Section III. State Summaries (continued)

Residential Care and Assisted Living

Kansas

Approach

Assisted living facilities are licensed by the Department of Aging. Surveyors inspect every facility annually. Consistent enforcement of the regulations has been credited with improved compliance and fewer complaints. Deficiencies are written more concisely with a focus on the consumer and outcomes. Under a new survey process, facility staff accompany the surveyor during the review. Problem areas are identified and discussed with the staff. Educational efforts have been increased. The licensing agency conducts regular 1-day training courses for nurses, owners, and operators on the role of nursing in assisted living, how to conduct an assessment and develop a service plan, managing medications, and the nurse practice act. During the training, scenarios are presented, and participants prepare a care plan based on the information presented.

Communicating with Consumers

The Department of Aging Web site contains a list of facilities (name, address, phone, name of the administrator, name of the building owner, the lessee, and licensed capacity), various forms for providers, licensing requirements, an interpretation manual, and complaint forms.

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Kentucky

Approach

The Cabinet for Health and Family Services, Division of Aging certifies assisted living facilities. The Division conducts a certification review upon application and an annual recertification review to ensure compliance with the certification requirements. Unless there is a formal complaint lodged against a facility, the Division does not monitor the quality of care in assisted living communities.

Communicating with Consumers

The Division of Aging Web site includes a checklist for consumers to evaluate facilities, an application form, a link to the regulations, and a list of facilities (name, address, phone number, and the date that the certificate expires).

The consumer brochure includes a checklist of issues that cover certification, services offered, atmosphere, community features, the lease agreement, employee qualifications, food services, and social, recreational and spiritual activities. A section on frequently asked questions addresses assistance with medications, costs, third party coverage, and move-out issues.

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Louisiana

Approach

The Department of Social Services licenses adult residential care facilities. Licenses are issued for 1 year, and facilities are inspected annually or upon receipt of a complaint. Inspectors follow a protocol on laptop computers to complete surveys. Interviews with residents and family members are not required but may be done at the discretion of the surveyor. Inspectors clarify the regulations and explain how the requirements may be met when they meet with staff and administrators.

The reports and citations are printed at the completion of the inspection. Licensing agency officials have an interest in profiling facilities but are not working on a method to do so at this time.

Communicating with Consumers

The licensing agency's Web site includes a database of all types of licensed facilities and programs. Consumers may search by adult residential care facilities. The database lists recent inspection reports. Reports issued after July 2004 are generally available; reports prior to that time can be obtained from the Department.

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Maine

Approach

The Bureau of Elder and Adult Services licenses residential care facilities. However, a new division of licensing and certification will consolidate licensing functions from multiple agencies. Licenses for residential care facilities are issued for 1 or 2 years based on the facility's previous history of compliance with health and safety requirements. The State uses the MDS-RAI (Minimum data Set—Resident Assessment Instrument) to establish case-mix payment rates and quality indicators to monitor quality of care. Information is shared with all facilities.

Surveyors use a standard set of questions to explore topics with residents and staff. Using assessment data, a sample of at least five residents, and up to 10 percent of the residents in larger facilities that represent the facility's case-mix, is selected prior to the survey. Residents may be asked if they like the food. If they respond negatively or express a complaint, they might be asked if they have spoken to the cook or other staff. Based on responses, followup questions are asked.

The Department is authorized to make regular and unannounced inspections of all facilities.

Communicating with Consumers

The Bureau's State Unit on Aging Web site contains a searchable database that allows consumers to search by name, county, city, population served, accessibility, and type of facility. The results display the name, address, and phone number of all facilities meeting the search criteria. Entries can be made to search for facilities within specified distance within a ZIP code. Users can check facilities for which they would like further information, including licensing period, capacity, contact person, and directions to the facility.

