Residential Care and Assisted Living
This report was commissioned by the Agency for Healthcare Research and Quality (AHRQ) through a subcontract with Westat to review:
- State monitoring and oversight practices of assisted living facilities.
- Information available on State agency Web sites to consumers and family members about assisted living. Assisted living also includes residential settings that may be licensed as residential care homes, personal care homes, adult homes, and other types of facilities. Proceed to the overview section of this report for additional information.
State monitoring and oversight practices of assisted living are similar to, although not as extensive as, those used by States to review nursing homes. Assisted living monitoring and survey tools track each State's own regulatory requirements and are not standardized across States. A review of the Web sites of State licensing agencies found that:
- 48 States post licensing regulations.
- 46 provide access to a database or list of licensed facilities.
- 12 post survey findings on their Web site.
- 14 States post a guide to help consumers and family members learn about and choose a facility.
Twenty-six States offer information to facility administrators and staff on a Web site. The information ranges from licensing application and renewal forms, administrator requirements, bulletins, information about the survey process, technical assistance materials, and incident and complaint forms.
Twenty-six State Units on Aging (SUAs) post information about assisted living on their Web sites. A few SUAs link to information available on the licensing agency's site, but most supplement what is available on other sites.
One purpose of this project was to assess the interest among State agencies in ways to help consumers compare facilities. Rating or profiling of facilities requires sources of information that are standardized and contain sufficient data to allow consumers to determine how a specific facility compares to other facilities or where it falls along a continuum. Types of data might include survey findings, resident functional and health information, or outcomes data.
A small number of States are actively developing a system to rate or profile assisted living settings, although some other States are interested in developing a rating system. Unlike nursing homes, most States do not require the reporting of assessment data that are needed to establish outcomes that can be tracked and compared with other facilities.
Facility performance information can be obtained from survey reports and complaint investigations, but this information is not automated or published in most States. State contacts noted that budget tightening has left many agencies with limited staff, and their primary priority is to monitor quality and program compliance.