WASHINGTON POST PUBLISHES SERIES

VCAL (06/01/04)

Beginning on Sunday, May 23rd, the Washington Post published a four-part series on assisted living facilities in Virginia which focused the publics attention on the need for a regulatory overhaul and stricter enforcement by the state.  The articles highlighted residents who suffered incidents of abuse, neglect, injuries and even death, and claimed that the problems stemmed from a range of causes, including poor staff training, lack of public resources and weak enforcement by state regulators.  The series also emphasized that Virginias current system mixes residents with diverse needs and conditions, including individuals with dementia, mental illness, other mental conditions and physical frailty . 

Maurice Jones, Commissioner of the Department of Social Services, commented to the Post that he would push to improve conditions and oversight of the state's assisted living facilities, suggesting increased fines for homes that violate regulations and the removal of obstacles that make it difficult to close troubled facilities.  He also noted his interest in making records on the homes more accessible to the public by posting them on the internet.

In response to the Post series, VHCA/VCAL submitted an editorial detailing the associations advocacy efforts calling for a restructuring of the current regulatory system and the need for improved Auxiliary Grant reimbursement.  For a number of years, VCAL, as the assisted living voice of the Virginia Health Care Association, has called for a regulatory framework that would require greater accountability and responsibility of providers to maximize quality of care for residents.  A copy of the letter can be found on VCALs website at www.vhca.org/vcal/docs/06204wn.pdf.

VCAL recently addressed the Virginia Board of Health Professions asking that they regulate or study the need for regulation of assisted living administrators which would result in administrator licensure or certification.  Other states have already established requirements.  Such a measure would provide public accountability of administrators, require professional conduct and establish a standard of practice to ensure the safety and protection of residents.

When regulations governing assisted living facilities were drafted in the mid 1990s in response to legislation, they included stronger provisions for oversight of resident health by licensed health care professionals.  Many opposed the proposal based on its cost when compared to Virginias inadequate public reimbursement for care.  In response to that opposition, and in spite of VCALs advocating for greater oversight of residents, the regulations were weakened from their original intent.  Additionally, VCAL has historically supported an increase to the reimbursement rate; it is unrealistic to expect a facility to provide services, meals, and assistance to residents for only $28 a day.
 
VCAL members have consistently called for a restructuring of the current regulatory system recognizing that it is unsafe for facilities to house mixed populations without assurances that there are adequate protections in place and increased staff training to care for residents.  Facilities housing the mentally ill should be reclassified from assisted living to a more accurate and traditional regulatory term that reflects the needs of these individuals.  VCAL has held that the mentally ill and the frail elderly should not be housed in the same facility or in a secure unit within an assisted living facility.  Virginia has not yet acknowledged that residents with special mental health needs comprise a distinct population with distinct needs.

It is unfortunate that all assisted living facilities in the Commonwealth were painted with the same brush in the Post series.  There are many excellent assisted living providers who offer compassionate, quality care for Virginias elderly.  VCAL member Susan Woodie, VP of Assisted Living, Richfield Retirement Community commented on the series, While I feel the articles did not accurately portray the profession as a whole, perhaps it will serve as the catalyst to push forward changes that VHCA/VCAL have so strongly supported.

In addition to the Post series, USA Today also published a multi-day series of articles on assisted living quality issues last week based on inspection records collected for seven states: Alabama, Arizona, Colorado, Florida, Indiana, New York and Texas.  Additional information was gathered for Michigan, Oregon, Maine, Washington and Minnesota.  The articles focus on results of inspection records which found patterns of medication errors, failures in staffing and training, and a patchwork of state regulations under which ALFs operate.  The series are available at www.washingtonpost.com and www.usatoday.com.