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Amid growth of assisted living, some renew calls for federal oversight


The number of assisted-living centers in the United States has jumped dramatically in the past 20 years, but there have been few efforts to systemically re-evaluate staffing or training guidelines necessary to properly serve residents.

CLEVELAND, Ohio — To work as an aide in an assisted-living center in Ohio requires empathy, compassion and very little training.


About 20 hours, to be exact.


In Kansas, it’s much different. Aides there must take a 90-hour class and pass a test. North Carolina requires aides to take 80 hours of instruction. But there are other states, such as Montana, that say training is needed, but don’t specify how much.


The number of assisted-living centers in the United States has jumped more than 150 percent in the past 20 years, fueled by an increase of residents with cognitive issues, a willingness of facilities to take more frail patients, and families who wish to avoid nursing homes.


But while the centers’ clientele has changed dramatically, there have been few efforts to systemically re-evaluate staffing or training guidelines necessary to properly serve residents. This has led some advocates of the elderly to renew the call for federal oversight of the facilities, much like nursing homes.


For instance, nearly half of the nation’s states lack extensive training programs for the facilities’ employees, with most requiring some form of a job orientation and less than a dozen hours of instruction.


When it comes to staffing, the differences are even more stark. Thirty-eight states leave the amount of personnel needed to care for residents up to individual facility owners.

In Ohio, facility owners must make sure “sufficient numbers of staff” are present to meet residents’ needs. That’s different than in South Carolina, where one aide or staff member must be present for every eight residents during the day.