Forum Session

Assisted Living Facilities and Their Growing Role in Long-Term Services and Supports (LTSS)
November 30, 2012


Carol V. O'Shaughnessy, MA


Assisted living facilities increasingly play an important role in providing long-term services and supports (LTSS) for many people with functional and cognitive impairments who do not need the level of care provided in nursing homes but cannot live independently. The market for assisted living facilities has grown substantially in recent years in response to consumer demand for home-like supportive housing. Individuals and families usually pay for assisted living arrangements out-of-pocket. For those with limited income and assets, Medicaid (at the option of each state) can finance some of the supportive services provided in assisted living facilities, excluding room and board. Unlike nursing homes, for which the federal government and states share responsibility for oversight and enforcement of federal standards, states have total responsibility for development of regulations and licensure requirements as well as oversight of assisted living facilities. During the past decade, various national provider organizations have promoted adoption of improved quality of care standards by states and providers, including protections for consumers.

This Forum session described the assisting living market, including resident and facility characteristics, based on findings of a recent major survey undertaken by the U.S. Department of Health and Human Services (HHS). The meeting also discussed the growth and evolution of the assisted living market from several viewpoints, including those of a state long-term care ombudsman, an educator of assisted living personnel, and an assisted living multi-state provider. Areas discussed included sources of financing and state regulation and oversight of quality of care provided to residents. 


Peter Kemper, PhD (bio)
Deputy Assistant Secretary
Office of Disability, Aging, and Long-Term Care Policy
U.S. Department of Health and Human Services

Heather Bruemmer (bio)
Executive Director and State Long-Term Care Ombudsman
Wisconsin Board on Aging and Long Term Care

Josh Allen, RN (bio)
President and Chief Executive Officer
Care and Compliance Group, Inc. (Wildomar, California)

Mauro Hernandez, PhD (bio)
Chief Executive Officer
Concepts in Community Living, Inc. (Clackamas, Oregon)

Related Materials

For background information, see "Assisted Living: Facilities, Financing, and Oversight" (The Basics, January 29, 2013).

The National Survey of Residential Care Facilities was conducted in 2010 by the National Center for Health Statistics (NCHS). See also two NCHS data briefs:

See also The Scan Foundation's "Trends in the Residential Care Industry" (Data Brief, No. 32, October 2012).

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