The State created a Division of Licensing and Certification that consolidates licensing functions for multiple types of settings which had been spread across agencies. The new division will create its own Web site. Over time, the new site may include deficiency statements. Statements will have to be converted from a narrative format to a database platform. Deficiency statements are posted by each facility and are available from the licensing agency upon request.

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Maryland

Approach

The State's assisted living programs are regulated by the Department of Health and Mental Hygiene, Office of Health Care Quality. The law allows the Department to delegate monitoring and inspection of programs to the Office on Aging and the Department of Human Resources or to local health departments through an interagency agreement. Survey findings and plans of correction must be posted in the facility.

The Office of Health Care Quality created an Assisted Living Forum (ALF) in 2003 to review policy issues under consideration by the State legislature through a series of meetings for interested stakeholders "to advise the Department and assist in the evaluation of Maryland's Assisted Living Program." There is no set membership of the ALF, and its meetings are open to the public. All stakeholders, interested parties, consumers, and members of the public are encouraged to participate and comment on all stages of the evaluation.

The ALF forum held meetings in 2003 and 2004. The Web page lists the meeting dates and meeting summaries and draft reports on manager training topics, an assessment tool, scoring of the assessment tool, and reports and resources from other organizations. Topics considered in 2003 included: certification of assisted living managers, differences in small and large providers, and standards for specialty units.

Topics for 2004 included training requirements for assisted living managers in mid-to small programs, quality standards for mid-sized programs, and methods for improving the efficiency of the regulatory process.

Communicating with Consumers

The Office of Health Care Quality Web site contains links to licensing regulations, material for providers, and information about the ALF. The site includes information on the use and scoring of the assisted living assessment tool that determines which level of care residents need, the form used by the manager to assess the resident's needs, and the health care practitioner's assessment form.

The Department on Aging Web site has a description of assisted living, links to subsidized programs for low-income residents, a 73-page consumer's guide to assisted living, and a link to the American Association of Homes and Services for the Aging.

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Massachusetts

Approach

The Executive Office of Elder Affairs (EOEA) is responsible for certifying assisted living facilities. EOEA conducts compliance reviews of assisted living residences every 2 years. The reviews include inspections of the common areas, living quarters (by consent of the resident), inspection of the service plans, and a review of the resident satisfaction survey. Additional reviews are conducted in response to complaints from residents or the ombudsman unit.

When requested by a facility, the State provides consultation concerning compliance with the regulations. State policy is based on a social model of care. Survey reviews focus on supportive service plans and include health factors, since assisted living residences are not responsible for the health status of residents.

Survey staff follow a protocol that reflects the regulatory requirements. A sample of resident records is reviewed to document the presence of an assessment, a care plan, and resident agreement and that a disclosure form was provided. Informal conversations are held with residents and staff. Direct care workers are "shadowed" to observe how they perform their tasks. At the completion of the review, survey staff address issues of concern during a debriefing meeting with the administrator. A letter describing the findings from the review and a request for a corrective action plan is sent to the administrator.

Most frequently, this relates to rewriting a policy or retraining staff. Medication issues are also common. The assisted living residence must submit documentation that corrective actions have occurred. If the State determines that the compliance review requires more intensive action (severity of the problem, number of residents affected, willingness of assisted living residence to address the problem), they will do a followup visit. Survey staff regularly find repeat violations on subsequent visits. Results of the survey are available to the public through a FOIA request.

In 2004, the State legislature created a task force to review the State's assisted living certification regulations. The task force includes State officials, stakeholders, and legislators. Three work groups are meeting on quality, specialty care facilities, and accountability. A report to the legislature and recommendations are due in June 2005. A report from Policy Studies, Inc.a, commissioned by EOEA, contained multiple recommendations for improving oversight, sanctions, quality assurance, and areas of the regulations. The recommendations included:

  • Collection of data on residents to track the level of assistance needed by residents.
  • Establish a 1-year initial provisional license with a 2-year renewal.
  • Establish a continuum of sanctions and require plans of corrections for violations.
  • Require that each residence develop a formal quality assurance/quality improvement process.

