Dave Cohen, Chair of Stark & Stark’s Nursing Home Litigation Group, authored the article, Nursing Homes and Assisted Living Facilities: Understanding the Differences and Keeping Your Loved Ones Safe, for the January 20, 2010 edition of US 1 Newspaper. You can read the full article below:

As a trial attorney for over twenty years and a litigator who has devoted his entire career to protecting the rights and safety of the elderly, I have seen a disturbing trend in recent years in the interplay of nursing homes and assisted living facilities.  As many are aware, when our loved ones’ health declines, families are faced with critical and emotionally heart wrenching choices.

Traditionally, nursing homes have been the most common choice in working toward obtaining the highest quality of life and safety for seniors who can no longer care for themselves and for whom family members simply do not have the qualifications to fulfill these needs.  More recently, assisted living facilities (ALFs) have been gaining popularity. They fulfill a well needed void in the healthcare continuum and are certainly a welcomed addition to the options available to families. 

However,Assisted living facilities are regulated, but not nearly as much as nursing homes.  The facilities themselves are generally much more attractive and family members tend to feel better about placing parents or spouses in them. However, ALFs generally have fewer nurses and fewer nurses’ aides.  Additionally, they frequently do not have registered nurses on site for significant periods of time.  For seniors with lesser needs and who are otherwise much more independent, this is an excellent environment.  However, the danger is twofold:

In the first instance, while the majority of ALFs are owned and operated by caring, professional and qualified individuals, many are so focused on filling beds that they often will admit those who simply are an improper fit for that level of care.  In my practice, I have seen far too many residents suffer from malnutrition, dehydration, bedsores, fractures and ultimately death based upon a poor fit for a facility which never could or should have let this person through their doors.  The second danger faced by families involves situations where the fit was initially appropriate, but when the resident’s health declines, it becomes dangerous to allow that person not to receive a higher level of care.  Much like poor admission situations, in my practice I have seen many residents needlessly suffer and die because the tough decision to move them into a higher level of care was overlooked by the staff at the ALF.

In the end, the decision to accept or reject the resident should be based upon the individual’s needs and not by profit.  This is the formula by which the vast majority of assisted living facilities operate.  It is those who do not operate in this fashion who create the dangers we speak of.  Families can and should be vigilant about all of these issues.  They should also conduct a significant amount of research into what the particular assisted living facility they are looking into can and cannot do.

Unfortunately, there is not a bright-line rule as to the level of care that assisted living facilities provide.  I have seen an incredibly wide variance between the lower levels of care and the higher levels of care.  At the lower end, there is very little supervision and medical/nursing staff available, while the higher end of care at some of these facilities is nearly indistinguishable from that provided in nursing homes.  Without a clear knowledge as to what these facilities can provide, families are ill advised to take the leap into admitting a loved one.  Every bit as important is monitoring the health and cognitive status of your loved one while living in an assisted living facility to ensure that they remain an appropriate fit.

With vigilance, attention and research, families can and should look toward assisted living facilities to provide the best of care and quality of life for their loved ones – but must do so with caution and their eyes open.