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Proposed licensure changes would increase costs for assisted living providers

Close-up Of A Person's Hand Stamping With Approved Stamp On Document At Desk
Close-up Of A Person's Hand Stamping With Approved Stamp On Document At Desk
(Credit: boonchai wedmakawand / Getty Images)

New Jersey’s proposed switch from one set of licensure standards for assisted living communities and personal care homes to another may or may not bode well for providers, but one thing is certain — it’s going to cost more.

The New Jersey Department of Health has proposed amending the licensure standards for assisted living residences / assisted living facilities / comprehensive personal care homes. The proposal recommends replacing the state’s Advanced Standing program with a “deemed status” program — both voluntary programs.

Advanced Standing recognized assisted living providers that complied with all state, federal and local regulations pertaining to New Jersey requirements. Those locations also met benchmarks for certain quality indicators established by the Health Care Association of New Jersey Foundation.

The deemed status program would establish a procedure for locations to apply for such a status, which indicates that a location is accredited by a third-party organization, such as The Joint Commission or CARF (formerly the Commission on Accreditation of Rehabilitation Facilities), and then it would not need to undergo periodic routine inspections by the state.

The state is accepting comments on the proposal until May 31, although the state ended the Advanced Standing program last year. And although the regulations are proposed, provider groups said that the state has indicated that the program itself is coming.

HCANJ President and CEO Andrew Aronson told McKnight’s Senior Living that the Advanced Standing program was a “fantastic” program for helping to develop quality assisted living providers in the state, adding that it provided not only quality monitoring and clinical support, but also regulatory compliance monitoring — something missing from the accreditation programs. 

Although he said he doesn’t see the deemed status program as bad for the industry, he said it remains to be seen how many providers would participate; 150 of the state’s 250 assisted living providers in New Jersey previously participated in the Advanced Standing program.

Senior living provider organizations said that it’s too early to tell whether the proposed change would benefit assisted living providers, but they said it definitely would cost providers more to pursue accreditation than through the former Advanced Standing program.  

Advanced Standing costs providers $3,500 annually, whereas the cost for a three-year assisted living accreditation from The Joint Commission is $15,000, according to LeadingAge New Jersey & Delaware President and CEO James McCracken. On top of the accreditation fee, communities also spend money to change their systems to meet Joint Commission specifications.

“Also, Advanced Standing was a New Jersey program. The staff worked with facilities to improve quality outcomes,” McCracken said, adding that The Joint Commission is headquartered in Illinois. “Many of the members of the Advanced Standing team were retired New Jersey surveyors who know the regulations and could advise facilities.”

Outside expertise

The state health department said that it is proposing the change as it pursues partnerships with agencies that “possess expertise in assessing and evaluating healthcare facilities.” 

“By involving the Joint Commission and other reputable organizations, New Jersey endeavors to ensure that assisted living facilities across the state adhere to stringent quality guidelines and provide optimal care to their residents,” according to a health department presentation. “This collaborative effort emphasizes New Jersey’s commitment to enhancing the well-being and safety of individuals residing in assisted living communities, ultimately fostering a culture of excellence in senior care throughout the state.”

According to state health department officials, those agencies bring several benefits to assisted living settings, including quality assurance, accreditation for meeting or exceeding industry-recognized standards, regulatory compliance, continuous improvement, consumer confidence, professional development and peer benchmarking.

“Overall, deeming agencies play a crucial role in raising the standards of care and promoting accountability within assisted living facilities,” according to the department. “Their involvement helps ensure that residents receive high-quality services and enjoy a safe and supportive environment.”

A location granted full deemed status would forgo required biennial inspections, although the state health department will continue to investigate complaints and conduct inspections prior to initial licensure. 

Accreditation programs

The Joint Commission launched its assisted living community accreditation program in 2021, requiring organizations to track and report on five standardized performance measures: off-label antipsychotic drug use, resident falls, resident preferences and goals of care, advanced care plan/surrogate decision-maker and staff stability. The SelfhelpHome, a nonprofit continuing care retirement community in Chicago, was the first community to achieve the accreditation.

Two years later, The Joint Commission launched the memory care certification program for assisted living communities in collaboration with the Alzheimer’s Association. The Wildwood Senior Living, an Arrow Senior Living Management community in Joplin, MO, was the first community to earn the assisted living memory care certification, awarded for meeting standards to support the delivery of high-quality care for residents in whom Alzheimer’s disease or another dementia has been diagnosed.

The National Center for Assisted Living has its own National Quality Award Program to recognize assisted living organizations that meet certain goals. The program is based on the Baldrige Performance Excellence Framework and has three award levels for commitment to quality, achievement in quality and excellence in quality.

Source: McKnights Seniorliving

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