Proposed assisted-living rules fall woefully short
For the first time, rules governing the operation of assisted-living facilities in Pennsylvania are spelled out in proposed regulations that have been put out by state officials.
For the first time, rules governing the operation of assisted-living facilities in Pennsylvania are spelled out in proposed regulations that have been put out by state officials.
The proposed regulations do represent a step in the right direction. But they must be beefed up to include stronger consumer protections.
The Pennsylvania General Assembly passed a bill last year with just that in mind. The new law establishes a separate category for assisted-living facilities, permitting them to serve consumers with more illness and disability, and greater care needs than do personal-care homes - which care for people who need only physical assistance, life-management assistance, and shelter.
Until now, assisted-living facilities have been treated as personal-care homes. And Pennsylvania already has plenty of frightening examples of people dying in the worst of such homes. Under the new law, assisted-living facilities are authorized to have residents with care needs as great as those in nursing homes but to give them care in a more home-like setting.
The law left to the Department of Public Welfare the job of spelling out what an assisted-living facility should be and do. Pennsylvania is not the first state to pass such a law; in fact, it is one of the last. So the commonwealth is uniquely positioned to offer up a regulatory package that draws down the best practices from the other states.
An effective and appropriate regulation package would ensure that assisted-living facilities are equipped, enabled, and accountable for providing all residents with quality care, provided by appropriate amounts of adequately trained staff in a home-like setting that is safe, accessible and stimulating. But the proposed regulations fall short of meeting this goal.
Under the proposed regulations, individuals would relinquish control over their health care and choice of health-care providers by virtue of moving in. While individuals are supposed to have the right to age in place, the regulations provide numerous ways in which a facility could evict the consumer, and the consumer would have no way to challenge the eviction. Staffing levels would be the same at personal-care homes, even though residents of assisted living, by definition, need more help. The same is true for training requirements.
According to the proposed regulations, a personal-care home can qualify for an assisted-living license even though its fire-safety protections and wheelchair-access assurances are inadequate. In fact, under the proposed regulations, old buildings that are converted to assisted living would be permitted to have living units that are only 175 square feet, which is not enough room for consumers who use (or might one day use) a wheelchair to maneuver.
Thankfully, the draft regulations are still in a formative stage and the public has an opportunity to give its input now.
The Pennsylvania Assisted Living Consumer Alliance (www.paassistedlivingconsumeralliance.org) has been formed to fight for quality and minimum standards. Share with us your experiences and your ideas for how we can make assisted living a safe and supportive place to live.
We face an awesome opportunity in the weeks ahead. While Pennsylvania is years behind in regulating this industry, we are positioned to learn from other states' experiences - and mistakes. How can we not take advantage of the chance to do so?
