The Non-Regulation of Independent Living

In the past twenty years, the range of retirement living and long term care options for senior citizens has expanded along with the elderly population. With an eye on senior citizens' preferences and their pocket books, the geriatric care industry now offers a rich continuum of care facilities and services, from in-home assistance, to assisted living centers, to hospice homes.

As so often happens, the innovations of the marketplace have outrun government legislatures and regulators. It is no wonder that there exist gaps in the regulatory framework governing the industry. But consumers should be aware of these gaps, one of the most conspicuous of which in some states concerns "independent living" facilities.

A relative newcomer to the industry, the independent living home or community evolved from the "assisted living" model. Assisted living options are tailored for seniors who need help with daily activities like eating or being fed, grooming, bathing, dressing, and mobility. Such homes do provide residents a modicum of independence, but they are really for very frail or infirm people who cannot survive on their own.

Thus, seniors with active lifestyles and relatively good health are often averse to the assisted living options available. They may be frail, may need assistance now and then, but on the whole they can eat, dress, bathe, and get around on their own. They are mentally sharp, but due to their age are looking to downsize to a single level, low maintenance living environment.

It is to this growing segment of the elderly population that the geriatric care industry markets independent living facilities. These homes or communities cater to people who still want to live on their own, but who may upon occasion need to rely on others for help with shopping, cooking, cleaning, and other necessary activities.

Independent living communities vary widely in terms of offerings and cost. Some are nothing more than subsidized apartments for seniors, while others are sprawling campuses complete with beauty shops, dining rooms, meal plans, and fitness and wellness centers. Some are connected to buildings that offer assisted living programs and offer the same amenities available to the assisted living residents.

What most people don't realize is that independent living flies completely below the regulatory radar in some states. Furthermore, there is no uniform industry definition of what is meant by the term "independent living", which is, in essence, a marketing label used to attract a certain segment of the population.

To appreciate the potential consequences of this, it helps to understand what regulation demands of other geriatric care providers. Take assisted living facilities as an example. Because they are regulated, everything from the contract you sign to the services provided must meet certain requirements. It also means that any assisted living administrator must maintain a license, and such programs are subject to inspection by the State and County governments.

Consider that in states where independent living is not regulated, facility administrators of such facilities do not need to be licensed or have any specialized training in senior health issues. There is no requirement that the facility maintain insurance, and no one conducts inspections to monitor these facilities and their services.

Consumers should also bear in mind that "independent living" communities are usually marketed by commissioned sales people who have little experience with senior care. Representations and promises made during the sales pitch should not be taken for granted. Indeed, services marketed as "amenities", such as social activities, may never be performed. And often the application process will reinforce people's assumption that residents will be checked on regularly, when in reality this may not happen at all.

The successful sales presentation typically culminates with the signing of a Resident Agreement, Lease, or other contract that specifies the terms of the residency. Since in some states there are no government agencies overseeing these facilities, and no regulations governing the services to be provided, it is imperative that you review the contract carefully.

Most facilities will provide you with a copy of the Resident's Agreement or other contract for your inspection. Make absolutely certain that all of the services that you want to receive, or that you want your family member to receive, are expressed within the language of the Agreement. Ask lots of questions. Find out if the facility has insurance. If you are counting on someone to check up on the resident, make sure daily status checks are mentioned within the contract.

Remember, if it is not in the contract, you should assume the service will not be provided.

As more people are deciding to become residents in independent living facilities, state governments that do not regulate this segment of geriatric care will have to take a closer look. Until then, a tragedy can only be avoided by educating yourself about the home or community and reading the contract carefully before you sign.