Assisted-living providers, healthcare officials and organizations for the aging have partnered to release a comprehensive national report calling for widespread quality improvements in assisted living.
The report, which provides guidelines for both federal and state policy and state regulations, builds on the federal government's ongoing initiatives to improve patient care in nursing homes and home health services.
Commissioned by the Senate Aging Committee in April 2001, the long-awaited, 381-page report on the swiftly growing assisted-living industry was the result of 18 months of collaboration among nearly 50 providers and consumer groups. Of its 110 recommendations and key points, affordability in assisted living was deemed paramount.
"Affordability is critical in trying to make independent, autonomous and dignified living available for all seniors, no matter their financial resources," said Doug Pace, director of assisted living at the American Association of Homes and Services for the Aging, Washington, one organization that contributed to the report.
The report made recommendations about accountability, affordability, direct-care services, medication management, operations, oversight, resident rights and staffing.
Pace said assisted-living opportunities and resources must be expanded, even under state budget constraints. Among the recommendations called for by the committee was the creation of a national center of excellence in assisted living to analyze and suggest regulations to states and Congress.
Assisted-living facilities, which offer a transitional phase for patients between living at home and in a nursing home, are regulated entirely by state governments. While many states have passed legislation in the last few years to uphold quality care in assisted-living facilities, patient and consumer advocates contend some of the laws have not gone far enough.
There are roughly 36,000 assisted-living programs nationwide, which collectively provide care to nearly 1 million patients, according to the National Center for Assisted Living, Washington.
The association's vice president, Dave Kyllo, called the report a "monumen- tal achievement."
"I've been in Washington (for) 20 years and I've never seen anything like it as far as the willingness by so many groups to work together and the desire to come up with solutions," Kyllo said. "Sure we recognize they're not perfect, but it was a good-faith effort to come up with recommendations that stakeholders in the states can consider as they modify and evaluate their assisted-living programs."
Sen. Larry Craig (R-Idaho), who is chairman of the Senate Special Committee on Aging, said rather than having Congress jumping in with another mandate, federal lawmakers provided industry officials with opposing viewpoints and a chance to examine current policy issues and devise workable solutions.
"This group took on a tough job, meeting for 18 months to hammer out an extensive report," Craig said in a written statement. "When I asked our witnesses what was left out, they all agreed that it covers nearly every base."
Among the work group's recommendations are improvements to staff training and medication management policies.
The work group also recommends that the U.S. Housing and Urban Development Department and HHS collaborate to craft and fund specific programs that blend housing and services subsidies to enable low-income patients to access high-quality, affordable assisted-living options.
The guidelines are nonbinding for states. Kyllo said states will be sent copies of the report and follow-ups will be done by the work group.
Craig called the report on the assisted- living industry a valuable first step but only a beginning. "When our committee reviews this issue again, it will look at the improvements that have taken place because of this report," he said.