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Jonathan Rosenfeld

March 15, 2021

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Many families face the undesirable decision to place a loved one in a caregiving facility to ensure they receive the assistance they require in a safe environment.

However, choosing the best place can be challenging, as is knowing if the facility has faced ongoing citations and violations from inspectors and formal complaints.

Understanding what agency regulates an assisted living facility is crucial before placing a loved one under their care.

Is your loved one the victim of caregiving negligence that left them with injuries and damages?

The Chicago, IL personal injury attorneys at Rosenfeld Injury Lawyers, LLC have years of experience helping the injured maximize their compensation.

Discuss your medical negligence claim with a Chicago residential care injury attorney who will protect your rights and obtain the compensation you deserve.

How are assisted living facilities regulated?

Assisted Living Facilities Are Regulated by Federal and State Regulations

Assisted Living Regulations

Aging senior citizens, people with disabilities, and those rehabilitating from a surgical procedure have numerous caregiving options in their local community.

Initially, families will likely read reviews and perform online searches of assisted living facilities, nursing homes, group homes, and senior communities.

Typically, more than one governmental agency is in charge of regulating a caregiving home. The Centers for Medicare and Medicaid Services (CMS) regulates nursing homes nationwide through routine inspections and unannounced investigations year-round.

In 2008, CMS launched its online Nursing Home Compare website providing a continually updated report card of every nursing facility statewide. The website uses a five-star rating system on every Medicare-certified nursing home.

While the website provides valuable resources on comparing nursing facilities throughout the community, Medicare does not evaluate any senior housing units or assisted living communities they do not fund.

Instead, agencies other than the Centers for Medicare and Medicaid Services (CMS) regulate senior housing at both the state and federal levels.

Some sites, including the American Health Care Association and the National Center for Assisted Living, provide a state regulatory review of each facility within the United States.

Nursing Home Reform Act of 1987

In 1987, the U.S. Congress passed the Nursing Home Reform Act following a lengthy study revealing that nursing center residents had been abused, neglected, mistreated, and provided inadequate care.

The Law enacted sweeping reforms, rules, and requirements under the Omnibus Budget Reconciliation Act of 1987, ensuring skilled nursing residents could receive the best care while maintaining or achieving the “highest practicable” physical, psychosocial, and mental well-being.

Additionally, the Act established a Residents’ Bill of Rights where Medicare pays for most of the resident’s care. The Law also changed Medicare’s survey, licensing, and certification process at all licensed facilities.

The Law states that at least once every fifteen months, the nursing facility will undergo scheduled surveys, unannounced investigations, and resident interviews at irregular intervals to identify any citation or violation of federal and state rules and regulations.

The laws were enacted to improve every resident’s quality of care through state monitoring, correction plans, Medicare/Medicaid payment denials, stripped licensing, and civil monetary penalties.

Assisted Living Communities

Millions of older adults live in assisted living communities throughout the United States, receiving help with daily necessities. These locations provide medical monitoring, medication maintenance, and interactive social activities.

Most assisted living communities differ from nursing homes that provide around-the-clock skilled nursing care.

Instead, older Americans retain much of their independence by residing in senior housing units while relieving much of the stress of maintaining a household.

Additionally, an assisted living community provides ongoing social interaction in a safe environment, managed by staff that provides freshly prepared meals daily served at the facility’s dining room or in the resident’s apartment.

Staff Handles All Necessities

Older adults, people with disabilities, and rehabilitating patients living at the family’s residence are often challenged getting groceries, preparing meals, taking medicine, and driving to and from doctors’ offices.

Alternatively, an assisted living community handles all the necessities, including household maintenance, housekeeping, I.T. support, and security.

On-Site Health Care Services

Many assisted living communities, senior housing units, and group caregiving units provide on-site medical care, prescription refills, drug management, and physical therapies.

Typically, the outdoor spaces and fitness centers are designed for Senior living, reducing exposure to the community.

State and federal government agencies typically regulate the on-site wellness services through unannounced inspections and scheduled surveys.

In recent years, assisted living communities have had to enforce strict infection control procedures by heavily sanitizing common areas, including the dining rooms, hallways, elevators, lobbies, and public bathrooms, to eliminate the spread of Covid-19.

