We support educational programs and research to find more affordable options for older adults who want to reside in senior living communities.

The Challenge: Symposium participants expressed great concern that assisted living is not affordable for many older Americans and likely to be even less accessible in future years, given continued shortfalls in state funding in all areas of long term care, and particularly home and community-based services

Participants noted that Medicaid funding for assisted living is not even available in many states and where it is available, residents face long waiting lists and little or no assistance for room and board.

Participants expressed a strong desire to see assisted living put on the same reimbursement footing as nursing homes, including mandatory coverage, inclusion of room and board costs, and payment commensurate with service costs.

Stakeholders’ observations are supported by recent research conducted by the National Center for Assisted Living. The study notes that the assisted living workforce is a “vital part of providing quality, person-centered care to assisted living residents,” and observes that the findings from the survey “indicate that many assisted living job positions experience a high level of turnover, including direct resident care positions.” The survey found that certified nurse assistant turnover was, on average, 33%, and non-certified resident caregivers’ turnover rate was 27%.

The Opportunity For Center for Excellence in Assisted Living:

Symposium participants recommended that effective training and toolkits should be identified or developed for all levels of assisted living staff, as well as protocols to assure that competencies are consistently maintained. Participants noted a need for a strong focus on training in all areas, including:

Medicaid entitlement and reimbursement creates opportunity through Accountable Care Organizations (ACOs) and Managed Care Organizations (MCOs), but gaps still remain where assisted living can create innovative models to fill the need for affordable senior living (e.g., assisted living without walls).

To address rising costs and increasing demand, affordable assisted living models should be developed beyond the use of government funding, through strategic partnerships with key stakeholders that could accommodate needs across the socioeconomic spectrum. Finally, consumer education is needed to increase the realization that Medicare does not cover non-skilled, long-term care provided in any setting.