Communicating with Consumers

The EOEA Web site provides a brief overview of assisted living, the costs, and the role of the assisted living ombudsman program. A list of facilities is available by city/town with the name, phone number, and number of units for each facility. The site provides information about the Medicaid Group Adult Foster Care Program, which subsidizes services for Medicaid beneficiaries and the State housing agency.

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Michigan

Approach

The Department of Human Services (DHS) licenses adult foster care homes and homes for the aged. Responsibilities for licensing and oversight were transferred from the Family Independence Agency. The Department of Labor and Economic Growth (or a local health department at the request of DHS) has responsibility for fire safety inspections. Homes for the aged are inspected annually by the DHS and the Department of Labor and Economic Growth for fire safety. Licenses for homes for the aged are renewed annually, and adult foster home licenses are renewed every 2 years.

Reviews of adult foster care facilities are scheduled by "licensing consultants," and unannounced reviews of homes for the aged are done by "licensing staff." Reviewers offer technical assistance to help licensees achieve minimum compliance with the regulations. Consultation may be available to help licensees achieve a higher level of compliance. Reviewers follow the licensing manual and use "review tools" for different aspects of the inspection (e.g., physical plant, quality, fire safety).

All the tools are posted on the Department's Web site and may be used by operators to prepare for a review or for self-monitoring. Interviews of residents, staff, and resident representatives are one source of information but are not required. Interviews are more likely when reviewers are investigating complaints. Complaints alleging abuse, neglect, or financial exploitation are investigated within 24 hours.

Communicating with Consumers

The DHS Web site provides an overview of adult foster care and homes for the aged. A searchable database includes several types of facilities: family homes; congregate homes; small, medium, and large group homes; and homes for the aged. The database contains information about the facility, the license number and expiration date, and capacity. It also includes inspection reports and investigation reports. Complaint forms can be completed online. Posting the information has reduced the volume of calls from consumers seeking recommendations or information about the quality of care provided by specific facilities.

Tools for facility administrators include an online licensing application request form and information about self-study and ongoing and scheduled training opportunities.

The Office of Services for the Aging Web site has a checklist (Table 12) and an explanation of resident rights and protections.

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Minnesota

Approach

The Minnesota Department of Health licenses assisted living home care service agencies (community agencies licensed to provide services in group settings). Surveys are conducted annually by registered nurse reviewers to evaluate and monitor the care provided and to determine compliance with the licensing requirements. Four types of surveys are conducted: focused surveys; expanded surveys when serious adverse outcomes or potential for adverse outcomes are identified through a focused survey, complaints, or as a result of the judgment of the reviewer; licensing followup surveys to verify correction of identified violations; and initial licensing surveys. The process includes consultation/technical assistance to educate providers and improve compliance.

Agencies that have been licensed for 2 consecutive years and do not have any serious violations may be surveyed less often than annually. The survey process includes an entrance conference; a tour; interviews with staff, residents or their representatives; observations; and a record review. Surveyors review the records of two current residents and one former resident. Current residents are interviewed. The sample may be expanded based on the findings. The survey guide lists potential questions that might be asked of residents, such as:

  • Tell me about the care you receive.
  • Do you have a contract or written service plan?
  • Are you receiving the services you thought you would receive?
  • Are you satisfied with the care?
  • Do the staff treat you with respect? Are they kind to you?
  • Does the registered nurse visit you? If so, what does she do?

Complaints are handled by the Office of Health Facility Complaints. The Office's Web site allows complaints to be submitted electronically. A database includes information on all resolved complaints and a description of the issue, investigative findings, and conclusions.

