Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Assisted living is meant to be a safe place for senior citizens where they can receive help with activities of daily living (ADLs), socialize with their peers and thrive in a secure environment. Unfortunately, some seniors may face abuse, neglect or mistreatment at the hands of a caregiver, leading seniors and their families to feel concern and mistrust when transitioning into assisted living or other types of senior care.
Elder abuse affects hundreds of thousands of adults living at home and in senior living communities across the United States each year. According to data published by the Centers for Disease Control, 10% of people aged 60 and older have experienced abuse. That abuse can occur in various forms, ranging from physical abuse and neglect to financial abuse.
Finding information about assisted living regulations can be difficult. While seniors and their families can access the audit and licensing history of Medicare-approved nursing homes online, this information isn’t readily available for assisted living facilities. Instead, assisted living is governed at the state level, which can make it more of a challenge to find information about a facility’s history and gain the peace of mind necessary to feel safe in assisted living.
This guide includes a comprehensive list of state agencies responsible for overseeing assisted living facilities and reporting violations or abuse, as well as detailed information on assisted living inspections, regulations, and common violations.
Assisted Living Regulations: What You Need To Know
Assisted living facilities are regulated at the state level instead of the federal level. In every state, a different government branch is responsible for creating and enforcing assisted living regulations. These regulations, and the particular branch in charge of enforcement, varies depending on the state.
Assisted Living Licensing
While the laws and regulations that assisted living facilities must follow vary in each state, there are high-level licensing requirements that are covered by these regulations across the country. While the exact rules facilities must follow may differ, each state’s regulations cover the following:
Staff-to-resident ratios
Meal services
Room requirements
Required social activities
Medication management and/or administration
Caregiver qualifications and training
Care planning
Criminal background checks for caregivers and staff
Assisted Living Inspections
To ensure compliance with state regulations, the department in charge of assisted living in each state is also in charge of conducting thorough inspections on a regular basis. The frequency of these inspections is determined by each state’s assisted living regulations but in most cases, they occur once every one to two years.
When a complaint is filed, the state or county’s long-term care ombudsman will determine appropriate steps. That typically includes following up with the complainant or the senior in question and the facility to gather more information and when necessary, a full investigation may be launched to determine whether abuse or violations have occurred.
Types of Assisted Living Violations
Assisted living violations can range from small deviances from state regulations to more severe problems, such as abuse and neglect. It’s important for seniors and their families to understand the types of violations that might occur and how to recognize them.
Types of Assisted Living Abuse
Abuse in assisted living facilities may be physical, emotional or sexual, or it may be in the form of neglect or exploitation.
Physical abuse: Physical abuse is any act that causes a senior physical harm. It can include hitting, kicking, pushing or unwarranted restraining. It can also occur when an assisted living resident is forcibly fed, starved or denied water.
Emotional abuse: Emotional abuse is any act that causes emotional distress. It can be in the form of verbal assault and name-calling, harassment or degradation.
Sexual abuse: Sexual abuse occurs when a caregiver or staff member engages in sexual touching or intercourse with an assisted living resident against their will.
Neglect: Neglect occurs in assisted living when a resident doesn’t receive the care they require. This can include lacking adequate food or water, help with ADLs such as bathing and grooming or providing housekeeping.
Financial exploitation: Exploitation can include theft of possessions or unlawful use of a resident’s money.
Common Assisted Living Violations
While abuse is the most severe issue faced by residents of assisted living, other violations can have a substantial negative effect on seniors’ quality of life. Some of the most common violations include:
Poor nutrition or dietary care: Missed meals or meals that don’t comply with dietary restrictions
Improper food handling procedures: Food that isn’t stored at the proper temperatures or served after the expiry date
Poor medication handling: Providing expired medication or failing to refill a resident’s prescriptions
Care plan violations: Deviations from a resident’s care plan or failure to provide adequate care planning
Neglectful caregiving: Failure to provide personal care services such as bathing or grooming to a resident each day
Lack of emergency preparedness: Maintaining poor emergency and evacuation procedures
Poor employee illness procedures: Employees providing care while sick or unvaccinated
Recognizing Signs of Potential Elder Abuse in Assisted Living
Elder abuse can happen to anyone, and it’s important for families to watch for signs that it might be occurring. It’s not uncommon for seniors who experience abuse to feel shame or embarrassment, and as a result, they may avoid seeing friends or family members who may catch on. Families of seniors in assisted living should check on loved ones routinely and be aware of the signs of elder abuse. These include:
Depression or confusion
Isolation from peers, friends or family members
Unexplained injuries, bruises or scars
Poor hygiene
Appearing underfed, dehydrated or over/under-medicated
Changes in spending
Spotting Elder Abuse
For each type of elder abuse, there are different signs families should watch for.
Physical abuse: Common signs of physical abuse include broken bones, bruises, welts, cuts, scrapes and pressure marks.
Emotional abuse: Hesitation or nervousness when speaking with family members, isolation or withdrawal from loved ones, and anxiety or depression could all be signs of emotional abuse.
Sexual abuse: Signs that a senior is being sexually abused include an unexplained STD, pain or irritation on the genitals, inappropriate relationships with a caregiver or bruising on thighs or genitals.
Neglect: Neglect is a common form of abuse in senior care with signs that include extended periods of time without care, bedsores, missing medical equipment and a lack of food, hygiene or hydration.
Financial abuse: Seniors who are being abused or exploited financially may have unusual withdrawals or purchases on bank statements, limited or no access to financial records or large sums of cash missing.
If a friend or family member suspects elder abuse has happened, asking the senior some of the following questions may provide clarity and help determine if a report or further investigation is needed.
Are you afraid of anyone?
Have you been hit, kicked, restrained or confined?
Have you been touched without permission?
Have you been force-fed?
Do your caregivers ever give you the silent treatment or otherwise deprive your emotional needs?
What happens when you disagree with your caregiver?
Do you require medical equipment that you’re not granted access to?
Have you been left alone for long periods of time?
How do you get help when you need it?
Does your caregiver depend on you for financial support?
Have you ever had money go missing or stolen from you?
How to Find Information About an Assisted Living Facility’s Past Violations
Every state has a different system in place to track and monitor assisted living regulations and violations. To find information about an assisted living facility and its past violations, it’s best to contact the department in charge of assisted living in one’s state directly.
How to Report Violations of Assisted Living Regulations
Complaints about senior care are directed to each state’s long-term care ombudsman. In the event any signs of abuse or violations of state regulations are noticed, it’s important to file a report to the facility or caregiver as quickly as possible to ensure the safety of seniors under their care.
How to Prepare to Make a Report
Before contacting the long-term care ombudsman, reporters should be prepared to provide as much detail as possible. They’ll be expected to make a general statement about what happened or why they suspect an issue has occurred, as well as to provide the following details:
Victim’s name
Caregiver/staff member’s name(s)
Place the event occurred
Date and time the event occurred
In the event all details can’t be provided, it’s important for loved ones to still go ahead with reporting any time elder abuse is suspected.
Where To Report Assisted Living Violations and Abuse in Each State
In every U.S. State, the long-term care ombudsman’s office gathers and investigates complaints about assisted living abuse and violations of regulations. Ombudsmen may be government employees or volunteers working at the state or county level. Their sole purpose is to collect and investigate complaints about long-term care and to follow up on reports of abuse or violation to ensure the safety and wellbeing of seniors.
