Residential Care and Assisted Living - Agency for Healthcare ...

considered violations or findings depending on the impact on resident care. Citations that are
issued as violations in one region may be cited as findings in another region.
The New York Department of Health, Adult Home Quality Initiatives Division issued a request
for proposals for the EnAbLE (Enhancing Abilities and Life Experience) Program to develop
innovative methods to improve the quality of life for individuals living in adult homes, enriched
housing programs, and residences for adults. The program was designed to teach independent
living skills, provide educational or vocational training, and/or teach residents preventive health
care skills and how to manage their own medications. This program offers operators an
opportunity to offer a variety of supportive services to improve quality of life for residents and
empower residents to become more independent and integrated into their community through a
vocational education program or independent living skills training. The type of activities that
might be proposed include teaching and supporting residents to navigate the bus line or transit
system, to keep appointments, resolve a disagreement with another resident, increase
socialization skills, or manage their needs within a budget. These are skills that may improve a
resident’s quality of life and independence. Other programs might assist and mentor a resident in
the steps required to enroll, attend, and complete a vocational education or GED program. The
Department may award up to $2 million in grants. The maximum award is $100,000.
New Jersey sponsors an annual Assisted Living Quality Initiative Best Practices Program. In
2005, the program selected “The Dining Experience: Using Resident Feedback to Enhance
Service” for the best practices topic. Awards were made based on the size of the facilities: small
(under 50), medium (50-99), and large (100 and larger). Selection factors include consumer
involvement and feedback, the goals of the practice, and the facility’s approach to evaluating the
impact of the practice. 26
Supporting Quality Through Technical Assistance
Several States use the survey process to offer additional assistance to operators to improve
quality. The assistance takes several forms: interpreting regulatory requirements, providing
technical assistance or consultation, and referring staff to facilities that may be considered a
“best practice” or peers that have successfully improved in a similar area. State officials in five
States described providing assistance during the survey process. Information about the survey
process and licensing requirements made available on State Web sites may also be considered to
be assistance. Licensing rules in eight States describe requirements for facility quality
improvement plans that are reviewed by survey staff.
Some States felt there is a conflict between oversight and consultation or technical assistance
functions. One State indicated that facilities are responsible for resolving quality problems, and
the State provides consultants to assist them in the process. Other States said they clarify rules or
statutes with facility staff during the survey or during exit interviews after the survey is
completed. If the facility is able to correct the problem during the survey, no deficiency is
issued. Utah allows new administrators to request assistance and has procedures for the licensing
agency to review survey forms, previous reports, and deficiencies with administrators.
Pennsylvania provides guidance by disseminating information about best practices.
26 See Section III, New Jersey, for more information on this program.
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