Summary: Assisted-living facilities provide a growing number of elderly Americans with an alternative to nursing homes. To make informed choices about various facilities, however, consumers need clear and complete information on services, costs, and policies. A GAO review of assisted-living facilities in four states--California, Florida, Ohio, and Oregon--found that the facilities did not always give consumers enough information to determine whether a particular facility could meet their needs, for how long, and under what circumstances. Marketing materials, contracts, and other information provided by facilities are often incomplete and sometimes vague or misleading. Only about half of the facilities reported that they provide prospective residents with key information in writing, such as the amount of assistance residents can expect to receive with medications, the circumstances under which the cost of services might change, or when residents might be required to leave if their health deteriorates. Consumers also need assurance that the facilities provide high-quality care and protect consumers' interests. All four states license assisted-living facilities and conduct periodic inspections and complaint investigations. Yet GAO found that more than one-fourth of the facilities it reviewed had been cited by state licensing, ombudsman, or other agencies for five or more quality-of-care or consumer protection deficiencies or violations during 1996 and 1997. Eleven percent of the facilities had been cited for 10 or more deficiencies and violations during the same period. Frequently identified problems included facilities' (1) providing poor care to residents, such as inadequate medical attention following an accident; (2) having insufficient, unqualified, and untrained staff; (3) not providing residents with appropriate medications and not storing medications properly; and (4) not following admission and discharge policies required by state regulation. This report summarizes the April 1999 GAO report, GAO/HEHS-99-27.
