Assisted Living Providers Face Uphill Battle to Educate State Regulators

The assisted living concept has been around for roughly 25 years, but there’s still a struggle to educate policy makers and regulators at the state level about the industry, according to panelists at the Assisted Living Federation of America’s annual event held last week in Dallas, Tex.

“The biggest barrier is a lack of understanding of the model,” said Ginger Lynch Landy, of Hodes & Landy—ALFA’s legal representation in New York.

Through ALFA’s New York chapter, the group was able to craft what many on the panel hoped could be the template that other states could adopt. Getting the states on board with the assisted living concept can take time, but recent efforts have shown it’s possible.


Consulting With Other Groups for Policy Development

After an almost decade-long campaign to work with regulators and legislators in New York, Landy said the association is consulting with several of the states’ working groups, such as the Medicaid redesign team, affordable housing work groups, the paperwork reduction group, and the adult care facilities and assisted living residences task force.

“Through groups like these, providers have a voice at the table when decisions are being made regarding resident care,” said Landy. “It has all been very positive and allows us to help develop the policies, not just react to them [when they’re negative].”


Getting to this point with the state hasn’t been easy; rather, it’s been time-consuming. 

“We’ve come a long way in the last eight or nine years,” said Landy. “It’s like a marriage: you have to keep at it and stay with it.”

Emphasizing Assisted Living’s Value

Regulators and lawmakers need to understand how important assisted living can be to the state. 

“Developing the credibility with the regulators, so they know there is nothing to hide,” she said. “Make the fiscal argument and show how we bring value to the state by bringing jobs and development.” 

It’s also a great option for the consumers, who on average will spend less money paying for assisted living compared to a skilled nursing setting. A study from Genworth Financial found the national median monthly rate for assisted living was $3,300, and roughly $6,000 for skilled nursing in a semi-private room. 

Stephanie Handelson, Benchmark Senior Living’s Chief Operating Officer, added that much of it has to do with education about what “aging in place” means and how assisted living can help to provide that type of care. 

“It was interesting to see how much they really didn’t understand assisted living [in New York],” she said. “At the end of the day, because of the persistence and tenacity [of everyone involved], that the regulations went through with the right outcome.” 

Dealing With Regulatory Challenges

Despite promising advances in New York, groups representing the nursing home industry in states like South Carolina and Rhode Island are challenging assisted living operators.

“Rhode Island is a very difficult place to do business, [in part because there is] a very strong nursing home lobby,” said Handelson.

Calling the state’s regulations antiquated, it’s forcing the providers to be more of a one-size-fits-all approach, which doesn’t work for residents, she said.

South Carolina is similar to Rhode Island in that they’re dealing with strong nursing home lobby groups that are fighting to preserve their businesses. 

“Our regulators are not going to fight against the skilled nursing associations,” said Laura Williams, executive Director of the South Carolina ALFA chapter. “[Assisted living providers] are the new kids on the block, we’re not the big guys yet.”

Written by John Yedinak

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