Straight Talk

Video Surveillance In Assisted Living: Know Your Rights Under New State Guidelines

Despite the ongoing concerns of CARR and other statewide advocates, California’s Department of Social Services, Community Care Licensing (DSS/CCL) recently released a set of guidelines permitting assisted living facilities to use video surveillance in both common and private areas of facilities.  The set of guidelines was reported to have been issued in response to the growing use of video surveillance systems in California’s assisted living facilities by facilities themselves.

CARR takes issue with both (1) the state’s creation of generic guidelines, rather than explicit statutory authority and regulations, and (2) the set of guidelines themselves.  CARR submits that the policy is a quick fix that neither promotes resident safety nor mitigates resident risks.  Instead, these guidelines provide facilities with unlimited discretion to monitor consenting residents. (You can read and evaluate CARR’s position paper here.)

As a service to residents and their families, CARR provides below an overview and itemized summary of DSS/CCL’s guidelines to ensure you are fully informed of your rights and areas where they might be limited.  Actual guidelines may be found on DSS/CCL’s website using the link provided here.  

Overview Summary—DSS/CCL’s video surveillance guidelines:

Flu Season in Assisted Living, Tips for Residents & Families

'Tis the season.  Flu season, that is.  And for the elderly, this means additional vigilance to safeguard their health. How well prepared is your facility as we enter flu season?  What preventive measures is the facility taking?  Is the facility prepared to handle an outbreak?

It is well known seniors are at a greater risk of complications should they contract influenza.  And group settings, like assisted living facilities, may increase a senior's exposure to contagious diseases. According to the CDC, it is estimated that between 80-90% of seasonal flu-related deaths occur in people 65 years and older and between 50-70% of seasonal flu-related hospitalizations occur within this same age group.  

San Diego County Awards Contract to CARR for Development of Assisted Living Rating System

"CARR is honored to be the County of San Diego's vendor entrusted with developing a fair rating system deserving the confidence of the public and providers." --Chris Murphy, CARR's Executive Director

SAN DIEGO, Calif., May 5, 2015 -- The County of San Diego, Aging & Independence Services awarded Consumer Advocates for RCFE Reform (CARR) a fixed price contract for a pilot project to create a rating system for the County's assisted living facilities, and to develop a consumer-friendly website to display the ratings and facility information.  The pilot program is a six-month effort with a current contract value of $50,000.

CARR Contributes To Discussion On Perceptions of Aging

"Why is there a drastic difference in people's perceptions of aging versus reality?"  This was the question recently put to 44 experts in the field of aging by  They compiled these responses to produce the report, American's Misconception On Aging. CARR was fortunate enough to be selected as one of the contributors, alongside Dr. Bill Thomas, the SCAN Foundation and the American Health Care Association.  Below are some of the key findings and an excerpt from our contribution.  The entire report may be viewed here.

Key Findings from the report included:

Centralized CCL Complaint Hotline

Department of Social Services, Community Care Licensing Division (DSS/CCLD) launched its new centralized complaint hotline this past week. The hotline's objective is to streamline the complaint process for consumers, and to assure information about complaints is consistently collected across all complaint report types.  Once a complaint is filed through the central call office, it is reviewed by a field-seasoned CCL inspector; within a few hours after the complaint has been reported, it is directed to the appropriate regional field office for investigation.  Once in the regional office, the agency must initiate its investigation within the 10-day regulatory time frame. 

The 8-4-4 number is toll free, so there is now one less impediment to filing a complaint - you don't have to pay for the call.  If its easier to email a complaint, the CCLD's new poster gives you the address:  CARR encourages all family members, visitors in assisted living facilities, and reminds all mandated reporters to immediately report any event or circumstance endangering the health and safety of residents of assisted living facilities.  As the poster says. . . If you SEE something, SAY something.  

