Table 3.
Assisted living facility healthcare staffing, infection control, and training requirements specified in state regulations, by time period in which the legislation took effect, United States, 2012
| Characteristics | 1998–2012 | 1998–2007 | 2008–2012 | p-value | |||
|---|---|---|---|---|---|---|---|
| n=50 | % | n=16 | % | n=34 | % | ||
| Staff Requirements | |||||||
|
| |||||||
| Licensed health care professional oversees medical care | 30 | (60%) | 10 | (63%) | 20 | (59%) | 0.80 |
| Licensed health care professional is on-site 24 hours a day | 5 | (10%) | 3 | (19%) | 2 | (6%) | 0.31 |
| Licensed health care professional oversees infection control | 3 | (6%) | 0 | (0%) | 3 | (9%) | 0.54 |
| All staff are required to receive infection control training: * | |||||||
| On hiring | 7 | (14%) | 2 | (13%) | 5 | (15%) | 1.00 |
| Within a specified time period from hiring | 12 | (24%) | 4 | (25%) | 8 | (24%) | 1.00 |
| Annually | 7 | (14%) | 1 | (6%) | 6 | (18%) | 0.41 |
| Other infection control training requirements | 3 | (6%) | 2 | (13%) | 1 | (3%) | 0.24 |
| Any of the above infection control training requirements mentioned | 27 | (54%) | 9 | (56%) | 18 | (53%) | 0.83 |
| Sub-contracting home health agencies or aides is permitted if: * | |||||||
| Patient arranges hiring of aides independently | 21 | (42%) | 6 | (38%) | 15 | (44%) | 0.66 |
| ALF coordinates hiring of aides for individual residents | 25 | (50%) | 10 | (63%) | 15 | (44%) | 0.23 |
| ALF sub-contracts with agency for all residents | 4 | (8%) | 1 | (6%) | 3 | (9%) | 1.00 |
| Other specified criteria | 4 | (8%) | 0 | (0%) | 4 | (12%) | 0.29 |
| Any of the above sub-contracting options permitted | 44 | (88%) | 14 | (88%) | 30 | (88%) | 1.00 |
|
| |||||||
| Infection Control and Prevention | |||||||
|
| |||||||
| Facility inspection includes infection control assessment | 8 | (16%) | 4 | (25%) | 4 | (12%) | 0.25 |
| Specific requirement to report cases of communicable disease | 25 | (50%) | 4 | (25%) | 21 | (62%) | 0.02 |
| Specific infection control measures referenced in the regulation: | |||||||
| Personal protective equipment | 11 | (22%) | 3 | (19%) | 8 | (24%) | 1.00 |
| Hand hygiene | 18 | (36%) | 6 | (38%) | 12 | (35%) | 0.88 |
| Safe injection practices | 5 | (10%) | 0 | (0%) | 5 | (15%) | 0.16 |
| Other infection control practice** | 5 | (10%) | 1 | (6%) | 4 | (12%) | 1.00 |
| Any of the above infection control measures referenced | 23 | (46%) | 7 | (44%) | 16 | (47%) | 0.83 |
| Infection control guidelines/standards referenced: * | |||||||
| Centers for Disease Control and Prevention | 13 | (26%) | 1 | (6%) | 12 | (35%) | 0.04 |
| Occupational Safety and Health Administration *** | 5 | (10%) | 1 | (6%) | 4 | (12%) | 1.00 |
| General infection prevention standard(s) †† | 8 | (16%) | 1 | (6%) | 7 | (21%) | 0.41 |
| Any of the above | 22 | (44%) | 3 | (19%) | 19 | (56%) | 0.02 |
| Specific reference to Standard or Universal Precautions: | |||||||
| Standard Precautions | 9 | (18%) | 0 | (0%) | 9 | (26%) | 0.04 |
| Universal Precautions | 16 | (32%) | 6 | (38%) | 10 | (29%) | 0.57 |
| Either of the above | 24 | (48%) | 6 | (38%) | 18 | (53%) | 0.31 |
| Specific requirement for written infection control plan | 18 | (36%) | 5 | (31%) | 13 | (38%) | 0.63 |
*
States could select more than one
**
Including but not limited to aseptic techniques, compliance with rules regarding special waste, immunization
***
Bloodborne Pathogens Standard, 29 CFR 1910.1030
††
Regulation includes general infection control language using terminology pertaining to “standard of care,” “scientifically accepted,” or “professional standards”