Senior woman and caregiver outdoors on a walk with walker in park, talking and laughing
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Recognizing that a “one-size-fits-all” regulatory approach is not in the best interest of assisted living residents and providers, the state of Maryland has assembled a workgroup to look at improving the quality of care and services offered in smaller communities.

The Assisted Living Facilities Workgroup, which met for the first time on Oct. 31, is tasked with improving the state’s smaller assisted living communities with nine or fewer beds. The commission was created following passage of House Bill 636 in May by the Maryland Legislature to standardize healthcare quality measurements as well as to better understand the challenges and successes faced by small providers.

The bill requires the Maryland Health Care Commission to conduct a study on the quality of care provided by smaller assisted living programs. The workgroup is a collaboration with the state Office of Health Care Quality, the Maryland Long-Term Care Ombudsman Program, the Maryland Medicaid Administration, the Governor’s Workforce Development Board and other interested stakeholders, including legislators and association representatives.

LeadingAge Maryland President and CEO Allison Roenigk Ciborowski told McKnight’s Senior Living that smaller providers account for 1,255 of the state’s 1,709 licensed assisted living communities. And although those providers are not members of the state’s long-term care or aging services organizations, they all are committed to helping the state find easy to better support smaller providers “who serve such an important role in our communities,” she said.

“The challenges that these small providers face highlight the gap between the overserved and the underserved in our community,” Ciborowski said. “Our state needs these small assisted living providers. They meet an important need for older Marylanders who need assistance but who don’t medically qualify for skilled nursing and who don’t have the financial resources to pay for what we might think of as the traditional ‘upscale’ or ‘luxury’ assisted living settings.”

The goal of the study is to identify where care quality can be improved, trends related to inspection data or regulatory requirements, and the feasibility of an emergency reporting system. The study also will review assisted living licensure regulations to determine whether the programs receive sufficient reimbursement to cover the cost of care and whether home- and community-based waivers can be used for assisted living programs. 

Ciborowski, who is a member of the workgroup, said that the group will survey small providers about their numbers of residents, the types of services they offer, how the care and services they provide are paid for, how they define quality, barriers they face in providing quality care and services, the state support they need, and whether they care for individuals living with dementia.

The workgroup is expected to deliver its study report and recommendations to the state legislature by October 2023.

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