Assisted living regulations, statutes and policies in 20 states (31%) were updated between July 1, 2022, and July 1, 2023, according to a new report from the National Center for Assisted Living.
The 2023 edition of the report, “Assisted Living State Regulatory Review,” released Wednesday, has added information about infection control and emergency preparedness regulatory requirements, which were in place in almost all 50 states as of July.
The report noted that 44 states (86%) have infection control requirements in place, 45 states (90%) and Washington, DC, have emergency preparedness requirements established, and 24 states (47%) have quality measurement, data collection or quality management requirements.
“NCAL added these additional categories to the 2023 report because it is important to understand how states are working with assisted living providers to protect residents overall, but especially in preparation for future public health emergencies,” NCAL Director of Policy and Regulatory Affairs Jill Schewe said in a press release. “States are making changes as they determine how to best serve their specific resident populations in the years ahead, and we anticipate this trend will continue.
Although some federal laws and regulations apply to assisted living communities — the Department of Labor Fair Labor Standards Act and Occupational Safety and Health Administration requirements, for example — NCAL maintains that state-level regulation of the sector “ensures an efficient, comprehensive licensure system,” allowing states to effectively coordinate a full range of housing and service programs. Varying state philosophies, NCAL said, enable “provider innovation and piloting of new models of housing plus services that respond to local consumer demand.”
“Assisted living providers are dedicated to delivering high-quality care to their residents every day, and state oversight and support helps them achieve this,” NCAL Executive Director LaShuan Bethea said in a statement. “NCAL supports ongoing collaborative efforts between these providers, state regulators and all stakeholders to ensure accountability, while encouraging innovation all in an effort to honor residents’ unique needs and desires.”
According to NCAL, approximately 48% of assisted living communities are Medicaid-certified as home- and community-based services providers, and almost 17% of residents rely on Medicaid to cover their daily care in assisted living. One in five of all assisted living providers has a unit, wing or floor designated for dementia care or only serve adults living with dementia.
The report provides summaries of select state requirements for assisted living licensure and certification, including information on the state agencies that license assisted living, and recent legislative and regulatory updates affecting assisted living, scope of care, limitations of service, staffing, training and more. In addition, some states refer to assisted living as residential care or personal care, and the report has information on these settings as well as information about person-centered supportive services or healthcare services for older adults and people living with disabilities.
The report is available on the NCAL website.
