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How to Measure Quality of and Compare Assisted Living Facilities

By: Clare Absher RN, BSN

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When our parents move to assisted living, we want to be sure they will be well cared for. Finding reputable facilities that provide quality of care is of course our top priority. This undertaking, however, is especially challenging because assisted living communities are not nationally regulated like nursing homes. Medicare/Medicaid certified nursing homes and home health agencies are required to undergo rigorous state inspections annually with results readily accessible to consumers. On the contrary, comparable data for assisted living is neither uniformly assembled by each state, nor is it made easily available to the public. Each state licensing or oversight agency has its own laws, regulations, and licensing standards. Therefore, the question remains "How does one go about measuring quality of and comparing assisted living facilities?"

1. Find your state regulatory agency, and see if they offer any comparison tools or databases.

Exploring new avenues and employing less known resources is essential to get some solid answers. A good starting place is to identify the state regulatory agency for assisted living communities in the state where your parents reside. The National Assisted Living Federation of America (ALFA) oversees these state regulatory agencies and you can learn more about state specific regulations by visiting their website. Find your state agency responsible for regulating assisted living and pay close attention to whether or not they offer any type of comparison database.

2. Explore resources provided by your ALFA state affiliate.

In addition, ALFA recognizes only one state organization in each state as its official ALFA state affiliate. This can prove to be another valuable source for gathering some practical information about assisted living in your community. Find your state affiliate or chapter.

3. Contact your long term care ombudsman.

Your long term care ombudsman, while undoubtedly a less known resource, can offer invaluable insight on assisted living in your community. Most state ombudsman programs are housed in their State Unit on Aging and are equipped to help you find a facility and advise you on measuring quality of care. Contact your long term care ombudsman for guidance.

4. Call your local health department and network with others in your community.

Another idea is to call your local Health Department to inquire directly about getting information sent to you. Use this map to find your local health department. In addition, network with staff employed at your county health department, physician's offices, and senior centers to learn more about reputable communities in your area.

5. Look up JCAHO accredited facilities.

JCAHO (Joint Commission on Accreditation of Healthcare Organizations) is a well-respected organization that accredits those assisted living communities that voluntarily elect to pursue accreditation. Meeting the higher standards required to become accredited by JCAHO is a worthy consideration symbolizing a feather in a facility's cap. Although by no means inclusive, the information on each accredited facility does consist of a detailed report of findings and a number score is given based on a 100 point scale. JCAHO's online directory allows easy access to this info and further explanation of the value of having this accreditation.

6. Look up CARF-CCAC accredited facilities.

The merging of Continuing Care Accreditation Commission (CCAC) and Commission on Accreditation of Rehabilitation Facilities (CARF) created another respected not-for-profit accrediting organization. While the numbers are limited, when assisted living facilities do participate in their accreditation program, it can be a valuable source for comparison nonetheless. Search the CARF online directory for participating assisted living facilities in your area to help gather more useful information.

7. Hit the pavement once you have narrowed your search to a few reputable homes.

Researching on the internet can uncover a wealth of info on a facility simply by searching with key words such as violations or penalties along with a facility name. However once you have exhausted all virtual channels of data, then it will likely be necessary to do some actual physical legwork. It's time to hit the pavement once you have narrowed your search to a few reputable homes that meet your criteria for location, cost, size, and types of support and medical services. Make visits to homes, planned and surprise ones, where you focus on more than the physical environment of the home. Talk with residents to find out overall satisfaction and try to get a feel from staff regarding general contentment. Keep in mind that the "whistles and bells" such as that of high end décor in a facility's lobby or cooks with fancy chef's hats, while impressive, matters little when it comes to quality of care. Make it your utmost priority to find assisted living homes staffed with kindhearted caregivers who are dedicated to the care of their elderly residents.