Background Checks, Medication & Caregiving Top State Regulation Changes in 2012

The most common assisted living reform changes reported in 2012 related to background checks, medication, and caregiving, according to the Assisted Living Federation of America (ALFA) State & Regulatory Snapshot.

Unlike nursing homes, the assisted living industry is not federally regulated. Legislation and regulations can vary from state to state, so providers need to be aware of trends as many states actively trying to pass or implement new laws and regulations. The State & Regulatory Snapshot 2012 tracks activity in all 50 states and provides a quarterly report about reform changes in both the legislative and regulatory environments. 

With 733,300 seniors in assisted living communities throughout the U.S., it’s important to monitor activity and try to prevent “reforms” that would negatively impact residents and senior living companies alike, says ALFA.


Connecticut, Idaho, and Utah implemented improved background check criteria for caregiving personnel. Criminal history screenings were common in each state, with Idaho requiring fingerprint-based history checks under legislature SB 1262.

Washington D.C., Maryland, and Michigan experienced regulatory updates that established rules for home health aides, resident spouses, and community staff to administer medications and accept phone orders for residents’ prescriptions. 

Arizona, North Carolina, South Dakota faced regulatory and legislative updates that focused on caregiving. Arizona adapted its state legislature to regard assisted living community manager and caregiver training programs. 


Earlier in 2012, North Carolina passed legislature amendments to Medicaid eligibility requirements. Under these changes, the North Carolina Assisted Living Federation will continue working towards modifying requirements to allow those with Alzheimer’s or related dementia to be served in assisted living communities, reports Alfa.

South Dakota legislature approved one-time spending of $430,157 to assisted living providers and hospice centers. This one-time reimbursement, ALFA notes, is to provide bonus monies to personnel and will be based on the assisted living center’s percentage of Medicaid residents.

The total number of bills introduced to date, ALFA notes, have exceeded 118,000 across all 50 states. The total of bills tracked by ALFA to date stand at 586, and the number of bills enacted so far has reached 169.

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Written by Jason Oliva