Specialized Information for:

Long-Term Care ConsumersFamily MembersAdvocates

News Article

Back to News Listing

More Must Be Done To Protect Residents of Assisted Living Facilities

February 06, 2018

In response to yesterday’s release of the Government Accountability Office (GAO) report, Medicaid Assisted Living Services: Improved Federal Oversight of Beneficiary Health and Welfare Is Needed, the National Consumer Voice for Quality Long-Term Care (Consumer Voice) is calling on states and the federal government to better protect assisted living facility residents.

According to the GAO findings, the Centers for Medicare and Medicaid Services and the majority of state Medicaid agencies are not effectively monitoring the abuse, neglect, exploitation, and other harm (referred to as critical incidents) occurring in assisted living facilities funded by Medicaid. In fact, not only is the government failing to protect these individuals from the most basic harm, it doesn’t even know the true extent of the problem.  In 2014, more than 330,000 beneficiaries received assisted living services through the Medicaid program.  In 22 states, nearly 23,000 critical incidents were reported.  Considering that more than one-half of the states surveyed by the GAO were unable to report the number of critical incidents and that abuse is generally underreported, this number is undoubtedly only the tip of the iceberg

Nationwide nearly one million residents live in assisted living facilities. Each year, billions of dollars are spent on these services. State and federal Medicaid funding for assisted living was about $10 billion in 2014, while the 2017 annual cost to a consumer paying out of their own pockets was $45,000. In the past, many of these individuals would have lived in a nursing home. Almost half need assistance with three tasks of daily living and over 40% have Alzheimer’s disease or other dementias. Given that a significant percentage of these individuals are highly vulnerable, the failure of both state and federal government to adequately protect them is unacceptable.

The GAO investigation is a step in the right direction, and Consumer Voice applauds Senators Collins, Hatch, McCaskill, and Warren for requesting this assisted living report. We support the GAO recommendations, including that states report critical incidents to CMS on an annual basis.

But more needs to be done.  The Consumer Voice has long been concerned about the safety and well-being of all assisted living facility residents.  Reports of abuse and neglect have been growing; between 2010 and 2015 complaints of abuse, gross neglect and exploitation reported by the long-term care ombudsman program grew by 22%.   

This is hardly surprising. State regulations vary enormously and are frequently inadequate.  At the federal level, there are a few very limited requirements for Medicaid-funded facilities, but none that address staffing, training, medication management or other critical areas. Weak, ineffective and often infrequent inspections and enforcement further undermine resident health and welfare by failing to ensure compliance.

As our population ages and residents’ acuity levels increase, stronger assisted living standards and more robust oversight and monitoring at both the state and national levels are needed more than ever.  Our goal must be for each resident, no matter where they live or how they pay for their care, to receive quality services, live free from abuse, and to be treated with dignity and respect. 

Back to News Listing