Assisted Living Facility Regulations FAQs

Our law firm understands you likely have many unanswered questions about how to hold an assisted living community financially accountable for the harm they did to your loved one.

Our legal team has answered the questions below regarding negligence and abuse.

Contact us at (888) 424-5757 today for more information on how assisted living communities are regulated based on rules, regulations, and standards.

Are Assisted Living Facilities Federally Regulated?

Due to federal funding, including Medicare and Medicaid, the federal government regulates memory care facilities, long-term care centers, residential care homes, and skilled nursing facilities.

Alternatively, the state regulates senior housing units and assisted living communities through rules, procedures, protocols, scheduled surveys, and unannounced visits.

Any violation could result in monetary fines or other severe penalties.

What Agency Regulates an Assisted Living Facility?

One or more state regulatory agencies regulate assisted living communities that are different between states. Numerous online sites provide vital information on who to contact if you suspect a violation has harmed or could harm a resident.

Check the American Health Care Association, the National Center for Assisted Living websites, and the U.S. Department of Health and Human Services website on state surveys.

Does CMS Regulate Assisted Living Facilities?

The Centers for Medicare and Medicaid Services (CMS) regulates skilled nursing facilities and rehabilitation homes that receive funds from Medicaid or Medicare. One or more state agencies regulate assisted living throughout the United States.

Regulating the senior living unit usually includes scheduled surveys and unannounced visits by inspectors investigating formal complaints.

Does an Assisted Living Facility Have To Report Falls?

Like residential care, long-term care, and assisted living facilities (ALFs) in every state, all businesses must provide a safe environment for every resident, visitor, invitee, vendor, or employee on-site under state civil tort premises laws.

Additionally, each ALF usually has a services contract with their residents that provide supervision and monitoring in common areas and possibly within the resident’s apartment.

Every fall must be reported promptly to the appropriate authorities to ensure no additional harm to the fallen resident. Any failure to report a fall according to assisted living regulations could result in a monetary citation or a more severe penalty.

As part of the licensed assisted living community’s services, all staff members must receive adequate training to prevent falls that may occur through negligence or lack of supervision.

How Do You Prevent Falls in Assisted-Living Facilities?

According to the National Council on Aging, 25% of the elderly fall every year, resulting in more than 30,000 preventable deaths. Employees must focus and commit to an ongoing process to prevent falls for assisted living facility management.

Environmental factors in assisted living may contribute to a resident falling. These factors include low lighting, slippery floors, cluttered areas, tripping hazards like unlevel surfaces, oxygen tubing, and slippery sidewalks.

When Should Someone Move into Assisted Living?

Any aging adult, rehabilitating patient, or disabled requiring daily caregiving should consider moving into an assisted living facility.

Typically, adult children recognize that providing care to an aging parent or grandparent has become untenable when their loved one is less capable of taking care of themselves or becoming needier in the assistance they need.

At some point, accidents, including falling, occur more frequently than before. An individual suffering from a chronic condition could be slower to recover from an injury, where even the most fundamental personal care task becomes challenging or impossible.

Those with memory loss or neglecting their financial obligations and paying bills often indicate it is time for outside help. Assisted living residents typically eat healthier meals, live in a cleaner household environment, and have access to social companionship often unavailable in the household.

Hiring an Assisted Living Facility Attorney to File a Formal Complaint or Resolve a Compensation Case

Has caregiving negligence harmed you? Contact our medical malpractice attorneys to schedule a free consultation to discuss your legal options.

Illinois assisted living injury attorneys at Rosenfeld Injury Lawyers LLC can determine your case’s merits to proceed with a personal injury claim. Our medical malpractice attorney will never charge a fee unless we can secure a financial award for you in your case.

Any family that lost a loved one from a preventable death can file a wrongful death lawsuit to recover all damages, including medical expenses, lost wages, lost future earnings, loss of companionship, funeral/burial costs, pain, and suffering.

All information you and your loved ones share with our experienced Chicago injury attorneys remains confidential through an attorney-client relationship.

Our practice areas include motor vehicle crashes, work-related accidents, premises liability, medical malpractice, nursing center abuse, product liability, and wrongful death.

Our law office currently represents injured clients throughout Illinois in Cook County, DuPage County, Lake County, Peoria County, Sangamon County, Will County, Winnebago County, Aurora, Chicago, Joliet, Schaumburg, and Waukegan.


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