Assisted Living Facilities in Many States Have Little Federal Oversight Despite CMS Funding

The dream of Americans is to age with dignity and independence while enjoying their golden years with family and friends and avoiding the need for any type of long term institutionalized care. However, trends in aging show that more and more Americans these days are relying on some type of intermediate institutionalized care before eventually moving into a nursing home to receive the attentive services they need.


However, despite receiving an estimated $10 billion in federal funding from the Centers for Medicare and Medicaid Studies (CMS), states encounter little oversight from regulators over the quality of care residents receive. Furthermore, over half the states do not report “critical incidents” to the federal government that include unexplained deaths, abuse, neglect or financial exploitation. All of that is according to a recent report from the Government Accountability Office (GAO).


Advocacy group Justice for Aging issued its own response to the GAO report to highlight the lack of accountability from many states and facilities receiving CMS funding. The directing attorney for Justice in Aging went as far as to point out that even among the 22 states that do provide the federal government with data on critical incidents the information is hard for the public to obtain and may not even illuminating enough.


Most states receiving CMS funding for assisted living facilities do so only for patients that require who having needs equal to an institutional level of care, such as a hospital or nursing home. As a result, many facilities do not employ full time nurses and instead utilize the services of so-called “caregivers” that require less education, training, and oversight.


Fortunately, some states like Alabama, Arkansas, and Florida have more rigorous standards that set these areas above most of the country. For example, Arkansas utilizes a tiered system that puts higher need residents into living separate living situations with more skilled nurses able deliver the attentive and personalized care plans these residents need while more autonomous residents have their own nursing staff delivering different levels of care.


The goal for many advocates is to see the models seen in the aforementioned states applied into national standards to help ensure all elders in assisted living care live with grace and the best health possible. Unfortunately, as other states slowly add in their own reforms and updated guidelines, some residents will still suffer from inadequate care.

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