The Risks of “Acuity Creep” in Assisted Living

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Published On: January 22nd, 2024Categories: Assisted Living & Residential Care, ClinicalTags: ,

Adults currently moving into assisted living communities today are on average 87 years old. Pamela Truscott, DNP/HSL, MSN/ED, RN, Director of Quality Improvement for the National Center for Assisted Living suggests that, in general, these adults have more in common with individuals who would have entered a nursing home in the past, due to a higher incidence of chronic conditions and overall amplified health care needs.

Her remarks were made during a panel discussion just before the opening of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) Convention and Expo held in Denver this past October.

Despite this change in demographics and status quo, “we can’t live in yesterday’s world,” Truscott commented, indicating that operators will have to decide which services and care continua they will be willing to offer. Panelist Amanda Johnson, RN, Vice President of Operations for Lifespark, pointed out that long-term care community operators should analyze residents’ age, condition, and diagnoses, and empower staff to obtain the skills necessary to care for the growing list of residents’ medical and health needs. They also need to address the expectation to offer everything. Since pricing models seldom cover the costs associated with social workers or therapists, operators will need to consider how to charge for additional services. Potential solutions include bringing in experts in infection and wound care, and leveraging residents’ benefits through Medicare Advantage, Medicare Part B, or state waiver programs.

Panelists pointed out that assisted living increasingly is serving as an alternative to skilled nursing, as well as a resource to address some of the obligations other parts of the healthcare system are currently handling. “Assisted living providers are becoming a bigger part of the healthcare continuum,” said Lisa Zeis, Lifespark Senior Director of Quality and Experience. Zeis commented that assisted living will play a big role in influencing how current payment models will change over the next few years.