May 01, 2020

Warren, Markey, Maloney Ask Large Assisted Living Operators What Actions They Are Taking to Protect Residents From COVID-19 Outbreaks

Assisted living facilities share many of the same risk factors as nursing homes - but are largely unregulated with no national reporting requirements for COVID-19 cases; A "parallel" COVID-19 pandemic may be occurring with "far less scrutiny in another setting housing vulnerable seniors"

Text of Letters (PDF)

Washington, DC - United States Senators Elizabeth Warren (D-Mass.), a member of the Senate Health, Education, Labor, and Pensions (HELP) and Senate Aging Committees, Edward J. Markey (D-Mass.), and Congresswoman Carolyn B. Maloney (D-N.Y.), Chair of the House Committee on Oversight and Reform, sent a letter to the nation's largest assisted living operators asking a series of questions about coronavirus disease 2019 (COVID-19) outbreaks at their facilities and the actions they are taking to prevent and mitigate outbreaks when they do occur. The lawmakers sent letters to Brookdale Senior Living Sunrise Senior Living, Five Star Senior Living, Atria Senior Living, Life Care Services (LCS), Senior Lifestyle Corporations, Capital Senior Living, Affinity Living Group, Enlivant, Eclipse Senior Living, and Gardant Management Solutions, each of which owns or operates more than 5,000 assisted living units nationwide.

Assisted living facilities typically serve seniors that need some help with day-to-day activities and care but who, unlike nursing home residents, often live independently. And unlike nursing homes, assisted living facilities are essentially unregulated at the federal level. Nursing homes have been the locus of the COVID-19 pandemic, accounting for approximately one-fourth of all fatalities.

"Assisted living facilities deserve particular scrutiny in this pandemic because they share several of the same characteristics that increase risks at nursing homes - a population of senior citizens, many with chronic health problems, living and interacting closely together - but they face a significantly less stringent regulatory environment," the lawmakers wrote

Additionally, there is no national reporting requirement for assisted living facilities with COVID-19 cases. A 2018 Government Accountability Office report that was conducted at Senator Warren's request -- and was the first national assessment of health risks and regulatory gaps at assisted living facilities -- revealed that in just one year, there were over 22,000 "critical incidents" involving Medicaid recipients in assisted living facilities. However, most states could not even adequately report the number of these serious incidents.

"As a result, there is little comprehensive national information available on the extent of COVID-19 outbreaks in assisted living facilities and the actions taken by assisted living facilities and their operators to address these risks. We must act quickly to identify and address the ongoing risks from the COVID-19 pandemic," concluded the lawmakers.

The lawmakers asked a series of questions about the number of assisted living facilities with COVID-19 outbreaks, the number of residents or staff who have contracted the disease, the number of fatalities, and the facilities' prevention efforts, and requested responses to their letter no later than May 8, 2020.