Guest Blog: Assisted Living, The New Nursing Home?
The following is a guest blog from Anthony Cirillo:
Fresh back from the American Health Care Association conference in Long Beach, California, I was struck by the increasing blur between skilled nursing facilities and assisted living facilities. Sessions were devoted to converting nursing home beds to assisted living beds; preparing for higher acuity levels in assisted living; and reviewing Medicaid waivers so that more assisted living facilities could house what were nursing home patients.
One person said it best, paraphrasing: "The assisted living facility is the nursing home of the past and the nursing home is taking the place of many hospital provided services."
In fact, in one session devoted exclusively to assisted living, the speakers were regaling the audience with all of the ancillary services that they offered - wound care, hospice, rehabilitation. So I thought assisted living is competing with both hospitals and nursing homes.
Of course much of this flux is being caused by health care reform and the uncertainty that surrounds it. And one message is always clear: follow the money.
I think it comes down to two things for providers. You need to act now to shape your destiny or face being gobbled up by others. And you need to take a soul-searching look at the type of care that you provide.
It is easy to put my business hat on and encourage assisted living operators to offer as many services as possible to drive revenue and become more attractive to residents and families. And that drives other business in the aging continuum - particularly home health, which is providing more and more services inside the assisted living facility. Equally I would encourage nursing homes to continue to pursue rehabilitation and the better payer mix from private payers and Medicare.
But then I put my consumer hat on and ask ‘what is best for my 89-year-old mother Philomena?' Because I have to tell you that at some of the presentations, it was implied in looks and unspoken words that the assisted living industry was at times skirting some of the letter of the law.
See I fear that there will be people caught in the crossfire. In the haste of the nursing home industry's race to fill the rehabilitation gap, I fear they will welcome the opportunity to put what were appropriate residents of their facility into assisted living. And while some assisted living facilities are equipped to handle nursing home type patients (and in fact to obtain a Medicaid waiver you the resident must be nursing home eligible) I believe that others are housing those in need of skilled nursing care without the proper ability to care for them.
So my advice is lead with your heart and a strong morale conviction and let that guide your decisions. If assisted living truly is becoming the nursing home of the past then expect further scrutiny and regulation. So be smart. Police yourself and demand the highest standards of care in your organization so that you can rightly seek and care for higher acuity patients who want the medical care and the amenities and home-like atmosphere that assisted living offers.
Anthony Cirillo, FACHE, ABC is a speaker, health care consultant, senior advocate and blogger. He consults with long-term care facilities and is available for management retreats and association keynotes. He is the author of "Who Moved My Dentures?" His company, Fast Forward Consulting empowers organizations to change the healthcare experience and leverage it in their marketing. Read more at www.4wardfast.com and www.anthonycirillo.com.