Congress lays off assisted living industry — for now
Congress lays off assisted living industry — for now
Congress plans to leave regulation of the rapidly-growing assisted living industry in the hands of state regulators — at least for the time being. That's good news for the growing number of hospitals and other health care providers that are taking advantage of this expanding market to reduce costs for patients requiring long-term care.
Recently, the Senate Special Committee on Aging heard testimony from the General Accounting Office (GAO) regarding an examination of assisted living practices in four states — California, Florida, Oregon, and Ohio. Kathryn Allen, the GAO's associate director, concluded that the industry's biggest shortcoming is the wide variation in consumer information about the services now offered to seniors. According to the GAO, key consumer information often is not provided, and when it is provided, it's often vague or misleading. Worse yet, only 25% of the facilities surveyed provide written contracts to potential residents.
Committee Chairman Sen. Charles Grassley (R-IA), who has a major say in whether or not federal regulations will be proposed to remedy any existing deficiencies, summed up the Senate's response by asserting that "the jury is still out" on the industry's capacity to correct these deficiencies and police itself. But he also added that any federal role will likely be limited in this largely private-pay industry. Instead, Grassley wants Congress to "monitor the industry's efforts at self-policing."
The backdrop to Congress' decision to back away from regulating this emerging industry is the major failure of existing federal regulations to adequately police the nursing home industry. Experts say the regulatory blueprint for that industry is not one many in Congress are eager to follow.
In short, Grassley put the onus for correcting the shortcomings outlined by the GAO on the assisted living industry itself. By all accounts, that's a challenge the industry is eager to assume. Scott Parkin, of the American Association of Homes and Services for the Aging (AAHSA) in Washington, DC, argues that any attempt to impose blanket standards at the federal level would stifle the innovation and flexibility that is now driving that industry. "That is a recipe for disaster," he says.
But the good news is that Congress has decided — at least for the moment — to let each state experiment with its own oversight tools to learn what works best, says Whitney Redding of the Assisted Living Federation of America (ALFA) in Reston, VA. "There is a recognition among key members of Congress," she says, "that assisted living is a new and different animal that needs time to mature and also needs time to fix its own problems."
That bodes well for hospitals and other health care providers entering this market. And according to Parkin and others, hospitals and hospital systems are increasingly viewing assisted living as a means to reduce the cost of their services especially if they are at risk for those services. Redding notes that the number of hospitals among ALFA's ranks is growing. She describes the changes under way in some quarters as a merger between the residential independent living environment and traditional health care.
That boundary is still being defined state to state," she says. But as that boundary takes shape, Redding says, the key for health care providers entering this market lies in understanding state regulations. "The model is slightly different from state to state," she says, "so any hospital that is thinking about expanding in this area should learn the ins-and-outs in their particular state."
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