Implementation of an Emergency Power Rule: Compliance of Florida Nursing Homes and Assisted Living Facilities.

OBJECTIVE: Thea aim of this study was to explore the relationship between Florida nursing home and assisted living facility characteristics and their ability to comply with a new emergency power rule in the aftermath of Hurricane Irma. METHODS: This study used characteristics data on Florida nursing homes (NHs) (N = 680) and assisted living facilities (ALFs) (N = 2940) in operation between September 2017 and January 2019. Logistic regressions were used to determine whether certain characteristics were associated with compliance with the emergency power rule by January 1, 2019. RESULTS: A total of 219 (32.9%) NHs and 2219 (75.5%) ALFs had an emergency power plan implemented by January 1, 2019. Results suggest having a dementia care unit increased the odds of compliance for NHs, while chain membership, for-profit status, and a higher reliance on Medicaid decreased the odds. Additionally, smaller size, mental health specialty license, and higher reliance on supplemental state funding increased the odds of compliance for ALFs, while nursing care specialty license and for-profit status decreased the odds of compliance. CONCLUSIONS: Policy implications from these results include informing policy-makers on the barriers faced by NHs and ALFs to implement a new regulation that may cause financial difficulties and compromise quality care.

Factors Associated With Assisted Living Facility Closure.

BACKGROUND AND OBJECTIVES: Assisted living facilities (ALFs) have experienced rapid growth in the past few decades. The expansion in the number of ALFs may cause markets to become oversaturated, and a greater risk of unprofitable ALFs to close. However, no studies have investigated ALF closure. This study adapted a model developed for the nursing home market for the ALF market to examine the organizational, internal, and external factors associated with closure. RESEARCH DESIGN AND METHODS: Data on 1,939 ALFs operating in 2013 from Florida were used to estimate a logistic regression to examine the organizational, internal, and external factors that were associated with closure between 2013 and 2015. RESULTS: During the 2-year study period, 141 ALFs (7.3%) closed. Significant factors associated with increased odds of closure included fewer beds, not accepting Medicaid, and more deficiencies. Two factors (market concentration and population density) were marginally significant. DISCUSSION AND IMPLICATIONS: The results of this study confirm the usefulness of a model that includes organizational, internal, and external factors to predict ALF closure. These outcomes highlight the concerns that closure can affect access to community-based long-term care, especially for rural older adults, and indicate an expansion of Medicaid acceptance in ALFs could be protective against closure.

Using Deficiency Data to Measure Quality in Assisted Living Communities: A Florida Statewide Study.

In 2014, more than 800,000 older adults reside in assisted living communities (ALCs) in the United States, yet few studies have examined whether state licensure inspection and citation information can be used to help consumers infer quality in choosing facilities. We examined the quality of ALCs using the deficiency citation data from the State of Florida. Data on 2,457 licensed ALCs operating between 2013 and 2015 were used to estimate logistic and negative binomial regression models to determine ALCs' structural characteristics that were associated with any and the number of deficiency citations. There were 2.6 deficiencies per facility (range 0-21); one-third of all ALCs received no deficiencies and one-third received four or more deficiencies. Specialty license and region were associated with receiving any deficiencies; ownership, rural location, and Northeast region were associated with receiving more deficiencies; and Southwest region was associated with receiving fewer deficiencies.