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Assisted Living Facility Rules Vary Widely From State to State

Consumers need to understand what they are getting before they choose an assisted living facility. A new report by the National Senior Citizens Law Center (NSCLC) finds that there are no common standards for assisted living across the United States. The report, "Critical Issues in Assisted Living: Who's In, Who's Out, and Who's Providing the Care," found that assisted living can mean different things in different states. In some states assisted living facilities are comparable to nursing homes, in other states they are similar to rooming houses.

Some of the variations in laws from state to state include the following:

  • Most states authorize facilities to evict residents when the facility's services do not meet a resident's needs. Facilities usually have discretion to determine whether the facility meets a resident's needs, which can result in early and late discharges.
  • Staff training requirements vary widely from state to state. Nineteen states have hourly minimums for the training of direct-care workers. Five states require 12 or fewer hours of training, four states require from 13 to 24 hours, and 10 states require 25 or more hours.
  • Many facilities do not have a medical staff. Only half of the states require facilities to employ or contract with a nurse. Even if the facility has a nurse, in most cases the nurse is rarely at the facility.
  • There is a trend toward letting non-medical personnel administer medicine. In 28 states, assisted living employees with limited training can administer medication. In nursing homes, only licensed or registered nurses can do so.

"In shopping for assisted living, consumers need to have their eyes wide open, and be prepared to ask hard questions about what 'assisted living' includes," according to the author of the report, NSCLC attorney Eric Carlson.

To see the full report, including a breakdown of assisted living facility laws by state, click here.