Communicating with Consumers

The Department of Health has a Web site with extensive information for providers. The site includes an application form, a general guide to home care services, a survey manual, survey guidelines, and a guide to the survey process. The guide lists the indicators of compliance, outcomes observed, and comments that include whether the indicator was met, a plan of correction was ordered, and education was provided. The comments section includes a description of the deficiency. Results of surveys are posted for surveys conducted after July, 2004. The State is interested in developing a system to profile agencies. A 2-year process to profile nursing homes was ready for release to the public in 2005; however, a bill pending in the legislation would delay its use.

"MinnesotaHelpInfo" is a search tool developed for all Department of Human Service agencies and programs. The button on the Board on Aging Web site allows consumers to enter a ZIP code or city and search for a range of service providers, including assisted living. The search provides the name, address, and phone number of the facility, as well as a button for more details (information about the features of the program, who is appropriate, how you enroll, the fees, the area served, and the provider's Web site and phone number).

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Mississippi

Approach

The Department of Health licenses personal care homes/assisted living facilities. Licenses are issued for 1 year, and facilities are inspected annually. Surveyors follow a handbook during the inspection process that parallels regulatory requirements. Informal interviews are conducted with residents, family members, and staff.

Operators are required to spend 2 concurrent days with the licensing agency for training and mentoring within 6 months of employment. The operator may be assigned within central offices or with a survey team. Surveyors who have passed the Surveyor Minimum Qualifications Test are also required to spend 2 concurrent days with a licensed facility for training and mentoring within 6 months of employment.

Communicating with Consumers

Personal care home/assisted living regulations are posted on the Department's Web site.

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Missouri

Approach

The Department of Health and Senior Services licenses two levels of residential care facilities annually. Facilities are inspected twice a year. The second inspection may be waived for facilities that are in good standing based on previous inspection reports, their history of compliance, and the number and severity of complaints, and whether there was a change in the ownership, operator, or director of nursing. Inspectors bring a copy of the regulations and policies with them during the review. Inspectors meet with the administrator and conduct a tour of the facility.

Inspectors interview 10 percent of the residents or a minimum of 3 and a maximum of 25, depending on the licensed resident capacity. Interviews are open-ended, and inspectors will spend time talking with residents who are identified as having difficulty navigating a path to safety. They will also talk with residents observed to have bruises about problems they may have getting to the bathroom and into and out of bed, whether they have problems with other residents or are fearful or worried about other residents. Inspectors do not provide consultation or technical assistance but do refer staff to other organizations under contract with the State to assist nursing and residential care facilities.

Complaints are triaged based on the level of harm to residents. Complaints involving imminent risk are investigated on site within 24 hours. Lesser complaints are investigated within 30 days.

Communicating with Consumers

Section 198.528 of the revised statutes, passed in 2003, requires posting on the Department's Web site of the most recent survey findings of deficiencies and the effect a deficiency would have on the facility; the facility's proposed plan of correction; and information on how to obtain a copy of a complete facility survey conducted during the last 3 years.

A searchable database includes links to each inspection report, including a description of the citation, the date corrected, the level of harm, and a plan of correction when required. The system uses the Automated Survey Process Environment (ASPEN) database used for handling nursing home licensing and survey information. Complaints may be added to the system in the future.

The database allows users to search by county, city, or ZIP code. The results show the name, address, city, phone number, licensure level, number of licensed beds, the administrator, and the operator of the facility.

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Montana

Approach

The Department of Health and Human Services licenses assisted living/personal care homes. Licenses may be issued for 1, 2, or 3 years. Registered nurses conduct unannounced on-site surveys within 120 days of the issue of a provisional license and annually, biannually, or triennially thereafter (depending on whether the facility has been granted an extended license) or upon receipt of a complaint. Surveyors provide guidance to operators during exit interviews or while discussing a plan of correction.

During the inspection, surveyors interview a 10 percent sample of residents, staff, and family members using a structured questionnaire. Additional interviews may be conducted if the surveyors find a pattern that merits further review. Surveyors receive annual training. The content of the training is based on survey findings and trends. For example, if deficiencies in specific areas increase, training will be held on the regulations, how they are interpreted, and how facilities found in violation may comply with the requirements.

