Today, a growing number of Americans live in assisted living facilities. These facilities are intended to be a bridge between living at home and residing in a nursing home. In an assisted living setting, a resident can still live with a high degree of independence, but can receive help managing their medications and performing activities of daily living, like bathing, dressing and eating.
In a shocking report released earlier his month, the Government Accountability Office (GAO) detailed their study that found the federal government lacks even basic information about the quality of assisted living services provided to low-income people on Medicaid. The report titled “Improved Federal Oversight of Beneficiary Health and Welfare is Needed,” was done at the request of a bipartisan group of senators including Orrin G. Hatch (R-Utah), Susan M. Collins (R-Maine), Claire C. McCaskill (D-Missouri), and Elizabeth Warren, (D-Massachusetts). The senators ordered the study in July 2015 to better understand federal and state oversight of these facilities, which increasingly receive federal Medicaid dollars but are not subject to the same federal rules as nursing homes. According to the study, states reported spending more than $10 billion a year in federal and state funds for assisted living services for more than 330,000 Medicaid beneficiaries, an average of more than $30,000 a person. Despite the tremendous amount of federal funds flowing to companies operating assisted living facilities, there is very little government oversight of the industry.
“The GAO report found that 26 states could not report to GAO the number of ‘critical incidents’—serious health and safety problems that could include physical assaults, sexual abuse, unexplained death, unauthorized use of restraints, medication errors and inappropriate discharges or evictions—occurring in assisted living facilities in their state,” a statement from Sen. Warren’s office said. “But the 22 states that did track this information used different definitions of critical incidents, further complicating effective oversight of such facilities.” While all states consider physical, emotional or sexual abuse as a critical incident, some states did not identify other problems. For instance, seven states didn’t indicate potential harm or neglect, such as medication errors, as a critical incident. Three states didn’t consider unexplained death as a critical incident. Of the 22 states that did track critical incidents, the study found that there were more than 22,900 incidents in one year, including the physical, emotional or sexual abuse of residents. In many cases, the report found that when states did identify a significant problem at a facility, that information was not made available to the public.