Who is “Assisting” at Assisted Living Facilities in Ohio and… Is It Enough?

If your neighborhood looks like mine, there are shiny new buildings going up on what seems like every corner. Looking behind the bricks and mortar, is this a good fit for your loved ones? Assisting living facilities in Ohio and around the country are an increasingly popular alternative to the traditional nursing home. But is this trend good for our seniors? Are they staffed with enough well-trained personnel?

A senior at an assisted living facility

What is an assisted living facility?

Per the National Institute on Aging, an assisted living facility “is for people who need help with daily care, but not as much help as a nursing home provides… Assisted living residents usually live in their own apartments or rooms and share common areas.” More apartment-like, assisted living facilities can serve as a middle ground between home care services and nursing facilities.

Services provided may vary, but assisted living/senior care facilities often provide:

  • Meals and dining services
  • 24-hour onside staffing
  • Onsite nurse/health clinic
  • Housekeeping, maintenance, and laundry
  • Transportation
  • Fitness options and social activities

There are often various levels of service provided at assisted living facilities, with some residents paying extra for personal care (help with daily living tasks), and nursing care (such as medication management). Some senior living facilities also offer separate wings, floors or “neighborhoods,” for residents suffering from dementia, Parkinson’s, or other conditions requiring additional care.

What is a nursing home or skilled nursing facility?

Nursing homes, also called skilled nursing facilities, are for individuals who require 24-hour supervision and more medical and nursing care than those in assisted living facilities. People may come for short-term, post-hospital rehabilitative stays, while others may have chronic medical conditions that require permanent residency. More hospital-like in nature, nursing homes offer assistance with daily living tasks and may also offer palliative care, mobility assistance, nutritional services, and. speech, occupational, physical, respiratory and occupational therapy.

What are the differences between assisted living facilities and nursing homes?

  • Regulations. Nursing homes are governed by extensive federal and state regulations which were put in place to guarantee a certain level of care for residents . Assisted living facilities are NOT governed by federal regulations and minimal state regulations. This is a significant and important difference.
  • Cost. Nursing homes often cost twice as much as assisted living facilities. The cost for assisted living facilities is usually paid primarily out of pocket or via long-term care insurance policies, with some financing options available.
  • Level of care. For those needing 24-hour, significant nursing care, assistance with daily living and monitoring, nursing homes may fit the bill. For those looking for more general custodial care and a more active, social lifestyle, assisted living is probably better suited.

There are many considerations when selecting the right assisted living or nursing home facility in Ohio. The Long-Term Care Consumer Guide is an online tool that can help you find and compare nursing and residential care facilities, including assisted living, in Ohio.

Why choose an assisted living facility?

More active seniors looking for a balance between independence and assistance may be attracted to assisted living facilities. With more of an emphasis on socialization, recreation and wellness, assisted living facilities offer a more home-like environment. They are also less expensive than nursing homes.

Assisted living facilities are primarily regulated at the state level, requiring additional due diligence during the evaluation and selection process.

Explosive forecasted growth

Per the National Center for Assisted Living, 28,900 assisted living facilities nationwide have nearly 1 million beds. Seniorliving.org shares that Ohio is home to more than 1,140 assisted living facilities, with “the most affordable facilities located around the Mansfield area, while the more expensive ones found in the Cleveland – Elyria metropolitan area.”

Axis Health examined the Boomers’ Healthcare Crisis, claiming that the “U.S. is not well-equipped to handle the largest generation of elderly adults in human history… That’s because of an already strained long-term care industry, fewer caregivers to assist with their needs and a world that just isn’t designed for them.”

With the population of people 65 and older expected to nearly double from 51 million people in 2017 to 95 million by 2060 and a loosely regulated, already strained caregiver workforce, system reforms are imperative.

Who works at Ohio assisted living facilities?

Ohio regulations merely state the following as staff requirements for assisted living facilities.

A residential care facility providing services… shall have staff on-site twenty-four hours each day who are able to do all of the following:

  • Meet the scheduled and unpredicted needs of the individuals enrolled in the assisted living program in a manner that promotes the individuals’ dignity and independence;
  • Provide supervision services for those individuals;
  • Help keep the individuals safe and secure.

There are not required staffing ratios and little training is required. These regulations leave a lot up to interpretation, the implementation of which can negatively impact quality care for the residents and working conditions of the caregivers.

In her report, “Understaffed and Overworked: Poor Working Conditions and Quality of Care in Residential Care Facilities for the Elderly”, Hina Shah of the Coalition for a Fair and Equitable Caregiving Industry highlighted recommended changes needed, including:

  • mandated staffing ratios
  • inspections and enforcement
  • licensing, including mandatory wage and hour compliance training

The  Ohio Fast Facts State Profile for Assisted Living reports that 57% of Ohio assisted living residents are over the age 85 and 44% have Alzheimer’s or other form of dementia. Their daily living needs include help with bathing, walking, dressing, toileting, bed transfers, and eating. These residents need a well-trained caregiving staff of sufficient size to keep the residents safe and cared for.

What working conditions need to be changed for caregivers?

Ms. Shah’s report highlights some of the challenges of assisted living caregivers.

  • Caregivers are understaffed and overworked. Live-in caregivers do not get sufficient sleep because many work in 24-hour shifts.
  • There is a lack of dignity and care. The work is physically demanding, and many caregivers succumb to chronic stress, anxiety, loneliness and/or other mental health problems. Grief counseling when dealing with the death of the resident is rarely provided, if at all.
  • Wage theft. When caregivers are required to work around the clock for a flat rate, many times the hours worked calculates to less than minimum wage.
  • Caregivers are misclassified as independent contractors.

Questions to ask when researching Ohio assisted living facilities

The AARP has put together a helpful checklist for use when researching and visiting assisted living facilities. Per their suggestion, it’s best to visit multiple times at different times of the day and week.

Also, before signing a contract, it can be helpful to have a financial advisor and elder care lawyer review the document.

What about assisted living facilities in Ohio?

The challenge, and in some cultures, the privilege, of caring for seniors is something most everyone will face in their lifetime. So how safe are Ohio’s assisted living and skilled care centers? According to the 2020 National Ombudsman Reporting System (NORS) Data Brief, 19,201 (12.5%) of approximately 153,324 complaints reported to Ombudsman programs involved abuse, gross neglect, or exploitation.

It has been my experience that most cases of neglect happen as a result of not enough staff and/or inadequately trained staff, so these proposed changes can only improve care for our seniors. The real issue at hand is whether necessary changes can be enacted in the face of a resistant long-term care industry.

Reports like these are scary both for seniors and their loved ones trying to make difficult placement decisions. But being aware that good, safe care in assisted living facilities is dependent on well-trained and sufficient numbers of staff will give you questions to ask when investigating assisted living facilities.

As a Negligence Lawyer in Ohio, I Seek Answers, Compensation, and Justice on Behalf of Residents and Their Families.

For more than 30 years, I and my firm have been supporting residents and families with assisted living and nursing home matters throughout Ohio and would be pleased to speak with you about your concerns.

I invite you to call me for a free consultation to learn about your rights, the rights of your loved one, and the options available for seeking justice. As an assisted living law firm, we accept cases on a contingency fee basis. There is no fee for our firm unless compensation is recovered.

Please Call Our Firm Today for a Free Consultation with Nancy Iler, Assisted Living Lawyer, to Learn About Your Options

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