2008 EDITION OF ASSISTED LIVING STATE REGULATORY REVIEW

VCAL (6/18/2008)

Analysis of information collected for NCAL’s 2008 Assisted Living State Regulatory Review shows that the pace of regulatory change quickened across the country last year as the assisted living profession continued to develop and diversify.  In 2007, more than 20 states made statutory and/or regulatory changes impacting assisted living residents and facilities – up from about one third of the states in 2006.  Of these, about 12 states overhauled or made significant changes to their assisted living regulations in 2007; many more than in each of the previous two years.  Several states intend to make major regulatory changes in 2008.  This annual report is widely used by regulators, policymakers, researchers, and assisted living professionals.  The full report, as well as a summary of regulatory changes in 2007 and state-by-state highlights, is available on NCAL’s website.

Three states initiated new levels of licensure in 2007, in part to accommodate increased resident acuity.  Pennsylvania and the District of Columbia began offering “assisted living” licensure alongside their existing licensure categories, while Wyoming added new rules allowing secure dementia units under a tiered licensing system. Other states continued refining multi-tiered licensing systems.  States continued the trends of developing enhanced standards for Alzheimer’s/dementia populations and standards for disclosure of information to consumers.  Several states established or tightened criminal background check requirements, augmented fire safety and emergency preparedness standards, and strengthened food safety and dietary standards.  States also added to requirements relating to staff training, staffing, medication management, reporting and record keeping, and infection control.  Other focal points of regulatory changes included survey procedures, licensure fees, requirements when closing or expanding operations, resident rights, dispute resolution procedures, move-in/move-out requirements, and resident assessments.

In 2007, at least two of the few remaining states without Medicaid coverage for assisted living services took steps toward including such coverage under Medicaid waivers. In addition, North Carolina passed legislation that bans smoking in licensed assisted living facilities statewide.