title: State Regulatory Approaches for Dementia Care in Residential Care and Assisted Living.
abstract: This policy study analyzed states' residential care and assisted living (RC/AL) regulations for dementia care requirements. Estimates suggest that at least half of RC/AL residents have dementia, and 22% of settings provide or specialize in dementia care. Residents with dementia might benefit from regulations that account for specific behaviors and needs associated with dementia, making states' RC/AL regulations address dementia care an important policy topic.
  
  
  
  This study examined RC/AL regulations in all 50 states and the District of Columbia for regulatory requirements on five topics important to the quality of life of RC/AL residents with dementia: pre-admission assessment, consumer disclosure, staffing types and levels, administrator training, and physical environment.
  
  
  
  Sixteen states license or certify dementia care units within RC/AL settings. All states had at least one dementia care requirement, though only four states had requirements for all five of the topics reviewed. Most states addressed administrator training, consumer disclosure, and physical environment, 17 addressed staffing types and levels, and 14 addressed pre-admission assessment for dementia. Thus, most states rely on general RC/AL regulations to cover dementia care policies and practices.
  
  
  
  This policy study provides a resource for researchers who do cross-state studies of dementia care in RC/AL settings and state policymakers who are updating RC/AL regulations, including those responding to a 2014 Centers for Medicare and Medicaid Services rule change.
authors.affiliation: Oregon Health & Science University-Portland State University School of Public Health and Institute on Aging, Portland State University, Oregon.
authors.forename: Paula C
authors.initials: PC
authors.lastname: Carder
mesh_terms: D040561:Assisted Living Facilities / Q000331:legislation & jurisprudence*; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000628:therapy; D003704:Dementia / Q000175:diagnosis / Q000628:therapy*; D030881:Disclosure / Q000331:legislation & jurisprudence; D005160:Facility Design and Construction / Q000331:legislation & jurisprudence; D033161:Government Regulation; D006801:Humans; D011788:Quality of Life; D012112:Residential Facilities / Q000331:legislation & jurisprudence*; D013219:State Government; D014481:United States; D000078329:Workforce
keywords: Alzheimer’s disease; Assisted living facilities; Dementia; Public policy