Promoting Quality of Life and Safety in Assisted Living: A Survey of State Monitoring and Enforcement Agents

Abstract

Our goal was to learn about monitoring and enforcement of state assisted living (AL) regulations. Using survey responses provided in 2019 from administrative agents across 48 states, we described state agency structures, accounted for operational processes concerning monitoring and enforcement, and documented data collecting and public reporting efforts. In half of the states, oversight of AL was dispersed across three or more agencies, and administrative support varied in terms of staffing and budget allocations. Operations also varied. While most agents could deploy a range of monitoring and enforcement tools, less than half compiled data concerning inspections, violations, and penalties. Less than 10 states shared such information in a manner that was easily accessible to the public. Future research should determine how these varied administrative structures and processes deter or contribute to AL communities’ efforts to implement regulations designed to promote quality of life and provide for the safety of residents.

Association Between State Regulations Supportive of Third-party Services and Likelihood of Assisted Living Residents in the US Dying in Place

“… 5 There is also an increasing knowledge about the extent of variation in state regulations for assisted living 6 and their enforcement. 18 It is possible that third-party services interact with other relevant policies across states, such as health care providers’ scope of practice or Medicaid state plans (eg, North Carolina), to assess the likelihood of remaining in place toward the end of life with the support of additional services and financial support to pay for that care.…”