Trends in Assisted Living

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Trends in Assisted Living

• Kevin Coughlin, Chief
• Assisted Living Section
• May 2003

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Future in Assisted Living

• NHs FDDs AL
• Campus Concept
• Aging Population - Baby Boomers
• Issues of Choice
• Shrinking Labor Force

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Nursing Home FDDsTrend in number of facilities
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Nursing Home FDDsTrend in number of beds
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Assisted LivingTrend in number of facilities
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Assisted LivingTrend in number of beds
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AL vs LTCTrend in number of facilities
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AL vs LTCTrend in number of beds
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New Facilities vs Closed FacilitiesCBRF AFH
2000-2002
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Growth in of Complaints
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Complaints - Subject AreaTop 5 Ranking
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Complaints - SubstantiatedTop 5 Ranking
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Enforcement Cases by Provider Type

• 2000 2001 2002
• CBRFs 149 253 341
• AFH 13 39 31
• RCACs 0 2
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• Total 162 294 373

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Deficiencies in CBRFsTop 5 Ranking
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Deficiencies in AFHsTop 5 Ranking
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Deficiencies in ADCsTop 5 Ranking
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IN SUMMARY.

• ? NHs and FDDs
• ? Assisting Living
• ? Larger Facilities
• majority remain small (8-bed or less)

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• Resident Care - ? Acuity
• ? Change of Ownership
• ? Corporate Ownership
• ? Financial Problems/ Bankruptcy
• impact on residents

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• BQA Assisted Living staff
• multi-tasking
• maximizing efforts

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• ? Enforcement
• ? Serious Violations
• Over past three years
• 57 facilities with good compliance record
• 43 facilities with substantiated complaints
  or enforcement action

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• BQA surveys occur every 30-36 months
• ? Workload
• Response to complaints - delayed
• ? Complaints (43 2002)
• ? Substantiated Complaints

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• How to solve the Critical Juncture that
  assisted living finds itself in.

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New Philosophy for the Survey Process

• Change survey process to include technical
  assistance and best practice
• Abbreviated survey - good compliance history
• More frequent presence - goal for annual
• Rapid response to serious complaints, responsible
  time on all complaints
• Strengthen the application process related to
  fit and qualified
• Enforcement action - negative outcome, repeat
  violations targeted areas
• Aggressive approach to facilities with compliance
  problems

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Regulatory Rigor