Additional State Oversight Needed to Improve Hospice Care for Assisted Living Population

Assisted living has become a more popular residential selection for elderly individuals who need help performing daily living tasks. Regulations that apply to these populations, however, vary between states. Meanwhile, little study has been performed on care outcomes.

New studies evaluated end-of-life care provided at assisted living facilities. These studies determined that in states with less restrictive regulations, people who reside at assisted living facilities are less likely to pass away at hospice or home. This stands as an important gauge of the quality of care provided by assisted living facilities.

The Role of Assisted Living Communities

Assisted living communities are a type of residential long-term care and were established for people who require personal and supportive care. Assisted living has become much more popular with the elderly because many people feel that these facilities help the elderly keep their independence. These communities have also gained favor with policymakers because they are a less costly alternative to nursing facilities. While nursing homes are highly regulated by both the federal and state government, issues like minimum staffing levels and oversight for assisted living populations can vary greatly based on where a person resides.

The Value of the New Research

This new research considers end-of-life care for over 100,000 residents at more than 15,000 assisted living facilities who passed away between 2018 to 2019. The research considers specifically whether the elderly passed away at home while receiving hospice care or after transfer to either a hospital or nursing home. The study ultimately determined that 60 percent of people who received Medicare fee-services and resided at assisted living facilities passed away at home, while over 84 percent of these individuals received hospice care. The chance of passing away at home was substantially lower by combined Medicare-Medicaid service. The percentage of how many people passed away at home was not influenced by ethnicity or race, which suggests that Medicare-Medicaid residents of these facilities might have worse access to top-tier end-of-life care.

Notably, the study determined that black people were substantially less likely to be part of hospice before they passed away. Several previous examinations, however, have determined that black families are inclined to advocate for aggressive care at the end of life, which is indicative of the population’s mistrust of the medical system. People who lived at assisted living facilities were also less inclined to pass away at home or with home hospice care in states that had fewer regulations involving assisted living communities when compared to other states.

The Conclusion of the Study

The scholars who performed the study concluded that these results should influence attempts to make sure that more equitable access to end-of-life care exists. These experts also hope that the study will suggest a critical role for state-based regulations of the communities.


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