Communicating with Consumers

The Department of Health and Human Services Web site contains the licensing regulations, an application packet, and other tools for operators. Other tools include the survey tool and guidelines, a complaint survey tool and guidelines, employee and resident file review checklists, Statement of deficiencies and plan of correction forms, menu and recipe options, links to training resources, staff screening and hiring resources, resources for infection control and skin care, and a list of optional forms that will assist facilities in complying with the regulations. A quarterly newsletter has recently been instituted. A list of facilities is available on the Web site.

The Montana Senior and Long Term Care Division Web site has an icon for housing resources that lists assisted living/personal care homes. The link leads to a description of the two types of assisted living arrangements licensed in the State and a link to search for a provider. The search button includes assisted living on the drop down menu. The results include the name, address, and phone number of each facility. A consumer guide is available in a question and answer format that describes the options (retirement home, adult foster care, personal care home A and B, assisted living, and residential hospice care), the services that can be expected, the criteria for admission, payment issues, and the content of an admission agreement. A checklist is also included.

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Nebraska

Approach

The Department of Health and Human Services licenses and monitors assisted living facilities. The Department may conduct an on-site inspection at any time it deems necessary. Each year, a 25 percent random sample of the licensed facilities is selected for inspection; inspections may be conducted more often in the event of complaints, incidents involving death, imminent danger or serious harm, or lack of selection over 5 years. The Department is in the 5th year of the survey cycle and must ensure that facilities that have not been visited are surveyed. The initial licensing survey is announced. Renewal surveys are not announced.

The Department provides education on the regulations during on-site reviews and participates with State assisted living associations to provide education at conferences. Surveyors are able to share effective practices used by other facilities or refer staff to other facilities.

Survey protocols are shared with the facility. Surveyors meet with the administrator and staff, tour the facility, and interview a sample of residents. At least four residents are interviewed using a protocol. Additional residents are interviewed in larger facilities. Family members or representatives for people with dementia are interviewed.

When an inspection reveals violations that create an imminent danger of death or serious physical harm or have a direct or immediate adverse effect on the health, safety, or security of residents, the Department must impose disciplinary action. The Department conducts a followup inspection within 90 days. For violations that do not constitute imminent danger, the Department may request a statement of compliance from the facility. The statement of compliance must indicate any steps that have been or will be taken to correct each violation and the estimated time to correct each violation. If the statement of compliance fails to address the problem(s), the Department may initiate disciplinary action against the facility.

Communicating with Consumers

The Department's Web site includes the list of facilities and licensing regulations, with links to specific sections that affect requirements for obtaining a license. A Web-based application for approval of administrator training is also available. The site includes a list of facilities (name, address, phone and fax, capacity, type of ownership, and whether the facility serves Medicaid waiver participants).

The Division on Aging Web site has links to the Medicaid HCBS waiver on the Department's Web site. Assisted living is highlighted as one of the services covered by the waiver. The link connects to a Web site developed by Answers4Families.org. Answers4Families.org is a project of the Center on Children, Families, and the Law at the University of Nebraska and is supported by funding from the Aging and Disability Services, the Office of Protection and Safety, and the Office of Family Health; and the Nebraska Department of Education, Early Development Network.

The site contains a brochure about waiver services, a consumer guide, a list of facilities that participate in the waiver program, information about filing complaints, and the Medicaid appeals process. The guide includes a series of questions, including:

  • What is an assisted living facility?
  • Are assisted living facilities regulated and licensed?
  • Are assisted living facilities the same?
  • When should a person consider assisted living?
  • How can I find out more about in-home options?
  • With such a variety of options, how can I know which is best for me?
  • How much does it cost, and how do people pay for it?
  • Can I get financial help to pay for assisted living?
  • Should I visit the facility I'm interested in?
  • What questions should I ask facility staff?
  • What is a resident service agreement?
  • How can I find facilities in my area?

