A Description of Board and Care Facilities, Operators, and Residents. 3.2 Facility Policies


3.2.1 Medication Management

Because a large proportion of board and care residents take prescription medication, it is particularly important for facilities to have appropriate medication management practices. Licensed and unlicensed homes reported significantly different practices. Regardless of size, licensed homes were more likely to allow at least some residents to manage their own medications (Exhibit 3-5).

EXHIBIT 3-5. Medication Management Practices by Licensure and Size

Medication Management Practices by Licensure and Size

3.2.2 Admittance and Discharge Policies

Board and care facilities varied immensely on criteria for admittance to their facilities. Almost half of the facilities reported that they would not admit residents who were mobility-impaired. Twenty-three percent would not admit incontinent residents, and 19 percent would not admit SSI recipients. Almost all facilities reported accepting residents with behavior problems (Exhibit 3-6).

EXHIBIT 3-6. Facility Admission and Discharge Policies
     Total Population  
% SE
Will not admit residents who are/have
Mobility impairment 46 5.4
Behavior problems 2 0.8
Incontinent 23 3.2
SSI recipients 19 3.7
Will discharge residents who become/develop
Mobility impairment 35 8.0
Behavior problems 2 2.1
Incontinent 8 4.1
SSI recipients 2 3.3

However, perhaps even more important to a resident who wishes to “age in place” is a facility’s discharge policy for residents who develop debilitating conditions while residing in the facility. We asked operators who reported that their facility did not admit residents with certain characteristics (e.g., incontinence, mobility impairment) whether the facility would discharge a resident who develops the conditions after being admitted to the home. Seventy-five percent of the facilities that did not admit mobility-impaired residents (35 percent of all facilities) reported discharging residents who became impaired while living in the home. Less than 10 percent of all facilities reported discharging residents who became incontinent, developed behavior problems, or started receiving SSI after moving to the facility.

Differences by Regulatory Environment. There were no differences in admission or discharge policies by regulatory environment, with the possible exception that licensed homes in extensively regulated States were significantly more likely to report that they will admit “no” SSI residents than was the case in limited regulation States (21 percent vs. 10 percent) (see Table A-11).

Differences by Licensure Status. We also examined resident admission and discharge policies for licensed homes compared to unlicensed. Large licensed homes were significantly less likely to admit mobility-impaired residents and were more likely to discharge them than were their unlicensed counterparts. Although licensed homes were somewhat more likely to report admitting SSI-funded residents than were unlicensed homes, almost no homes reported discharging residents once they became SSI recipients (see Table A-3).

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