Facilities Strive To Put Safety First

In Washington, the state Department of Health licenses facilities categorized as boarding homes - a technical description fitting many assisted living residences.

But if the facility contracts with the state to accept individuals receiving Medicaid, the state Department of Social and Health Services also plays a role in overseeing services that residents receive.

In Idaho, the state Department of Health and Welfare is responsible for monitoring these facilities.

Licensing involves a long checklist of inspection points aimed at ensuring the health and safety of residents. Those range from the soundness of the structure to sanitary conditions.

In Washington, comprehensive follow-up inspections are supposed to be conducted annually.

In Idaho, there isn’t a formal timetable for follow-ups. But checking back on facilities where there have been complaints is a high priority, says a state official in Boise.

In Washington, employees of an assisted living facility who do not have health-care practitioner credentials, such as a nursing license, are required to have training in CPR, first-aid and HIV/AIDS procedures. Criminal history background checks are required.

The rules are somewhat similar in Idaho, though only the facility’s owner and administrator must undergo criminal background checks.

Requirements for the presence of on-site nurses are determined by the physical limitations and needs of a specific facility’s resident population.

That’s partly a judgment call. Expectations for the facility’s exact staffing profiles aren’t always spelled out by the states. The wording of some regulations simply directs that the staffing be adequate to provide necessary care and services.

In other matters, such as the issue of who may handle residents’ medications, the rules are specific.

Some assisted living facilities display a stamp of approval from the Continuing Care Accreditation Commission, a branch of the American Association of Homes and Services for the Aging.

“We look at the community as a whole,” says Laurie Hall, spokeswoman for the commission, based in Washington, D.C.

Backgrounds and capabilities of caregiving staffs vary from place to place, industry observers say. Salaries for nonprofessional employees tend to be low.

Many certified nursing assistants, who do much of the work in many assisted living communities, get paid not much more than minimum wage.

That doesn’t mean they are not responsible and dedicated workers. But it does suggest implications for long-term job satisfaction.

Jeff Crollard, a Seattle attorney who wrote a report for the Washington State Long-Term Care Ombudsman Program dealing in part with regulation of assisted living communities, says staff turnover at some facilities is a nagging problem. He says it is so high at some places that many employees don’t stay long enough to complete what he refers to as “minimal” training requirements.

, DataTimes ILLUSTRATION: Graphic: Daily living needs