Assisted Living Centers on Verge of Boom
Aging Baby Boomers Expected to Increase Need for Homes, Oversight
Nov 21, 2008
With perhaps a million or more Americans now living in assisted living centers and that number apt to grow rapidly as more Baby Boomers become seniors, legislation in that area is likely to also grow on the state level and possibly on the federal level.
The National Center for Assisted Living (NCAL), an industry association, provides the following figures for 2006 or 2007:
- An estimated 975,000 residents lived in about 36,000 assisted living centers.
- About 115,000 (12%) received Medicaid assistance.
- The "typical" resident was 85 years old.
- Three fourths of the residents were female.
- The average stay in an assisted living home was about 27 months.
- About 34 percent of residents eventually move into a nursing home.
- About 30 percent die while living at the assisted living center.
- About 36 percent leave to move back home or to another location.
Consumer Consortium on Assisted Living
The Consumer Consortium on Assisted Living (CCAL), a nonprofit consumer organization, said in 2008 that monthly payments at assisted living centers ranged from $1500 to $6,000 or more. It said 90% of the payments came from private funds.
The regulation of assisted living centers is currently a responsibility of the individual states, but with inconsistent regulations across the country, federal intervention becomes a temptation.
The scope of the business is already impressive, as are the services and responsibilities of the homes. NCAL says there is "no common definition for assisted living facilities" but it says the typical centers provide "relatively independent seniors with assistance and limited health care services in a home-like atmosphere."
24-Hour Protective Oversight
The NCAL website says assisted living services include "24-hour protective oversight, food, shelter, and a range of services that promote the quality of life of the individual." It says assisted living centers provide:
- 91 percent of their residents with housework assistance
- 86 percent with help in managing their medications
- 68 percent with bathing assistance
- 47 percent with dressing assistance
- 34 percent with toileting assistance
- 25 percent with transferring assistance
- 22 percent with assistance in eating.
The level and quality of those services vary with each home and the supervision varies with each state. NCAL says the many different state laws and regulations "have created a diverse and fluid operating environment for providers and a mix of terminology, settings, and available services for consumers."
Senior Policy Director Karl Polzer
In his 2008 report to the NCAL, Senior Policy Director Karl Polzer noted that "the pace of regulatory change quickened" in 2007 as more than 20 states made changes in their regulations or legislation affecting assisted living. He expected that trend to continue in 2008.
Various states tightened their standards for emergency preparedness following deaths and problems in evacuating residents from nursing homes during recent hurricanes.
Others enhanced their standards for serving Alzheimer and dementia residents, for food safety, staff background investigations, staff training, the management of medication and for infection control.
Resident Rights
Polzer reported that some states also tightened financial rules, including rules on such issues as resident assessments, license fees and resident disputes. Some states showed more interest in resident rights.
NCAL said residents should have the right to interact freely with other people both within the center and within the community, as well as rights to:
- Privacy
- Be treated with dignity and respect
- Control their personal finances
- Retain and use personal possessions
- Freedom of religion
- Organize resident councils
- Control the receipt of health-related services.
CCAL maintains ombudsman resource centers around the nation to assist individuals and families in dealing with assistant living centers.
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