The contract said residents might be discharged if they developed certain health conditions.
"We got a clear message from the aging committee that they want action on marketing material and consumer information," said David Kyllo, head of the National Center for Assisted Living.
National trade associations last year banded together in an initiative to pre-empt government attempts to regulate quality in assisted-living facilities. Now those same groups are working together to map out a response to the disclosure issue, he said.
Kyllo and others disputed the quality-of-care findings.
"They took three to four pieces of anecdotal evidence and really seemed to go crazy with them," said Andrew MacPherson, a San Francisco-based analyst following assisted-living stocks for Volpe, Brown, Whelan & Co.
That evidence included instances of untreated bed sores, staff's failure to report falls to a physician and medication errors.
Kyllo didn't defend such examples of poor care. But he noted that the overall numbers did not distinguish between citations for harmful errors and those for technical faults.
Trade associations and analysts were also quick to point out that the GAO sample did not appear to typify the assisted-living industry.
Some 40% of residents in the reviewed facilities received assistance from Medicaid. Most other national studies have found a Medicaid-dependent rate of about 10%.
The study also failed to distinguish facilities of different sizes, which have different track records in terms of resident care.
"I don't think that any conclusions can be drawn (on quality of care) from the GAO report because of the methodology," Kyllo said.