Industries oppose proposed assisted living regulations

Oct 22 2009

With Pennsylvania just weeks away from the publication of final assisted living regulations, recently-released survey results about the size of living units in existing facilities show the wisdom of the proposed rules -- and the absurdity of the industry's opposition.

The size of the living units has been one of the most contentious issues in the battle over the regulations between consumers and the industry. Existing rules governing facilities that call themselves assisted living only require 80 square feet of living space per person. This is woefully small, equivalent to the federal minimum requirement for a prison cell. Rooms of this size do not provide a home-like environment and are not big enough to ensure comfort and safety for residents who are usually elderly and have disabilities.

The state has proposed setting the minimum requirement at 175 square feet for existing construction and 250 square feet for new construction, excluding bathrooms and closets. The latter number also is the recommended size supported by the Philadelphia Housing Authority and Pennsylvania Housing Finance Agency. But the assisted living industry wants the minimum set at 125 square feet for existing construction and 150 square feet for new construction.

Trade associations argue that facilities cannot currently meet the proposed standards. But the survey results show that many facilities are meeting the standards already.

According to a recent voluntary survey conducted by the state of Pennsylvania, more than 72% (20,801 units out of 28,774 units as reported to the state this Spring) of existing living units already meet (and mostly exceed) the state's proposed 175-square-foot requirement. More than 700 facilities that are currently licensed as personal care homes -- that may or may not call themselves assisted living -- voluntarily participated in this survey. The survey was distributed by the state via e-mail and has been posted on the Pennsylvania Assisted Living Consumer Alliance website at www.paassistedlivingconsumeralliance.org.

These survey results are heartening and strongly support the state's proposal on this topic. And they significantly undercut continued lobbying by the industry for lower standards.

"Consumers deserve a home-like setting with enough room that they can have a quality life and that they can maneuver around their living space while using their wheelchair or scooter," said Alissa Halperin, Senior Attorney and Deputy Director of Policy Advocacy at the Pennsylvania Health Law Project and director of the PA Assisted Living Consumer Alliance (PALCA). Published data from 1999, the most recent available such report, showed more than 21 percent of residents in assisted living facilities relying on wheelchairs and 44 percent on walkers. "According to the architects we've consulted, who are recognized experts in the Americans With Disabilities Act and accessible design, anything less than roughly 200 square feet, even excluding bathrooms and closets, is not accessible to a wheelchair user," Halperin added. "And even that amount of space is only accessible if arranged and furnished in just the right way."

Residents who use wheelchairs and staff at various facilities have told the Pennsylvania Assisted Living Consumer Alliance that some residents have to sit in bed and wait to be transferred to a nearby wheelchair because the room doesn't provide enough space for the residents to roll the chair up to the side of the bed so that they can transfer on their own. See their stories at www.paassistedlivingconsumeralliance.org.

About 50,000 people in Pennsylvania live in facilities that may call themselves assisted living facilities, housing people who are not so sick as to require a nursing home. Residents generally need help with bathing, dressing, medication management and other basic care needs. Current Pennsylvania regulations lump assisted living facilities together with personal care homes and other homes for the elderly and disabled.

The Alliance has identified numerous ways that the Department of Public Welfare's proposed rules for assisted living need to be improved before becoming final. For more information on PALCA's concerns with the proposed regulations or to find a list of participating organizations that are part of the Alliance and where PALCA stands on each of the regulatory issues, visit our website at www.paassistedlivingconsumeralliance.org.