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Watching the Caretakers: Regulation in the Assisted Living Industry

Regulation of assisted living facilities is determined on the state level.  There are no federal regulations for the industry.  In fact, “assisted living” is colloquial term used to describe a variety of types of care.  The legal definition of what constitutes an assisted living facility differs from state to state.  Nearly 1/3 of states don’t even use the term at all.  Some states have multiple licenses for specialized levels of care within what is normally considered “assisted living care.”

Courtesy: Flickr's peasap

Courtesy: Flickr's peasap

When the term is used, some states require that assisted living facilities provide a minimal level of care.  Many also prohibit facilities from housing residents whose need for care is too great.  Still others provide a large degree of flexibility. In these states the requirements are very minimal.  Often, a facility only need to be staffed 24/7.

All states have ombudsmen who have the authority over assisted living and other long term care facilities such as nursing homes.  Ombudsmen will inspect facilities, field complaints, and mediate disputes.  You should check with your state ombudsmen if you have specific questions about regulations in your state.

It is important to do your research because state regulations are all over the board.  As of 2006, only 32 states required CPR and first aid certification and only 24 required a nurse on staff.  It is also particularly easy to open a facility.  For example, in Florida, an administrator must only take a 26-hour course and pass an exam before opening a facility.  It may then apply for an annual license upon physical inspection of the facility.

In our opinion, concerns that assisted living isn’t federally regulated are overblown.  Assisted living facilities serve a plethora of needs.  Some are very close to a retirement community while others provide care closer to a nursing home.  If your parent or loved one still has most of their cognitive abilities, you shouldn’t be overly concerned about regulation.  However, as your loved-one requires more care it is important to understand the legal obligations of the assisted living facility.  Keep in mind that ultimately assisted living facilities are not nursing homes and they are not regulated as such.

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