A few respondents commented that access can be limited due to maldistribution of assisted living facilities.
It's a big issue in Family Care where you're supposed to have a choice. In some of the counties, there may not be a facility within 100 miles. This is a major access issue. The RWJ project is supposed to address this. There is also a maldistribution of service providers, particularly in the northern part of the state.
I've heard that in certain areas they're overbuilt -- other areas have none or not enough. The same for nursing homes. The state does not have a planning process to determine where they should be built. The developers build wherever they want and they don't even do a market analysis -- they don't look at the demographics of the area. They also assume that lots of elderly people are going to move in. But clients still consider assisted living to be institutional (CBRFs primarily). Private pay clients going into assisted living are not thrilled, but it's less of a stigma than a nursing home -- more like a hotel.