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YOU MUST BE A WATCHDOG Some advocates for seniors worry about conditions in the homes that accept Medicaid payments under the so-called Medicaid waiver program, which allows people who might
qualify for care in a nursing home or other institution to get money for long-term care in another setting. Those are the homes that sparked the GAO reports since they are paid with federal
money, and some senior advocates say the quality of some of those homes is questionable. Medicaid pays lower rates, so some places may cut corners in caring for residents, said principal
investigator Chrisy Selder of San Diego-based Consumer Advocates for RCFE Reform, which helped strengthen California assisted living laws. RCFE is an abbreviation for residential care
facility for the elderly. The leader of California's assisted living trade group said all assisted living employees receive elder abuse training, and homes accepting Medicaid have added
requirements. "While we cannot speak for other states, California has strong and overlapping abuse reporting requirements and staff training mandates,” Sally Michael, president of the
California Assisted Living Association, said in a statement to AARP. In Oregon, the state's long-term care ombudsman is concerned about the differences in protections for residents of
nursing homes vs. assisted living communities. Fully 95 percent of assisted living homes in his state are doing an excellent job, said the ombudsman, Fred Steele. But nonlicensed,
noncertified employees typically care for residents, he said. And he is especially concerned about homes with large numbers of residents on Medicaid that may be providing substandard care.
Steele recounted his visit to such a home after receiving a photo of its empty refrigerator. The front door was missing, every hand sanitizer dispenser was empty, and the decrepit van for
transporting residents had expired license plates, he said. "Very simply, CMS needs to be looking at this,” Steele said. “They need to be exploring and thinking about this with
congressional members about what regulations are needed." HOW TO FIND ASSISTED LIVING RECORDS Consumers searching for nursing homes can rely on Medicare Nursing Home Compare, which
ranks homes with a five-star system and provides online inspection reports. But no such efficient nationwide system exists for assisted living homes. So consumers searching for high-quality
homes must review state inspection records to learn more about potential elder abuse issues and other problems. This can be a challenge. Health agencies in some states and social service
departments in others regulate assisted living facilities. Many states do not post inspection reports online, and some states require that consumers file formal public record requests to
obtain copies of records. Some examples: • CALIFORNIA. Inspection reports, complaints and other records can be found on a searchable website overseen by the California Department of Social
Services. • CONNECTICUT. Reports are available via public record requests from the Department of Public Health, which has begun posting new violation letters and correction plans online,
accessible by clicking on a home's name and the word Detail. • SOUTH DAKOTA. Reports can be obtained from the Office of Health Facilities Licensure & Certification of the state
Department of Health by emailing requests to [email protected]. Check out your state's regulations in the National Center for Assisted Living's 2019 report. _Deborah Schoch is
an independent journalist who helped found the California Health Care Foundation's California Center for Health Reporting at the University of Southern California. Earlier, she worked
for 18 years at the Los Angeles Times._