Use CARR's "Facility Snapshots"* To Narrow Your Facility Search

Long-term care options require extensive research, research that few consumers have the time to do, especially when an immediate need occurs.  The Centers for Medicare & Medicaid Services (CMS) provides consumers with decipherable icons and easy access to compliance histories for skilled nursing facilities; however, this type of data is still not provided for consumers of assisted living services.  CARR was founded in 2009 to begin to fill this void and is currently the only public charity in California providing consumers unbiased, online access to the compliance histories for assisted living facilities.

But....poring over individual public documents is quite time-consuming (we should know) and, to the untrained eye, may provide limited assistance when attempting to initially narrow down a facility search.  To ease this burden for the consumer, CARR has partnered with San Diego County’s Aging and Independence Services, to provide "Facility Snapshots"* on the assisted living facilities in the region.  (AIS-sponsored Facility Snapshot's are denoted on our site by this green icon). 

A Safe Place for Mom and/or Dad

By now, we all know someone contending with the needs of an aging family member.  And while aging and dependency are not synonymous, there does come a point in time (be it brief or extended) where reliance on others will enter the picture.  Sound familiar:

“I am worried about my aging mother continuing to live alone.  Her memory-loss is becoming more apparent.  Her ability to drive herself to the store and appointments is diminishing.  Her overall health and functioning seem to be declining.   I feel she would be safer with more assistance and supervision.”

           “I do not know what to do about my aging father.  Since my mother passed, I worry about him being alone.  He can no longer keep up the house.  His medication regimen is quite complicated.  And his gait has changed, I worry he may fall as a result and I will not be there to help him.  I feel he would be more comfortable with some additional help and prompting.”

And so, the search for support is triggered. 

Facility Shopping? Take Along Your IPAD!

All you web-savvy users can now easily access using your ipad.  And because your ipad defaults to Safari as the browser, you will optimally see the site and all its contents.  So now, while you are out and about, taking tours of the RCFEs of interest to you, you are now able, with a login, to access the public documents on our site, in real time while.  Use our public documents to inform the questions you ask the facility administrator or licensee.  

CARR's Guide for Evaluating Assisted Living Facilities

So, you have narrowed your search and have scheduled a handful of facility tours.  You arrive to any of these tours—introductions are made, accommodations previewed, stop and observe the staff interacting with the residents, follow-up with an invitation to stay for lunch. This is the tour you can expect.  This is the tour they have prepared.  It is called the “marketing tour”.  This is not the only tour you want.

Having worked as an administrator’s assistant, and having served as a long-term care ombudsman, I can tell you with great certainty that many facilities are doing their best . . . to hide the corners they are cutting.  Some are cutting fewer than others, it is true.

CARR has prepared a "Facility Evaluation Guide" containing questions and tips based on our personal experiences; they have been condensed to educate and empower you to receive the facility tour you need to make an informed placement decision.  This will be your family/friend’s new home.  You should be allowed to inspect the ENTIRE facility.  Treat the tour as if you were looking at real estate for purchase.  Click HERE to download the Guide.

RCFE & Skilled Nursing Facility: Is There a Difference?

The table below shows the primary differences between an RCFE (aka Assisted Living) and a Skilled Nursing Facility.  We are hopeful the content will help your differentiate between the two.  

A Residential Care Facility for the Elderly (RCFE) is the name in California's Title 22 regulations that refers to a "housing arrangement chosen voluntarily" by a resident or his guardian or other responsible party, where 75% of the residents are 60+, where care and supervision is provided to the residents in a manner consistent with their particular needs. In the vernacular, it is often called assisted living or supportive housing.  It is non-medical in nature, and is considered a "housing alternative" that provides care.   It is not a medical facility, and is therefore not classified as a health-care facility.  The disparity is that despite these parameters, residents may be accepted and retained exhibiting many types of serious and chronic medical conditions.  

By contrast, a Skilled Nursing Facility (SNF) is a facility licensed by California's Department of Public Health, licensed to provide 24/7 skilled professional medical services.  It is a considered a medical facility, not a housing alternative.