A report provides the most
detailed look to date at the role of assisted living in Medicaid, one of
the nation’s largest health care programs.
Credit
Nam Y. Huh/Associated Press
WASHINGTON
— Federal investigators say they have found huge gaps in the regulation
of assisted living facilities, a shortfall that they say has
potentially jeopardized the care of hundreds of thousands of people
served by the booming industry.
The
federal government lacks even basic information about the quality of
assisted living services provided to low-income people on Medicaid, the
Government Accountability Office, a nonpartisan investigative arm of
Congress, says in a report to be issued on Sunday.
Billions
of dollars in government spending is flowing to the industry even as it
operates under a patchwork of vague standards and limited supervision
by federal and state authorities. 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, the Government Accountability Office found in a survey
of states.
States
are supposed to keep track of cases involving the abuse, neglect,
exploitation or unexplained death of Medicaid beneficiaries in assisted
living facilities. But, the report said, more than half of the states
were unable to provide information on the number or nature of such
cases.
Just
22 states were able to provide data on “critical incidents — cases of
potential or actual harm.” In one year, those states reported a total of
more than 22,900 incidents, including the physical, emotional or sexual
abuse of residents.
Many
of those people are “particularly vulnerable,” the report said, like
older adults and people with physical or intellectual disabilities. More
than a third of residents are believed to have Alzheimer’s or other
forms of dementia.
The
report provides the most detailed look to date at the role of assisted
living in Medicaid, one of the nation’s largest health care programs.
Titled “Improved Federal Oversight of Beneficiary Health and Welfare Is
Needed,” it grew out of a two-year study requested by a bipartisan group
of four senators.
Assisted
living communities are intended to be a bridge between living at home
and living in a nursing home. Residents can live in apartments or
houses, with a high degree of independence, but can still receive help
managing their medications and performing daily activities like bathing,
dressing and eating.
Nothing in the report disputes the fact that some assisted living facilities provide high-quality, compassionate care.
The
National Center for Assisted Living, a trade group for providers, said
states already had “a robust oversight system” to ensure proper care for
residents. In the last two years, it said, several states, including
California, Oregon, Rhode Island and Virginia, have adopted laws to
enhance licensing requirements and penalties for poor performance.
But
the new report casts a harsh light on federal oversight, concluding
that the Centers for Medicare and Medicaid Services has provided
“unclear guidance” to states and done little to monitor their use of
federal money for assisted living.
As
a result, it said, the federal health care agency “cannot ensure states
are meeting their commitments to protect the health and welfare of
Medicaid beneficiaries receiving assisted living services, potentially
jeopardizing their care.”
Congress
has not established standards for assisted living facilities comparable
to those for nursing homes. In 1987, Congress adopted a law that
strengthened the protection of nursing home residents’ rights, imposed
dozens of new requirements on homes and specified the services they must
provide.
But
assisted living facilities have largely escaped such scrutiny even
though the Government Accountability Office says the demand for their
services is likely to increase because of the aging of the population
and increased life expectancy.
That potential has attracted investors. “Don’t miss out on the largest market growth in a generation!” says the website of an Arizona company, which adds that “residential assisted living is the explosive investment opportunity for the next 25 years.”
Carolyn
Matthews, a spokeswoman for the company, the Residential Assisted
Living Academy, said: “Unfortunately, there has been elderly abuse in
this business. We are trying to change the industry so the elderly have
better quality care and we are not warehousing them.”
The
government report was requested by Senator Susan Collins of Maine, a
Republican who is the chairwoman of the Special Committee on Aging;
Senator Orrin G. Hatch of Utah, a Republican who is the chairman of the
Finance Committee; and two Democratic senators, Claire McCaskill of
Missouri and Elizabeth Warren of Massachusetts.
The
Trump administration agreed with the auditors’ recommendation that
federal officials should clarify the requirement for states to report on
the abuse or neglect of people in assisted living facilities. The
administration said it was studying whether additional reporting
requirements might be needed.
“Although
the federal government has comprehensive information on nursing homes
providing Medicaid services, not much is known about Medicaid
beneficiaries in assisted living facilities,” the report said.
Assisted
living was not part of the original Medicaid program, but many states
now cover it under waivers intended to encourage “home and
community-based services” as an alternative to nursing homes and other
institutions.
Full Article & Source:
U.S. Pays Billions for ‘Assisted Living,’ but What Does It Get?
1 comment:
The need for assisted living facilities is growing and yet they are less regulated than nursing homes and we all know how bad nursing homes are generally.
Post a Comment