An emotional Larry Minnix addresses members during LeadingAge's 2015 annual meeting.
An emotional Larry Minnix addresses members
during LeadingAge’s 2015 annual meeting.

A post by former LeadingAge President and CEO Larry Minnix caught my eye a few weeks ago.

You’ll recall that Minnix stepped down as CEO in 2015. These days, he is busy with blogging and speaking engagements related to his 2018 book, “Hallowed Ground: Stories of Successful Aging,” as well as working on projects related to board leadership development, including with LeadingAge, and serving on a couple of boards himself.

It was on his blog that I saw a piece about assisted living — particularly, his belief that the assisted living and personal care sector needs a national quality initiative like the one that applies to its skilled nursing cousin. 

“It needs to be provider and consumer-driven, an accreditation, peer-review-type approach, because there is not enough money to have a national government-run inspection program to cover the thousands of providers,” Minnix wrote.

He went on to share in his blog advice with consumers on how to go about choosing an assisted living community, given the lack of a uniform, national quality standard. And in a subsequent phone call, he shared some advice with me for assisted living operators.

“Get your act together and create a quality movement,” he said. Individual operators, Minnix added, should learn all they can about quality improvement and get underway. “Quality improvement works,” he said.

To be sure, quality efforts in assisted living are underway.

Argentum has community standards and the Senior Living IQ quality initiative, the National Center for Assisted Living as its Quality Initiative and Quality Awards, and real estate investment trust Welltower previously enlisted those two organizations, as well as the American Seniors Housing Association and some operators, to be part of a National Assisted Living Quality of Care Network, tasked with developing care quality standards for Welltower’s assisted living and memory care community operators.

“All those things are good,” Minnix said, “but in my view, you’re not going to make a dramatic improvement until everybody’s in. …I don’t fault their effort, but fragmented doodad kinds of things are not going to get the job done.”

Why now? NCAL’s own research shows that state regulation is increasing. In Minnix’s home state of Georgia, an ongoing series in the Atlanta Constitution Journal is critical of assisted living.

“And now the governor said he plans to do something about it, and my guess is, his plans don’t include much money from the state, if any,” he said. “I’m not sure we could afford to hire enough inspectors, to take the approach they have with nursing homes. So you’re back to self-responsibility on the part of assisted living providers. That will inevitably happen, or the whole thing will be regulated by lawsuit,” Minnix added.

The skilled nursing profession is a different animal, and not perfect, but assisted living can look to its history for lessons, Minnix said.

In 2002, the Quality First initiative was launched by LeadingAge, the American Health Care Association and the Alliance for Quality Nursing Home Care to demonstrate skilled nursing’s commitment to quality, he said. The effort had the support of the government, AARP, the Service Employees International Union and other consumer groups.

“It was a success from that point forward. There was improvement every year on the chosen metrics,” Minnix said. “That program eventually led to the five-star system, and it is a standard approach to any industry that got in trouble with the public for their failings and lack of credibility. It worked.”

And it can work in assisted living, he said.

“My view is that we have to take responsibility for defining and measuring quality and being transparent about it,” Minnix said.

Do you have thoughts on this topic? Look for Minnix at LeadingAge this week.