WASHINGTON — U.S. senators from both parties are sounding the alarm about costs, staffing shortages and unsafe incidents at nursing homes across the country as the needs of aging Americans grow. forecast boost dramatically.
Senator Bob Casey, chairman of the Senate Aging Committee, led a hearing Thursday to emphasize the committee’s fact-finding mission. Unlike nursing homes, assisted living is largely unregulated at the federal level.
“It is long past time for Congress to reexamine this model and make sure it meets the needs of our country,” the Pennsylvania Democrat said in his opening remarks.
To quote A recent study With the study finding that 80% of adults would not be able to afford to stay in an assisted living facility for four years, Casey reached out directly to the public to share their experiences.
“I’d like to hear from you about what it really costs to live in nursing homes,” Casey said, holding a sign urging people to submit stories aging.senate.gov/assistedlivingbills.
“I think it’s really important that we listen to people — listen to people about their own experiences as family members, as people who pay the bills and also expect the promises that are made when someone becomes a resident of an assisted living facility,” Casey said.
“Only by listening to these stories, only by listening to these experiences can we bring about the necessary change that we all agree needs to happen.”
Residents and family members recall penniless care
Among those testifying was a Virginia woman who said she witnessed troubling situations caused by understaffing and penniless training at the facility where her husband lived. Lewy body dementia.
Patty Vessenmeyer of Gainesville, Virginia, described an “extremely loud” central group room at the facility, where she found a resident “covered in blood and staggering in the hallway” after tripping on a raised section of floor covered with carpet.
“A company that knows anything about dementia care wouldn’t design a facility like that,” she said.
She also told lawmakers about how she had to break up a fight when one resident was hitting another with a cane and how her husband urinated on himself when staff were not there to lend a hand him to the bathroom.
Without naming the Warrenton, Virginia, facility, Vessenmeyer told the committee’s top member, Senator Mike Braun, that the base cost of her husband’s room was $7,900 a month, but her monthly bill ended up being $13,000.
“It sounds unattainable,” said Braun, a Republican from Indiana.
“If he hadn’t passed away so soon … all my savings would have been exhausted,” Vessenmeyer said.
“That’s the kind of thing that scares me,” Braun replied.
Jennifer Craft Morgan, director of the Gerontology Institute at the University of Georgia, told the panel that the average cost of assisted living nationwide is $4,500 a month, making it “unaffordable for most Americans.”
In addition to breaking down cost barriers, Morgan recommended that the industry continually educate and train workers, reward companies that provide high-quality care, and standardize monitoring and resources to boost oversight and transparency at the state level.
Costs and care vary by condition
But care is not as high-priced in all states, and providers can choose to go beyond state requirements, Julie Simpkins, co-president of Gardant Management Solutions, told lawmakers.
The Illinois-based company is the fifth-largest assisted living provider in the U.S. Gardant serves low-income seniors in Indiana, Illinois, Maryland, Ohio and West Virginia.
Simpkins told Braun that in states like Illinois and Indiana, low-income families have constrained out-of-pocket costs because of those states’ agreements with federal Medicaid Waiver programs.
Asked if this situation is affecting low- and moderate-income families nationwide, Simpkins told Braun, “Nationally, every state needs to have programs that provide access to affordable assisted living. Not all of them are there yet.”
Simpkins also testified that Gardant facilities go beyond state requirements “when we believe it is in the best interest of our residents.”
Such instances include immediate reporting to state authorities when residents leave a facility, a practice known in the industry as “absconding.”
“Even something as technical as a situation where a resident walks out the door and comes right back in with a staff member — we know they didn’t leave our community and our staff addressed the situation immediately, but we still report it,” Simpkins said.
Simpkins also said every Gardant memory care facility employee completes training beyond the required level to become a certified dementia specialist.
Debate on national standards
“However, it is important to remember that every state, every community and every resident is different,” Simpkins said in her testimony.
“Attempting to standardise all care homes would be unworkable and irresponsible in terms of caring for residents,” she said.
Richard Mollot, executive director of the Long Term Care Community Coalition in New York, disagreed.
Because the needs of older adults have changed since the 1980s, when assisted care services were first introduced, Mollot advocates for national standards and the creation of a national database of caregivers and assisted care companies.
“The lack of any federal quality and safety standards, coupled with a virtual lack of reliable public information on the quality, safety and costs of assisted care, have made assisted care a vulnerable sector to investment by sophisticated private companies that can shift resources and profit without regard to the promises made to seniors and their families,” Mollot said in his opening statement.
Later, during the hearing, Mollot told Casey, “There is essentially no independent, peer-reviewed information about assisted living for consumers, policymakers or the general public. So families, as you noted, have to rely on facilities and facility marketing materials.”
Casey responded to Mollot that he believed it was “fundamental that people should be able to rely on a source that is objective and, as they say, independent.”
Braun also criticized Simpkins’ argument against standardization, especially when it comes to transparency.
“I don’t know how you can say that wouldn’t be good,” he told Simpkins.
“I was the most vocal senator in saying our health care system is broken,” Braun continued later. “We have no transparency. We have no competition.
“It’s a bit like an unregulated service, and you get a bill after a bad health care scrape or a serious accident. You have to hold your breath to see how much it’s going to cost or whether you can afford it,” he said.
Looking to the future
The hearing did not focus on pushing for specific legislation. Instead, senators said they would gather information to assess the industry.
Casey raved about it letters wrote in mid-January to three of the largest corporate assisted-care operators, including Atria Senior Living based in Louisville, Kentucky; Brookdale Senior Living in Brentwood, Tennessee; and Sunrise Senior Living in McLean, Virginia.
The Pennsylvania lawmaker also announced he was joining his colleagues in calling for the Government Accountability Office to investigate how much federal money is spent on assisted living facilities, what they charge families and whether they publicly disclose their fees.
Democratic Senators John Fetterman of Pennsylvania, Kirsten Gillibrand of New York, Elizabeth Warren of Massachusetts, Richard Blumenthal of Connecticut, Mark Kelly of Arizona and Raphael Warnock of Georgia jointly signed letter to GAO.
