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Quality Concerns in Assisted Living Facilities

ASSISTED living facilities are the long-term care choice of approximately 1 million older Americans.1 Assisted living facilities provide personal care assistance and supportive services in a homelike environment to older adults who are no longer able to live independently, but who do not require the care provided in skilled nursing facilities.2 The number of assisted living facilities in the United States grew rapidly in the 1990s to approximately 30,000 to 40,000,1 but because standards and regulations have not kept pace with that growth, there are concerns for the quality of care in assisted living facilities. Unlike skilled nursing facilities where federal regulations define the rights of residents and the standards of care, assisted living facilities lack a federal regulatory standard that would apply throughout the United States. Instead, each state has developed regulations and a licensure mechanism for this level of care. Among the states there are considerable differences within the sets of regulations, differences that begin with the very names applied to these facilities. Although some states used the name assisted living facility, other states’ regulations use names such as resi-