For decades, Minnesota families seeking senior living arrangements for their elderly loved ones have found themselves casting about in an informational void.
But a proposal by the Minnesota Department of Human Services would create the state’s first standardized system for measuring the quality of assisted-living homes — a fast-growing but lightly regulated industry that now serves more than 50,000 Minnesotans in nearly 1,200 facilities.
The proposal would create an online “report card” that would allow people to compare assisted-living facilities based on quality of life, safety and other measures. It would be modeled after an existing report card developed more than a decade ago for nursing homes.
More Minnesotans now live in assisted-living homes than in nursing facilities, but assisted living has largely avoided the same level of regulatory scrutiny.
“You can find more information on a household appliance like a washing machine than on assisted-living homes, and assisted living is a helluva lot more important than washing machines,” said Robert Kane, chair of long-term care and aging at the University of Minnesota’s School of Public Health, who helped craft Minnesota’s nursing home report card. Kane called the new plan “long overdue.”
The proposal comes amid rising concerns about the safety of older Minnesotans in senior homes across the state. The state Department of Health disclosed last week that it has fallen dangerously behind in its investigations of abuse and neglect at state-licensed health facilities, including assisted-living homes, since the state launched a centralized abuse reporting hot line.
Thousands of allegations of harm, including physical abuse by staff, thefts and drug diversions, are not being investigated because the agency lacks the staff to pursue them. Even when the state opens an investigation, families often have to wait six months or longer for a resolution, officials said.
However, information on the safety of assisted-living facilities is notoriously difficult to locate. The Department of Health posts the most recent state surveys of assisted-living facilities on its website. But the surveys are conducted only once every three years and are narrow in scope, focusing on whether facilities comply with basic state and federal rules rather than quality-of-life measures. By contrast, families can find a raft of safety violations and other information on nursing homes through Nursing Home Compare, Medicare’s online ranking tool.
When assisted living first gained popularity in the 1980s, the facilities were thought to need less regulation because their residents typically were younger and required less care than people in nursing homes. Over the years, however, the distinctions have blurred. Assisted-living centers have expanded in size and have opened specialized “memory care” units for people with dementia, housing that resembles skilled nursing homes. Meanwhile, the nursing home population has shrunk dramatically, driven by state and federal efforts to deinstitutionalize care for the elderly. As of 2015, there were 30,700 nursing home beds in Minnesota, compared with 54,000 assisted-living beds.
“The marketplace has really shifted toward assisted living,” said assistant DHS Commissioner Loren Colman. “It’s been growing and we need to pay more attention.”
Under the DHS proposal, the assisted-living report card would include measures from existing data sources, such as state health inspections, as well as information gathered through biennial consumer surveys. DHS estimates that roughly 37,000 people would be surveyed every two years, and the surveys would be funded through fees paid by assisted-living providers. The online report card tool would not be ready until 2020.