Residential Care and Assisted Living Compendium: 2007. Increased State Use of Websites to Provide Information

11/30/2007

In the past few years, the information available about assisted living and other residential care settings on websites hosted by state agencies has expanded considerably. A review of licensing agency websites identified a wide range of information useful to consumers and their families, as well as owners, operators, and developers (e.g., licensing regulations, survey guidelines, and incident reporting forms). See Table 1-1. Links to each website are included in the state summaries.4 States also post information to assist consumers and family members to determine whether residential care can meet their needs and to compare facilities (e.g., guides, disclosure forms, and survey findings).

  • All 50 states and the District of Columbia post links to their licensing regulations and statutes.

  • Thirty-nine states post additional information primarily for facility owners, administrators, and managers. For example, documents relating to the survey process, survey guidelines, training requirements, background check requirements, forms, and notices.

  • Forty-two states list all licensed facilities and some sites include their address and phone numbers, and the number of units.

  • Sixteen states post a consumer guide or a list of questions to help consumers and family members understand residential care options and to compare and select a facility.

  • Thirteen states include information from survey reports and complaint investigations. Survey reports are prepared by state monitoring staff following on-site visits to assess compliance with state licensing requirements.

  • TABLE 1-1. Information Provided on States’ Websites

  State     Rules   List of
  Facilities  
  Provider  
Tools
Survey
  Findings  
  Consumer  
Tools
  State     Rules   List of
  Facilities  
  Provider  
Tools
Survey
  Findings  
  Consumer  
Tools
AL x x x x   MT x x x   x
AK x x x   x NE x x x    
AZ x x x x x NV x x x    
AR x   x     NH x x x    
CA x x x     NJ x x x x x
CO x x x   x NM x   x x  
CT x         NY x x x x  
DE x x x     NC x x x x  
DC x x x     ND x x x    
FL x   x   x OH x x     x
GA x x x x   OK x x x    
HI x x       OR x x     x
ID x   x     PA x x x   x
IL x x x     RI x   x    
IN x x x     SC x x x    
IA x x x   x SD x x      
KS x x x     TN x x x    
KY x x x   x TX x x x x  
LA x x       UT x x x    
ME x x       VT x x      
MD x x x   x VA x x x x x
MA x x     x WA x x x   x
MI x x x x   WV x x      
MN x   x x x WI x x x x  
MS x         WY x        
MO x x x x   Total 51 42 39 13 16
 

