A Texas assisted living quality of care study is drawing concern from at least one senior living association.
The University of Texas at Austin School of Nursing is partnering with the Texas Health and Human Services Commission to study quality of care and quality of life for the state’s assisted living residents. The study was mandated by the Texas Legislature in 2021.
Texas Assisted Living Association President and CEO Diana Martinez told McKnight’s Senior Living that although she knows that the University of Texas will do an “excellent job” in the mechanics of conducting the study, she is apprehensive about some of the data they will attempt to collect. Those worries center on questions related to preventable occurrences and any adverse outcomes related to issues, including medication errors, inappropriate use of antipsychotic medication, falls, inappropriate placement of a resident in a locked unit, and healthcare-acquired infections.
Citing the assessment related to inappropriate use of antipsychotic medication, Martinez noted that prescriptions are based on a resident’s physician’s orders and medical judgment, as well as on an evaluation. Assisted living community staff members supervising or administering the medications record that information on a medication administration record.
“The assisted living community has no opinion or expertise to advise the physician on whether a medication is appropriate or not,” Martinez said. “Because assisted living community staff are not part of the prescribing process, it is unclear what surveyors would use to determine appropriateness of the prescription, or how that appropriateness relates to the assisted living community and the quality of care it provides.”
Some of the information to be collected will be of value and will “demonstrate the incredible need assisted living communities fill” for residents and families, however, she said.
“The required information to be collected was drafted without consultation with assisted living providers and includes some elements which are either completely outside the control of an assisted living provider or are not within the scope of practice for assisted living staff,” Martinez said. “We hope that elements beyond the control or scope of an assisted living community are not used to try to shape future policies that would be detrimental to an assisted living community’s ability to provide for their residents’ care and safety.”
Investigators will survey 300 assisted living communities in urban / metropolitan locations and 150 in rural locations. In addition, the study will include a detailed policy and procedure review of a randomly selected subset of communities on key operational metrics, incident reports, quality of life, consumer satisfaction and medication use.
Visits will be coordinated with the HHSC long-term care ombudsman. The goal of the research, according to HHSC, is to assess resident quality of care, evaluate resident satisfaction with care provided and identify potential areas of improvement.
The University of Texas is recruiting registered nurses, pharmacists and others to help collect data.
TALA is a state parner of Argentum.