Some who work in the aging services field once again are countering claims that federal regulation of assisted living is needed to standardize training and staffing requirements and help ensure quality resident care.

The responses came as part of a set of articles beginning on the front page of Sunday’s Cleveland Plain Dealer newspaper and also published online.

The newspaper cited training requirements for assisted living workers that vary widely from state to state. For instance, Montana doesn’t specify an amount of training for aides, Ohio requires 20 hours, North Carolina requires 80 and Kansas requires 90, according to the media outlet.

Caregiver-to-resident ratios that vary from state to state were another area of concern cited by some consumer advocates who were interviewed. Thirty-eight states let operators decide the appropriate number of workers, according to the report. Ohio requires a “sufficient numbers of staff” but doesn’t specify a number, whereas in South Carolina, the mandated daytime staff-to-resident ratio is 8:1, the newspaper said.

The consumer advocates’ concerns come as the number of assisted living communities in the United States has increased by more than 150% in the past 20 years, with the industry now serving approximately 1 million residents, the Plain Dealer said. That resident population as a whole has higher-acuity needs and includes more people living with dementia; also, in 42 states, an increasing number of residents have services covered by the federal Medicaid program through waivers, reporter John Caniglia wrote.

Among those calling for more oversight in the article were representatives from Elder Voice Family Advocates and the Center for Medicare Advocacy.

The National Center for Assisted Living, however, maintains that regulation should stay where it is, at the state level, closer to the assisted living communities, spokeswoman Rachel Reeves told the newspaper. States, she said, “can see what is best for residents and deal with those issues.”

Sheryl Zimmerman, MSW, Ph.D., director of aging research at the University of North Carolina School of Social Work, also suggested to the media outlet that federal oversight might not provide the security some seek.

“By and large, the people who run the facilities know the [staffing and training] that is needed there,” she told the newspaper.

And Beverley Laubert, Ohio’s long-term care ombudsman, said that if one training program were designed for all assisted living communities in the state, it would not meet the specific needs of each individual community and its residents. One setting might focus on memory care, for instance, whereas another might have residents who are relatively independent, she told the newspaper.

See the online versions of the Plain Dealer articles here:

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