Assisted Living Communities: The Forgotten Frontline

April 24, 2020

By Scott Title, executive director of the National Center for Assisted Living

The COVID-19 pandemic is unlike anything we have seen in recent history. We are all in this together, as there is hardly an industry or individual that hasn’t been impacted by this global health crisis. But with seniors among those most susceptible to the virus, the assisted living profession, in particular, is facing historic challenges when it comes to our most sacred charge – the health and safety of our residents.

Nursing homes and assisted living communities are often used interchangeably, but there is a key distinction between the two. Unlike nursing homes, assisted living communities are not medical facilities. Assisted living communities typically serve seniors who are high functioning and mostly independent. While some may have clinical staff, most of the assistance residents receive is for everyday, personal tasks. They don’t require continuous 24-hour skilled nursing care like those in nursing homes.

Given the unique role assisted living communities have in our nation’s long-term care continuum, the challenges we are working diligently to overcome match this reality.

Prior to this outbreak, we had been calling on policymakers to help recruit more caregivers for our growing baby boomer population. The current public health crisis has only magnified this workforce challenge. Assisted living communities across the country grapple with a shortage of caregivers during this pandemic due to personal or family illness and childcare obligations. We need help and we are working with states to find solutions that will address this urgent need.

Despite such staffing challenges, assisted living communities continue to work tirelessly to protect their residents. These caregivers are the forgotten heroes on the frontlines. We are following all guidelines set forth by the Centers for Disease Control (CDC) as well as local directives made by governors to combat the spread of COVID-19. Facilities are regularly cleaned and disinfected, residents and staff are encouraged to wash their hands often, visitor access has been limited, and social distancing is enforced.

These common-sense precautions can help. A recent study on an assisted and independent living facility conducted by the CDC found that “early intervention, increased social distancing among residents and limiting contact with health care providers were possibly effective at minimizing the spread of the virus in an assisted living setting.”

While these preventative measures are important, containing the spread of the virus includes equipping assisted living and long-term care facilities with the proper resources. That means ensuring that facilities have adequate testing and the personal protective equipment (PPE) they need to keep residents and caregivers safe. Unfortunately, shortages of testing and PPE continue to be a challenge nationwide and because assisted living communities are not medical facilities, they have not been prioritized for testing or supplies. We encourage our elected leaders to prioritize our most vulnerable and those who care for them in long-term care settings as they allocate these critical resources.

The caregivers at these facilities have dedicated their lives to taking care of our elderly loved ones, and are going above and beyond to continue this work in the current environment. They deserve the same priority and support as the thousands of other brave men and women on the frontlines in our hospitals.

In the face of this generational challenge, some have suggested that imposing stricter, national regulations on assisted living communities could have mitigated COVID-19 outbreaks from occurring. While we are committed to working with elected representatives and regulators at all levels of government, it is important to keep a few things in mind. Most importantly, facilities are already doing everything in their power to keep residents safe from this virus. Just as the virus has spread in hospitals, apartment buildings and other settings where people are living in close contact with their neighbors, preventing the spread of the virus in a densely populated environment, such as an assisted living community, is a real challenge. We are not backing down from this challenge, rather we are rising to meet it.

We must also remember that each assisted living community is different. They have unique populations and therefore, services vary across facilities and states. That is why we see state regulations as being the most impactful. Regulations from state capitals best address specific needs within assisted living communities, encourage innovation, and often seek collaboration between various stakeholders.

In fact, state regulations tend to be more dynamic than federal regulations. Local policies have evolved over the years to meet the changing needs of assisted living residents. Last year, our NCAL state regulatory review found that 84 percent of states have reported changes since 2015, compared to federal regulations for skilled nursing facilities where the national requirements were not updated for 10 years. This virus doesn’t bother with bureaucracy. A “one size fits all” regulatory structure for assisted living would not have prevented its entry and can’t solve this crisis now. What our assisted living communities need immediately is priority testing and adequate protective equipment.

This is a difficult time for all of us, but I am encouraged by the messages we receive every day from caregivers. Despite the risk to themselves and their loved ones at home, they continually express their commitment to returning to work each day to keep their residents safe. After all, many have come to see their residents as members of their own families.

We don’t know what will come in the weeks and months ahead, but one thing is certain – we will continue to do everything within our power to provide a safe environment for our residents and caregivers, and make sure we stop the spread of COVID-19.

Originally published in The Hill