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Proposed regulatory changes to assisted living facilities

March 18, 2009
by Hill
assisted living, Catholic health care, healthcare, PCHA, Pittsburgh, senior citizens
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I get by with a little help from my friends…,” sing the lyrics to a tune by a famous band from Liverpool, England. Those words ring particularly true for about 50,000 men and women currently living in assisted living facilities in Pennsylvania.

Assisted living is relatively new in the health care industry. It is for disabled or elderly people who are not well enough to live at home anymore, but not sick enough to need a nursing home. Assisted living residents generally need help with bathing, dressing, managing medications, getting to and from doctor’s appointments and other basic activities for daily living. Assisted living facilities allow people to live as independently as possible with some supervision and assistance.

The Pennsylvania Department of Public Welfare (DPW) has proposed new regulations for the licensing and oversight of assisted living residences. The Pennsylvania Catholic Health Association (PCHA), an associate of the Pennsylvania Catholic Conference (PCC), is a statewide organization that represents the Catholic health ministry in public policy matters. PCHA reviewed the proposal considering the interests of both consumers and providers of care including Catholic assisted living facilities.

Sister Clare Christi Schiefer, OSF, President of PCHA, said, “We asked if the regulations will encourage options for consumers and consumer involvement. Will they reach out to low income and vulnerable populations by providing adequate reimbursement and subsidization? Is there flexibility to accommodate changing needs? Does the proposal avoid over-regulation, which would increase cost and create a focus different from the concept of personal choice and residential freedom? Is it assured that our Catholic identity and mission focus are not jeopardized or stifled?”

Using this framework, PCHA voiced a number of concerns about the proposed regulations in a letter to DPW. It was noted that increased licensure fees and some staffing requirements could increase the cost to residents. The proposed physical requirements for facilities seem too demanding, costly and prevent necessary flexibility. And, the regulations that provide for transportation of residents outside the facility should be more clear in allowing essential opportunities for residents to be faithful to their religious beliefs.

Sister Kelly O’Mahony, SCN, Director of Assisted Living for the Vincentian Home in Pittsburgh, was part of PCHA’s statewide task force to review the proposed regulations. She said, “According to PANPHA (a Pennsylvania association of nonprofit senior services), Pennsylvania would be more than twice as expensive as Florida and would be five times the cost of licensure in Illinois, Ohio, Texas and Virginia combined. (Other requirements) would place the cost of the unit beyond the reach of lower income people; non-profit providers will struggle with the need to balance giving mission-driven benevolent care with the costs required to stay in operation.

“Generally, the intent of the regulations is good but more negotiation is needed to ensure high quality services balanced with the cost of providing those services.”

There are four Catholic assisted living facilities in the Pittsburgh area. The Vincentian Home first provided nursing home care 80+ years ago; the assisted living opened in 1997. Marian Manor joined the Vincentian Collaborative System last year. Marian Hall Home in Bellevue is operated by the School Sisters of Saint Francis and the Little Sisters of the Poor have a personal care home.

“Catholic facilities provide for the sacraments, devotions and religious observances of the Catholic culture,” added Sister O’Mahony. “We provide care with a philosophy of compassionate care and dignity for the individual throughout all stages of life.”

The Catholic vision regarding assisted living is to provide a decent and safe home for all aging persons allowing them to remain in the community for as long as possible. They should live in the least restrictive setting practical for their needs and wishes and have access to all necessary health and social services. There should be a special concern for low-income, frail and other vulnerable aging persons.

The Department of Aging provides a listing of homes according to location. Their website is www.aging.state.pa.us or you can call them at 412-350-5460. The DPW lists homes and their licensure status at www.dpw.state.pa.us/PartnersProviders/LongTermLiving/, but Sister O’Mahony says, “The best way to evaluate a facility is to visit it yourself and see whether the residents seem comfortable and happy.”

The DPW will take the concerns of PCHA and all others public comments into consideration. The final form regulations are expected later this year.

by A.B. Hill, Communications Director of the Pennsylvania Catholic Conference – the public affairs arm of Pennsylvania’s Catholic bishops and the Catholic dioceses of Pennsylvania, for the Pittsburgh Catholic, March 2009

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