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NCAL: More than one-third of states changed AL regulations in 2012

March 20, 2013
by Patricia Sheehan, Editor-in-Chief
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Assisted living (AL) regulations, statutes and policies in 18 states were changed in 2012, according to the 2013 edition of Assisted Living State Regulatory Review, released Wednesday by The National Center for Assisted Living (NCAL).

“Nine states made major changes to their assisted living regulations last year. Colorado, Michigan and New Jersey made innovative changes to their survey processes,” said Karl Polzer, NCAL’s senior policy director and the report’s author, in a statement. “Continuing a multi-year trend, more than one-third of states refined or developed assisted living regulations.”

The annual report summarizes state AL regulations across 21 categories including life safety, physical plant requirements, medication management and move-in/move-out criteria.

An analysis accompanying the report identified several trends such as expanding disclosure and reporting requirements in five states—California, Florida, Ohio, Oregon and Washington. The life safety or physical plant standards were changed in Missouri, North Dakota, Oregon and West Virginia.

In 2012, New Jersey and Colorado joined the small but growing number of states with innovative survey approaches, developed in part to help better target resources, according to the report. New Jersey’s Department of Health (DOH) collaborated with The Health Care Association of New Jersey Foundation to create a voluntary program called “Advanced Standing.” To receive this distinction, a facility must comply with all applicable regulations as well as submit quality data reaching benchmarks established by a peer review panel. Participating facilities do not receive a routine survey, but any time a facility falls below DOH standards, it can be removed for cause from the program. The state also performs follow-up surveys based on a random sample.

In January 2013, Colorado began conducting risk-based re-licensure inspections for assisted living residences (ALRs), initially on a pilot basis. Under the new system, ALRs meeting criteria specified in the law will be eligible for an extended survey cycle. In 2012, Michigan also began using a new renewal inspection system.

After creating an additional level of licensure for AL communities a year earlier, Georgia updated rules for personal care homes in January 2013, including new requirements for additional staff training, staffing above minimal standards and a resident needs assessment upon move-in. Also effective in January 2013, New York adopted rules stating that no adult home with a capacity of 80 residents or greater may admit or retain more than 25 percent census of residents with serious mental illness.

Several states made changes to policies and rules for care provided to residents receiving Medicaid services, some to accommodate managed care contracting. In 2012, the state of Washington changed its licensure term to “assisted living facility” from the outdated “boarding home.” Oregon began requiring facilities to adopt policies for the treatment or referral of acute sexual assault victims.

The report also provides contact information for state agencies that oversee assisted living and includes each agency’s website address.

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