TABLE 1-2. Summary of Major Activities in Residential Care Policy Since 2004

State Activities
Alabama The state revised rules for ALFs and special care ALFs in 2005, 2006 and 2007. A system to profile facilities was implemented in 2004. A Medicaid waiver to serve persons with dementia in ALFs has been approved but not implemented due to budget constraints.
Alaska Licensing for multiple entities was centralized in 2004. Safety and sanitation requirements were changed in 2006. A background check unit (BCU) was established in 2007 to centralize checks for direct care workers for programs administered by the Department of Health and Social Services (DHSS) that are subject to the licensing and certification authority of or are eligible to receive payments, in whole or in part, from the department.
Arizona A general review of the regulations is underway. The governor issued an executive order in 2007 directing the state agency to develop a three year strategy to improve quality in nursing homes, assisted living and community care.
Arkansas No new changes.
California A law requiring additional training on assistance with self-administration of medications was enacted and will be effective in 2008. A Medicaid waiver pilot program covering assisted living was implemented.
Colorado The state approved rules changing the licensing category for residential care facilities to assisted living and added intermediate sanctions for violations in March 2004. Further changes concerning donated medications were made in 2006 and provisions covering administrator qualifications, staffing and hospice services in licensed settings are being reviewed.
Connecticut   None.
Delaware Changes in the definition of “incident” and “reportable” were approved in 2004. The state is phasing out the rest home licensing category. Those that meet the standard are converting to ALFs. Homes that do not meet the standards will continue to operate as rest homes.
District of Columbia ALFs will be licensed in 2007. The new Medicaid waiver will be implemented once facilities are licensed.
Florida The state modified training requirements in 2005 and “elopement” standards for persons with dementia were adopted in 2006. The Department of Elder Affairs transferred responsibility for training administrators and direct care workers to private organizations.
Georgia The Office of Regulatory Services (ORS) has formed a workgroup to develop a method for rating facilities based on survey findings. The rating system is expected to be available on the ORS website in early 2008.
Hawaii The licensing agency is planning to establish licensing fees that would be used for training and other licensing-related activities. The state is considering changes to the structural requirements for facilities, nutrition, staffing, and service plans.
Idaho Significant revisions to the regulations became effective in October 2006.
Illinois The number of licensed assisted living and shared housing facilities grew dramatically. Changes were made to the requirements for criminal background checks. Legislation passed in 2005 that expands shared housing establishments from 12 to 16 residents; allows licensed health professionals to administer sliding scale insulin, and requires that all applicants must complete their application within six months of the initial filing if portions of the application were incomplete. Supportive living facility (SLF) rules were amended in 2005 and 2006.
Indiana The licensing regulations expired and were reissued in 2007. Medicaid Rates for assisted living providers were increased.
Iowa Revised regulations became effective in May 2004. The state has transferred all rule making and oversight authority from the Department of Elder Affairs to the Department of Inspection and Appeals.
Kansas Regulations are being reviewed in 2007, and minor changes are expected in 2008.
Kentucky Changes to the certification requirements for assisted living communities will be finalized by the end of 2007.
Louisiana   No changes have been made to the regulations since 1999.
Maine Minor changes to the regulations were made in 2006.
Maryland Revisions to the regulations are expected to be final in 2007. Legislation passed in 2006 requires facilities to file a uniform assisted living disclosure statement with the licensing application. The disclosure form is posted on the licensing agency’s website.
Massachusetts   The regulations were revised in August 2006. Several changes were made, including the addition of special care facility training requirements and sanctions.
Michigan Revisions to the Homes for the Aged regulations were promulgated.
Minnesota Laws governing the licensing of home care agencies that provide services in housing with services establishment were changed in 2006. Coverage of assisted living services under the state-funded alternate care program was terminated.
Mississippi The state revised rules in 2007.
Missouri The Department of Health and Senior Services revised its regulations in 2007. Legislation addressing sprinkler system requirements was passed in 2007. A Medicaid HCBS waiver is being developed.
Montana Regulations allowing the Board of Nursing to implement a medication aide program were issued in 2006.
Nebraska Changes in 2007 added definitions, extended the occupancy certificate from 12 to 18 months, modified criminal background check requirements and raised licensing fees. Facilities may not call themselves assisted living unless they are licensed.
Nevada The rules were revised in 2005 and 2006. Facilities that are marketed as providing assisted living services must have an endorsement on their license and provide potential residents with a disclosure statement that describes the personal care services that will be available.
New Hampshire   New rules for a new type of ALR called supported residential health care were effective in October 2006. Additional rules for a second model -- assisted living residence-residential care (ALR-RC) -- will be issued in 2007.
New Jersey The regulations were revised in February 2007. The Medicaid payment methodology changed from a monthly to a daily amount.
New Mexico Revised rules will be issued in late 2007 or early 2008. Additional funding was approved to hire more surveyors for adult residential care facilities. A new statute expanding criminal history background checks is being implemented.
New York In 2004, the state enacted an assisted living reform law creating a new level of service for ALFs and rules implementing the changes will be final in 2007. Facilities may obtain a certificate allowing them to offer enhanced assisted living services to support aging-in-place.
North Carolina   Rules were amended in 2005 and further changes are expected in 2008 that will cover assessment and care planning, staff training, staffing, and special care units (SCUs).
North Dakota None.
Ohio RCF rules were revised in 2007. The changes affected special populations, admission/retention, staffing, training, dietary standards, and fire safety. Adult care facility rules were updated in 2006. A new Medicaid HCBS waiver to cover services in assisted living was implemented in 2006.
Oklahoma In 2007, the Department of Health revised rules regarding medication administration, staffing in special care facilities, complaint procedures, incident reports, and other areas.
Oregon A four-year review of the regulations was completed in 2007. Rules for assisted living and residential care facilities were consolidated. The state extended a moratorium on new ALFs until June 2009.
Pennsylvania Regulations for personal care homes (PCHs) were revised in 2005. Legislation establishing an assisted living licensing category was signed by the governor in 2007.
Rhode Island Legislation affecting administrator qualifications, inspections, and staff training passed in 2006.
South Carolina None.
South Dakota Changes to the regulations were adopted in 2006. The state is planning to amend its Medicaid waiver to broaden coverage of services available in assisted living centers.
Tennessee Assisted care living facility (ACLF) rules were revised in 2007. Legislation passed in 2007 that allows facilities to serve Medicaid HCBS waiver participants.
Texas The regulations were revised in 2007 and further changes may be made in 2008.
Utah The state revised the regulations in 2005. The state plan managed care program that covers assisted living was converted to a 1915(c) HCBS waiver.
Vermont None.
Virginia Revisions were adopted in 2006. Legislation passed in 2007 that supports aging-in-place by allowing residents who do not meet the retention requirements to continue to live in the facility.
Washington None.
West Virginia   Minor revisions to the regulations were effective in 2006.
Wisconsin Revisions to the community-based residential facilities (CBRFs) rules are expected to be final in 2007. Information from inspection reports are now being posted on the licensing agency’s website.
Wyoming Legislation establishing an adult family care home pilot and expanding funding for HCBS assisted living slots was approved in 2007.
 

4. Please note that websites change over time and the links listed may not be current when you try to access the site.

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