Assisted living rules provoke an uproar

Marjean Birt regularly walks four blocks from her home to visit her husband of 54 years, Lucas, at Dogwood Forest assisted living facility in Alpharetta. “We appreciate it so much and think it’s a wonderful facility,’’ she says.

On Wednesday, Birt took a much longer trip, traveling to downtown Atlanta to testify at a public hearing on proposed state rules regulating seniors’ living facilities. She said the new rules would be too restrictive and could jeopardize her husband’s ability to stay at the assisted living facility.

Birt was among dozens of patients’ relatives, seniors advocates, facility operators and others who jammed a Department of Community Health boardroom to offer criticism of the proposed rule changes, which would replace current regulations on personal care homes.

DCH officials said Wednesday that the proposed rules will be revised before they are submitted to the agency’s board. That news suited the attendees at the hearing, who generally testified that the proposals were vague and overly restrictive. The passion of their testimony underscored the depth of emotion on an issue that will undoubtedly spill over into the 2011 session of the Georgia General Assembly.

Much of the hearing focused on assisted living facilities, and on families’ desire to keep their loved ones there.

For years, advocacy groups for older Americans have wanted to change the way Georgia regulates assisted living facilities. Under Georgia law, assisted living facilities can provide several services, including food; 24-hour “watchful oversight”; help in bathing, dressing and other daily activities; and supervision of self-administered medication. But assisted living can’t provide routine medical or nursing services. That level of care is delivered by skilled nursing facilities.

If an assisted living resident is considered non-ambulatory, the state requires that person to be discharged – often moving to a nursing home – unless a special waiver is granted.

Some family members of assisted living residents are dissatisfied with the current rules — and are  alarmed at the proposed changes.

Consumer advocacy groups such as AARP want to loosen the restrictions on assisted living to allow residents to remain there longer – to “age in place.” These groups want to ease the rules requiring that an assisted living resident who becomes “non-ambulatory” be moved. Another change they want is to allow assisted living facilities to provide more help for residents who must be administered medications.

The state’s proposed regulations go too far on the ambulatory issue, says Kathy Floyd, advocacy director for AARP Georgia. Those rules would require that all residents of an assisted living facility have the ability to escape in an emergency “without physical, hands-on assistance from staff.”

The Georgia Health Care Association, which represents nursing homes, has said that requiring patients to have a certain level of mobility is simply for their own safety. “We want to make sure there are appropriate safeguards for patients,” says Jon Howell, president of the association. Not being ambulatory “creates some fire marshal issues,” Howell says.

Gary Johnson, a Duluth architect, is not convinced. He said at the hearing that the assisted living facility where his 86-year-old mother lives is at least as safe as a nursing home – even in an emergency.

The proposed rule changes “would have a devastating effect on families like ours,” testified Pat Murdock, whose mother, 83, has dementia and lives in a Buckhead assisted living facility.

Several people at the meeting called for a task force or work group to iron out problems in the new regulations. “The proposed rules are not clear enough,’’ said David Sprowl, executive director of Lutheran Towers, an Atlanta high-rise for seniors.

Laurey Sherman, owner of Providence Assisted Living, said the rules would be burdensome for small facilities and could put them out of business.