The Web page has a matrix/checklist to track the type of assistance that is available—reminding/supervision needed, the assistance needed, and the cost—in 14 areas: eating, dressing, hair care, nail care, oral care, shaving, bathing, toileting, walking, transportation, arranging medical appointments, taking medications, housekeeping, and special individual needs. Suggestions are made about things to observe and questions consumers should ask facility staff (Table 13).

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Nevada

Approach

The Bureau of Licensure and Certification licenses residential facilities for groups. The Bureau conducts unannounced, annual, on-site inspections and investigates complaints. The annual inspection follows standard protocols for a focused survey that looks at primary health and safety regulations such as care needs, staff training, background checks, and medication needs.

A full survey is conducted as needed, based on observation and the results of the focused review. Inspectors review resident records and interview a sample of residents that includes residents recently admitted from a hospital or community setting, those who have special care needs, and those who receive home health or hospice care. All residents in facilities of 10 or less are interviewed; in larger facilities, surveyors interview a sample of residents based facility size. Inspectors ask residents how long they have lived at the facility, what their interests are, what kind of care they are receiving, and questions about medications and food service.

Surveyors use the ASPEN software to record information. Consultation is not provided, but inspectors explain the regulations and comment on how other facilities respond to problems as they are identified. Inspectors may be registered nurses, social workers, or generalists with a health or aging background. Nursing home inspectors do not typically inspect residential facilities for groups, but some are cross-trained to help if there is a backlog.

Communicating with Consumers

The State posts its licensing regulations and an application for licensure on a Web site. The site also presents a list of facilities that includes the name, address, phone number, and the number of beds. The Bureau purchases pamphlets from a national organization that explain how to select a facility. The Bureau uses funds collected from fines levied against facilities to pay for the pamphlets.

The Division of Aging Services Web site has a "links" button to multiple topics of interest to seniors. The nursing home/assisted living topic leads to Web sites of national associations.

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New Hampshire

Approach

The Department of Health and Human Services, Bureau of Health Facility Administration conducts annual health inspections of facilities. Separate life safety code inspections are also completed annually. The Department has five surveyors, four RNs, a social worker, and a national certified life safety code inspector. Based on the survey results, the Department has the authority to impose a fine or suspend, revoke, or deny a license. By statute, the Department offers education in the regulatory requirements. New administrators and administrators in newly licensed facilities are invited to meet with the survey staff who explain the requirements. Facilities that receive deficiencies may be referred to another facility that has been successful dealing with a similar issue.

The survey process includes an entrance visit; tour; interviews with residents, family members, if present, and staff; record reviews; and an exit interview. Surveyors use standard protocols for entrance interviews, tours of the physical environment, and reviews of medication orders. Residents who will be interviewed may be identified during the tour of the facility based on observations about their activity, cleanliness, and care needs.

Surveyors focus on quality of life and quality of care. Observations and discussions with residents are used to pursue quality of care issues. For example, if a resident is in bed at 11 am, the surveyor determines the reason. If a person is recovering from pneumonia, the surveyor checks to see that they are getting sufficient fluids and are being turned appropriately. If they are in bed because no one has helped them get up, the surveyor looks for a staff member to explain why. Survey staff also complete some resident assessments and compare their findings with the resident's record.

In January 2003, the State implemented a two-page standard disclosure form17 that serves as a guide and allows consumers to compare facilities. The form provides information to residents and prospective residents of assisted living, residential care, and congregate housing programs. The form provides specific information about services offered by the housing entity in its base rate. The form also lists other services available and the additional rates for those services. The form is completed by an individual designated by the facility administrator. The form is not submitted to the State but is kept at the facility and attached as the cover sheet of the residential services agreement.

Communicating with Consumers

The licensing agency plans to adapt the ASPEN database for assisted living survey information and post it on their Web site.

