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Protections for Residents of Elder Care Facilities

Laws create restrictions for referral firms

Les Ostermeier, consultation, Oregon has adopted tighter regulations of the adult family home and referral industries.

Les Ostermeier, co-owner of an adult home referral agency, meets with prospective clients. Oregon has adopted tighter regulations of the adult family home and referral industries. — Photo by Geo Rittenmyer

Two new laws governing the fast-growing adult family home industry will offer Washington residents protection against shady practices and outright abuse.

See also: Caregiving Resource Center.

  • A law that took effect Aug. 24 will require more frequent inspections by the state Department of Social and Health Services and improved safety standards in Washington's nearly 3,000 adult family homes.

Adult family homes are small residential facilities that offer care for up to six older or disabled adults. Nursing homes are heavily regulated, but the rules for adult family homes are less clear.

The law requires that caregivers speak and read English so they can read patients' care plans, speak with doctors and talk to 911 operators when necessary. It also increases financial penalties for violators of the provisions.

Starting Jan. 1 a new law will require elder care referral agencies to disclose fees and commissions; disclose when they conducted their most recent on-site screening of each facility; conduct criminal background checks of employees; and use standardized intake forms that track seniors' medical histories.

Exposé prompted action

Ingrid McDonald, AARP Washington advocacy director, credited a 2010 Seattle Times series, "Seniors for Sale," for exposing shady practices in the industry. Some referral companies charged finders' fees to older people while referring them to substandard facilities, the Times found.

McDonald said such revelations were "critical because they created an awareness among lawmakers" and prompted them to take action.

Most adult family homes and assisted living facilities pay commissions to referral agencies that send them new patients. But some agencies don't screen the facilities, and in scores of cases since 2008 they referred older clients to facilities with a history of negligence and even abuse, the newspaper series found.

Next: New laws will make industry more transparent >>

AARP Washington pushed for the two measures to rein in a previously unregulated industry, McDonald said. Combined, the two measures mean Washington is a pioneer in regulating the adult family home industry.

While some referral agencies and elder care facilities opposed the new regulations, many others favored the efforts.

"Some of them were sick of bad actors making their industry look bad," McDonald said.

Les Ostermeier, co-owner of a referral agency in the Seattle area, called the legislation "a necessary step to give needed protection to older adults and their families." His firm provides placement advice to families seeking senior housing. It collects fees from elder care providers, not from older people and their families.

More transparency

Ostermeier said the disclosure required by the law will make the industry more transparent.

He said most agencies that make referrals to assisted living facilities are operated by ethical individuals and that many of the problem agencies are national, Internet-based firms that collect and sell the names of prospective clients.

"They really don't offer any guidance or support to seniors," he said. "Their focus is on generating money, not on helping people find what they want or need."

Jeff Crollard, attorney for the Washington State Long-Term Care Ombudsman Program, said the elder care referral industry has grown substantially in the past five years, "but it's been completely unregulated." That explosion is expected to continue as more boomers age and need long-term care.

Crollard said the new laws are a "major step forward," but licensing of referral agencies may be necessary eventually to establish uniform qualification standards.

To report problems with an adult family home or referral agency, contact the Long-Term Care Ombudsman Program toll-free at 1-800-562-6028.

Neal Thompson is a writer living in Seattle.

Also of interest: Background checks of all nursing home employees? >>

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