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Is a Crisis Looming for Senior Living Facilities?

Consumer Affairs reports that there are more than 810,000 residents in assisted living facilities nationwide. With current trends in mind, it is estimated that 7 out of 10 people will require assisted living care during their lifetime. With this projection, our country will need about 1 million additional senior living units by 2040. These alarming and significant statistics leave many asking questions about the availability and quality of senior living facilities.

Most people don’t want to move into an assisted living facility. However, factors like chronic illness, dementia, degenerative aging, and other disabilities leave many without a choice. Unfortunately, assisted living facilities in the US are faced with some major issues. Solutions and plans are constantly being discussed, but many of the issues are difficult, and the solutions are costly.

Unfortunately, there is little we can do right now individually. However, being aware of the issues at hand is important. Awareness is not only the first step to help facilitate change but also essential to protect ourselves and our loved ones if assisted living is necessary.


In September 2021, The American Healthcare Association and National Center for Assisted Living released the findings of an industry survey. The reports found that only 4% of assisted living facilities and 1% of nursing homes claim they are fully staffed. Additionally, 82% of assisted living facilities and 89% of nursing homes reported moderate to severe staffing shortages.

Prior to the COVID-19 pandemic, facilities were already faced with significant staffing shortages. Factors for these shortages include low wages, poor working conditions, and the number of qualified individuals to work in this field. Now that we live in a post-pandemic world, staffing shortages are worse than ever. Many healthcare providers and caregivers left the field due to burnout, health risks, and worsened working conditions as a result of the COVID-19 pandemic.

The ratio of staff to residents directly affects the quality of care provided. When facilities are faced with staffing shortages, patient care suffers as a direct result. Even though facilities and state officials are working to find sustainable solutions for the current staffing crisis, this issue remains the most critical ever faced by senior living facilities.


Elder abuse also proves to be a common issue among senior living facilities. Abuse can be intentional or unintentional and present in many forms. The most common forms of elder abuse in assisted living facilities include:

  • Neglect is when the basic needs of an individual are not being met. These needs include hygienic, medical, nutritional, emotional, and personal care needs. Neglect is a common form of abuse seen in assisted living facilities and a direct result of the current staffing crisis.
  • Physical abuse is physically harming another individual. It is typically intentional and can result from grabbing, kicking, pushing, hitting, or other forceful actions. Injuries from the overuse or misuse of restraints and bedsores that result from neglect are also classified as physical abuse.
  • Financial abuse or fraud occurs when a caregiver illegally or improperly takes advantage of another’s money, assets, belongings, or benefits for their own gain or an entity other than the resident. While living in a facility, the caregivers or staff members have access to sensitive personal information. This increases the risk of falling victim to identity theft or fraud. Additionally, it’s not uncommon for a facility to commit billing fraud. Unfortunately, insurance companies may be billed for services that were not rendered. While this may not affect the resident, it is still considered abuse and fraud.

Oversight and Regulation

There are significant gaps in the oversight and regulation of senior living facilities. Regulations vary significantly by facility type and from state to state. When looking at senior living facilities, the greatest factors that affect regulation and oversight are funding and facility type.

Nursing homes are medical facilities that require around-the-clock skilled nursing care. Much of nursing home funding comes from Medicare or Medicaid. As these are both government programs, nursing homes are federally regulated. The Centers for Medicare and Medicaid Services (CMS) is the entity that monitors and inspects nursing homes through unannounced inspections nationwide. This serves to ensure these facilities are within compliance.

In comparison, assisted living facilities are not considered to be medical facilities. Caregivers help with daily needs, medical management, and maintenance but are not skilled healthcare providers. These facilities are mainly funded by private pay. Therefore, there is minimal federal regulation. Instead, assisted living facilities are regulated by various state entities. Most states do require inspections, but the occurrences vary from annually to every five years or more.

Even though these facilities are not considered to be medical, most residents have medical conditions that require management and are being dealt with daily by non-medical staff. This creates a gray area in which the inconsistent regulation of these facilities can lead to safety, health, and legal concerns.

The above information may feel uncomfortable or unsettling. However, it’s important to be aware of the obstacles we are facing as a community. The trends point to an increased need for senior living facilities in upcoming years. The current issues related to staffing shortages, abuse, and lack of federal regulation may leave many with great concern and unanswered questions. We invite you to contact our Albany office today at (518) 452-6979 and schedule a consultation.

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