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Leaders Forum 2016
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By Albert Lechner and Wayne Hogan

Today, according to the U.S. Department of Health and Human Services, more than 750,000 people reside in more than 31,000 assisted living facilities across the country. Assisted living facilities provide housing, meals and one or more personal services to residents. Like nursing homes, assisted living facilities are licensed by the State. Assisted living facilities became a growth industry in America; they attracted the affection of Wall Street. Assisted living facilities became a big business. As that big business grew, it also encountered the ups and downs of the national economy and the business of assisted living facilities has confronted the question of how to maintain the life of the bottom line without contributing to the deaths of those they were trusted to assist.

Assisted living facilities that claim to provide care of persons with Alzheimer’s disease or other related disorders must meet certain, more stringent requirements. These include having a specified number of providers on duty night and day depending on the number of residents and/or having mechanisms in place to monitor the safety of residents, and having activities specifically designed for persons who are cognitively impaired. Assisted living facilities, also called “ALFs”, must hire and provide staff with specialized training and continuing specialized education on a yearly basis.

ALF’s are required to report changes in a resident’s cognition/brain function or signs of impairment or dementia to a licensed physician within a certain period of time. If such a condition is determined to exist, the facility must provide the necessary care and services to treat the condition.

The assisted living facility is responsible for determining the appropriateness of admission of a particular individual and the continued appropriateness of residence at the facility. However, a resident may not be moved from one facility to another without consultation with – and agreement from – the resident (or, if applicable, the resident’s representative or designee). A facility must give the resident at least 45 days notice of relocation or termination of residency from the facility unless a physician can certify that for medical reasons the resident requires an emergency relocation. Reasons to terminate the residency must be set forth by the facility in writing.

Lately there have been increasing reports of ALFs across the country cited for hiring inappropriately trained staff, for inadequate staffing levels, or for failing to provide appropriate and necessary medical care. Many ALFs are owned by huge corporate entities; to deflect attention from proven violations of federal and/or state regulations, they may point to “overall” resident satisfaction, but satisfying some does not diminish the trauma of death and disease among other residents; one abused or neglected resident is one too many. Just as in nursing homes, when abuse or neglect in assisted living facilities cause personal injuries and wrongful deaths, the law provides ways to hold facilities accountable when they violate the trust of those who rely on them for assistance. In Florida, Florida Statute 429 covers how ALFs should operate.

Tonight, Frontline, on PBS, explores Life and Death in Assisted Living. There is much to learn about this growing aspect of aging in America. This documentary is one source of information about a subject that many, many families have faced, are facing now or will face over the coming years. It provides a history of the industry and how it has grown, reveals approaches to sales and promotion and how aspects of the industry conduct business, and discusses responsibility and accountability for the owners and operators of assisted living facilities.