Long term care is a service that is defined and governed at both the state and federal levels. So it is not the same in every state, and (sadly) the rights of residents in long term care are not the same in every type of long term care facility in every state. Residents of long term care can face discrimination, even within their own communities, as discussed in a previous post.
Most residential long-term care is provided in private businesses – for-profit and not-for-profit nursing homes, assisted living, and adult family homes. And in this nation, private businesses have private property rights. Think of an apartment building: people who lease apartments, and the guests of these tenants, have the “right” to be there. Everyone else can be considered “trespassers.” May seem “harsh” in this context, but “on balance,” “We the People” value private property rights.
State and community taxpayer-funded long term care facilities, such as county-run nursing homes in some states – these “public” places would have less flexibility to discriminate, just as public schools have little flexibility to discriminate.
But all long term care facilities, public and private, are required to have a state license to operate as a long term care facility. “We the people” in each state get to decide through laws and regulations our state’s definition of “long term care facility.” But within our state’s definition, every business that gets a license to operate in the long term care world is required to disclose all the services, and all the fees, and all the rules to potential residents and their loved ones, before admission and at least thirty days in advance, in writing, to current residents, before any change.
Here’s the catch: What is different from one state to the next is the definition of “long term care facility.” In many states, including Washington, a “continuing care retirement community” (CCRC) is not a licensed long term care facility. It is an independent apartment building, or residential community. And like any independent apartment business, a CCRC in Washington State gets to decide, under private property rights, who is allowed to be where. And there are residential communities in this state that limit, or prohibit, the presence of “higher care” residents in the beautiful spaces set aside for only the “independent” residents….. and for the sales department and the parade of “prospective residents” who might “buy into” only a vibrant, youthful community.
And because a CCRC is not required to have a long term care license in this state, it is not bound by the regulations that would require a licensed long term care business to disclose limitations like this – along with all services, fees, and rules – to residents before residents move in.
The next post will offer a few ideas about what residents in licensed long term care, residents in un-licensed residential communities, their loved ones, and consumers can do.