The Bureau of Elder and Adult Services Web site has a brief description of assisted living, residential care, and congregate housing.

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New Jersey

Approach

Assisted living residences are licensed by the Department of Health and Senior Services, Division of Long Term Care Systems. The licensing agency conducts an annual resident profile survey that records admission and discharge, sex, age, residential setting prior to admission and after discharge, reason for admission, and information about ADLs, medications, and cognitive status. New Jersey sponsors an annual "Assisted Living Quality Initiative Best Practices Program." In 2005, the program focused on the dining experience and the role of resident feedback in enhancing dining services. Three awards were made based on facility size: small (under 50 residents), medium (50-99 residents), and large (100 and over residents).

Consumer involvement and feedback were important aspects of the decisionmaking process. Applicants were asked the following questions:

  • How does the facility communicate with residents and families with respect to dining services?
  • How often does this communication take place?
  • What kind of materials does the facility use?
  • Which staff members are involved?
  • How does the facility collect and process feedback from residents and families?

The request also sought information about the goals that were established by the assisted living community related to dining services and how the staff enhanced socialization in dining services in the community. The dining experience was addressed by asking facilities to describe any specialty dining provided (e.g., private dining, ethnic foods, barbeques, elegant dining, etc.) and any additional techniques that were used (e.g., decorations, flowers, music, candles, aromas, etc).

Evaluation was also an important part of the competition. Facilities were asked to describe how their community evaluated the effectiveness of their dining services program and what criteria were used to measure success, such as resident and/or family satisfaction surveys. Applicants were asked to provide examples of how the community's approach to dining services made a difference in terms of quality of care and quality of life for the residents.

Winners received a plaque from the licensing agency at the State's annual fall conference for providers. Each winning facility presented their program and involved the chef in the presentation.

Communicating with Consumers

The Department has extensive information on assisted living for consumers and providers. The information is easily accessed from several Web pages. The Department's Web site has a multipurpose program and services drop-down menu. A click on "long-term care" leads to the Division of Long Term Care Systems Web page. Following links to assisted living, there is a searchable database of all licensed facilities (including nursing homes, assisted living residences, comprehensive personal care homes, adult day care, alternate family care, and child day care).

Facilities may be searched by county, source of payment (private pay, Medicaid, and Medicare), and also for specialized care (behavioral management program, hemodialysis, peritoneal dialysis, and ventilator beds). The facility's name, address, phone number, capacity, and funding (private pay, Medicaid) are reported. The Web site posted best practices that were awarded in 2004 for in-service training and managing transitions. A comprehensive "Assisted Living in New Jersey: Guide for Choosing" checklist includes a series of questions to help consumers. Regulations, regulatory requirements, and medication aide training requirements are accessed through the regulations link and the facility and personnel licensure/certification link.

Consumers can also access information about assisted living on the program and services drop-down menu that lists Aging and Community Services. This Web page offers information about assisted living through links to the Community Choices and the Office of Community Programs. The Community Choice button gives consumers a link to multiple housing alternatives: assisted living, adult family care, residential health care facilities, congregate housing services program, and other subsidized housing options.

The assisted living link leads to a description of three types of assisted living settings: assisted living residence, comprehensive personal care homes, and assisted living programs, including the services provided, staffing, costs, and links to local organizations for lists of facilities. The housing alternatives page also has a link to a facility checklist page that has a series of useful questions that are similar to the checklist available on the Division of Long Term Care System Web page.

The Office of Community Programs site has a link to information about coverage of assisted living under the Medicaid waiver and lists of assisted living providers.


a  Assessment of the Massachusetts assisted living facility regulations and oversight model: report of findings and recommendations. Policy Studies, Inc., January 5, 2005.

Page last reviewed September 2006
Internet Citation: Section III. State Summaries (continued): Residential Care and Assisted Living. September 2006. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/residentcare/rescare7.html