chapter 4. assisted living
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Chapter 4. Assisted Living . Long-Term Care: Managing Across the Continuum (Second Edition). Learning Objectives. Define and describe assisted living Identify sources of financing for assisted living Identify and describe regulations affecting assisted living - PowerPoint PPT PresentationTRANSCRIPT
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Chapter 4. Assisted Living
Long-Term Care: Managing Across the Continuum
(Second Edition)
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Learning Objectives
1. Define and describe assisted living2. Identify sources of financing for assisted
living3. Identify and describe regulations affecting
assisted living 4. Identify and discuss ethical issues affecting
assisted living 5. Identify trends affecting assisted living into
the future and the impact of those trends
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What is Assisted Living?
Many different definitionsAssisted Living WorkgroupA long-term care residential alternative:
More assistance than a retirement community
Less medical and nursing care than a nursing facility
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Other Residential Living
Similar types of residential living:Residential CareIndependent LivingCongregate HousingContinuing Care Retirement
Community (CCRC)
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How Assisted Living Developed
Two separate tracks:Boarding homesIndependent living
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Philosophy of Care
Maximizing personal dignity, autonomy, independence, privacy, choice
Providing a homelike environmentAccommodating changing care needsMinimizing the need to change facilitiesInvolving families and the community
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Ownership of Nursing Facilities
88% For-Profit 12% Non-Profit
Reasons:High proportion of self-payFew government regulationsGood investment for owners
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Services ProvidedPersonal careHealth careSocial servicesSupervisionSocial and religious activitiesExercise and educational activitiesTransportationLaundry and linenHousekeeping and maintenance
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Consumers Served
Elderly – average age: 80Female – two-thirdsChoose facility close to family
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Prior Placement:Where They Come From
Home – 46 %Other assisted living– 20%Hospital – 14%Nursing Home – 10%Other – 10%
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Placement After ALF:Where They Go
Nursing facility- Because of higher nursing and
medical needs, or loss of functional capacity
Death
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Market Forces
Seeking care alternativesImpact on childrenCost-cutting efforts
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Regulations
• Few regulations until recently• Increasing number of states now
regulating assisted living• Very little commonality or uniformity• Assisted Living Workgroup
recommendations
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Types of Regulations
Affecting residentsOthers:
- Affecting employees- Affecting building
construction & safety
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Accreditation
JCAHOCARF/CCAC
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Financing Assisted Living
Reimbursement Sources:• Mostly self-pay• Medicaid – small, but
growing
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ChargesBasic daily charge
- Varies by type of facility and resident’s living quarters
- Single room, apartment, suite“Ala Carte” charges:
- Residents pay for what they need- Some meals, housekeeping, laundry, etc.
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Staffing/Work Force
Largely non-clinicalCustomer service focusFew staffing regulations – mostly
based on nursing facility modelTraining staff to recognize residents’
privacy & independence
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Legal & Ethical Issues
Decision-making: - how to balance autonomy
& resident care & safetyAging-in-Place
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Management
Administrators come from:• Nursing facilities• Outside of long-term care• Within assisted living
- AssistantsEach must learn new culture
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Management QualificationsLicensed by a few statesDifferent state regulations re:
Minimum education Hands-on experience Continuing education
Usually less stringent than for nursing facility administrators
NAB
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Management Challenges& Opportunities
Developing an organizational identity
Interacting with residents
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Significant TrendsMovement toward agreementIncreased regulationGrowth in managed care coverage –
private and governmentIntegration with other providers
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In Summary:
Assisted living has developed somewhat haphazardly, but is approaching maturity, which
should lead to more consensus on what it is and what it does.