1. Assisted Living Workgroup 2011 8/8/11 Carol Berkowitz, Esq. Sr. Director of Compliance and Legal Affairs Florida Association of Homes and Services for the Aging

2. About FAHSA Florida Association of Homes and Services for the Aging has more than 500 members, including approximately 370 continuing care retirement communities (CCRCs), nursing homes, assisted living facilities (ALFs), home and community-based services and affordable senior housing Over 85,000 seniors reside in FAHSA-member communities FAHSA-member homes are sponsored primarily by community- based nonprofit civic, religious, fraternal, mission-driven organizations

3. Recommendations for Improvement: Survey Process Consumer Information Regulations

4. Recommendations for Improvement: Survey Process  Improve Survey Consistency so that there is no misunderstanding about expectations  Implement Joint Training for ALF providers and surveyors (In person and Web based)  Target resources so that more surveyor time is focused on ALFs that have serious regulatory problems  Implement an abbreviated survey for ALFs with a better than average survey track record, a traditional survey for ALFs that provide acceptable care, and a more intense survey for poor performers (These terms would have to be defined)

5. Recommendations (con’t.) Consumer Information:  Strengthen information available to the public so consumers are in a better position to make informed decisions when selecting an ALF

6. Recommendations (con’t.) Regulations While Providing Quality of Care:  Retain provider flexibility to offer diverse service packages and set residency criteria within parameters established by law  Recognize that ALFs are not homogeneous  Avoid increased regulations that apply to both good and bad performers and instead focus efforts on the early detection and correction of serious regulatory problems in facilities with a history of regulatory problems or marginal care  Carefully evaluate current public policy to determine if ALFs should be given the authority to provide additional services

7. Recommendations (con’t.)  Eliminate the limited nursing service license and instead allow ALFs with a standard license and a nurse on staff to provide any or all of the services currently permitted in an ALF with a limited nursing service license. (This flexibility was proposed in an interim senate report and bills filed by Rep. Hudson during the 2010 and 2011 legislative sessions)  Encourage coordinated communications among state agencies regarding resident care  Case managers must communicate to coordinate care  Require case managers associated with Medicaid reform to immediately report ALF quality of care problems to AHCA. With the push to decrease Medicaid spending on nursing home care, the risk of inappropriate placement in an ALF increases and could result in care problems

8. Questions? Florida Association of Homes and Services for the Aging 1812 Riggins Road Tallahassee, FL 32308 Contact: Carol Berkowitz, Esq. (850) 671-3700