ObjectivesTo examine perceptions of patient safety culture (PSC) among assisted living (AL) administrators and direct care workers (DCWs), and their associations with state regulations. DesignWe conducted a survey using the PSC instrument developed by the Agency for Healthcare Research & Quality. Secondary data on ALs and residents were derived from the Medicare Master Beneficiary Summary […]
Regulation/Monitoring
Promoting Quality of Life and Safety in Assisted Living: A Survey of State Monitoring and Enforcement Agents
Promoting Quality of Life and Safety in Assisted Living: A Survey of State Monitoring and Enforcement Agents
Our goal was to learn about monitoring and enforcement of state assisted living (AL) regulations. Using survey responses provided in 2019 from administrative agents across 48 states, we described state agency structures, accounted for operational processes concerning monitoring and enforcement, and documented data collecting and public reporting efforts. In half of the states, oversight of […]
Association between State Regulations Supportive of Third-Party Services and Likelihood of Assisted Living Residents in the US Dying in Place
Association between State Regulations Supportive of Third-Party Services and Likelihood of Assisted Living Residents in the US Dying in Place
Importance: Older adults are increasingly residing in assisted living residences during their last year of life. The regulations guiding these residential care settings differ between and within the states in the US, resulting in diverse policies that may support residents who wish to die in place. Objective: To examine the association between state regulations and […]
State Regulations and Hospice Utilization in Assisted Living during the Last Month of Life
State Regulations and Hospice Utilization in Assisted Living during the Last Month of Life
Objectives: To examine the association between hospice/staffing regulations in residential care or assisted living (RC/AL) and hospice utilization among a national cohort of Medicare decedents residing in RC/AL at least 1 day during the last month of life, and to describe patterns of hospice utilization. Design: Retrospective cohort study of fee-for-service Medicare beneficiaries who died […]
Coronavirus Disease 2019 (COVID-19) in Assisted Living Communities: Neighborhood Deprivation and State Social Distancing Policies Matter
Coronavirus Disease 2019 (COVID-19) in Assisted Living Communities: Neighborhood Deprivation and State Social Distancing Policies Matter
Background: Residents of long-term care facilities face significantly greater risk of contracting or dying from coronavirus disease 2019 (COVID-19). However, little is known about COVID-19 in assisted living communities (ALCs) and the potential determinants of its spread. We examined the association between COVID-19 cases in ALCs and the proportion of Medicare-Medicaid (dual) eligible minority residents, […]
Class and Culture in the Making of an Assisted Living Market
Class and Culture in the Making of an Assisted Living Market
This article examines the growing industry of elite assisted living in Chile, which represents a break with a longstanding culture of care provided at home by family members and domestic workers. How does this market, locally associated with deprivation, abandonment and standardization, become a legitimate option for the rich clientele it caters to? Drawing on […]
Governance of Assisted Living in Singapore: Lessons for Aging Countries
Governance of Assisted Living in Singapore: Lessons for Aging Countries
A global trend toward aging populations means that the challenge of providing adequate long-term care to older people looms large in many countries. In Singapore, a public discourse revolving around the expansion of assisted living to create age-friendly environments in long-term care has emerged. This study examines Singapore’s experience in developing regulations for assisted living […]
End-Of-Life Care In Assisted Living Communities: Race And Ethnicity, Dual Enrollment Status, And State Regulations
End-Of-Life Care In Assisted Living Communities: Race And Ethnicity, Dual Enrollment Status, And State Regulations
Assisted living communities are the final home for many of their residents, most of whom are older, frail, and cognitively or functionally impaired. Yet little is known about end-of-life care in this setting. We examined associations of both death at home and home hospice care with individual characteristics, such as race or ethnicity and dual […]
Factors Associated With Assisted Living Facility Closure
Factors Associated With Assisted Living Facility Closure
Background and Objectives Assisted living facilities (ALFs) have experienced rapid growth in the past few decades. The expansion in the number of ALFs may cause markets to become oversaturated, and a greater risk of unprofitable ALFs to close. However, no studies have investigated ALF closure. This study adapted a model developed for the nursing home […]
State Variation in Potentially Burdensome Transitions among Assisted Living Residents at the End of Life
State Variation in Potentially Burdensome Transitions among Assisted Living Residents at the End of Life
This cohort study uses Medicare administrative claims data to describe potentially burdensome transitions among assisted living residents at the end of life and assesses variations by US state.
Prevalence and Persistency of Deficiency Citations in Florida Assisted Living Facilities
Prevalence and Persistency of Deficiency Citations in Florida Assisted Living Facilities
Background Assisted living facilities (ALFs) are plagued with quality issues but there are limited studies on the quality of ALFs. In Florida, state surveyors conduct inspections of ALFs and cite and/or fine facilities that are in violation of regulations. Yet, we do not know the types of quality problems identified and the extent to which […]