Assisted Living Regulations Change in 20 States, Infection Control Now the Norm 

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Infection control protocols and emergency preparedness requirements are now commonplace in the U.S. as 20 states enacted regulation changes and updates for assisted living operators in the last year.

That’s according to the latest annual “Assisted Living Regulatory Review” report from the National Center for Assisted Living, released Jan. 10.

The report this year tracked three new categories – infection control requirements, emergency preparedness requirements and quality requirements – and found the majority of states enacted regulations related to them. Inclusion of infection control and emergency preparedness regulatory requirements, which 86% and 90% of states have in place respectively. 

Among the 50 U.S. states, 44 (86%) have set some infection control requirements in place, while 45 states and the District of Columbia (90%) have enacted emergency preparedness requirements. Just under a half of states (47%) have quality measurement, data collection or quality management requirements.

The new categories were added for this year’s report to understand how assisted living providers protect residents in preparation for future public health emergencies, according to Jill Schewe, NCAL director of policy and regulatory affairs and the report’s author.

“States are making changes as they determine how to best serve their specific resident populations in the years ahead, and we anticipate this trend will continue,” Schewe said in a press release.

Among the states that saw updates includes Arizona, which in 2023 passed a law modifying training requirements for assisted living to be consistent with in-home direct care workers.

Another example includes Colorado, which had a change regarding Medicaid reimbursement that allows eligible facilities to receive reduced licensing fees if 35% or more of licensed beds are occupied by Medicaid enrollees for at least nine months in a fiscal year.

The full list detailing all regulation changes was released by NCAL on Jan. 10.

The report notes with the exception of some labor laws and regulations that apply from the federal level, such as the Fair Labor Standards Act and OSHA, states are largely in charge of regulation for assisted living communities.

“Assisted living providers are dedicated to delivering high quality care to their residents every day, and state oversight and support helps them achieve this,” LaShuan Bethea, NCAL executive director, said in the release. “NCAL supports ongoing collaborative efforts between these providers, state regulators and all stakeholders to ensure accountability while encouraging innovation all in an effort to honor residents’ unique needs and desires.”   

Recently, The Washington Post released a series of articles in December that have raised some questions regarding the possible need for increased regulation in U.S. states across the country.On the whole, industry stakeholders have pushed back against regulatory scrutiny in recent years, at least on the federal level where a “one-size-fits-all” would be difficult to implement, they say.
NCAL itself has noted that additional federal regulations “would limit residents’ independence and autonomy, as well as the ability to customize care for the individual.”

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