Recommendation 1: Enhance the capacity of the assisted living registry to enforce the Community and Assisted Living Act by substantially increasing the number of assisted living investigators, and by developing policies that build on the inspection provisions in the act.

These policies should:

• Mandate yearly inspections of all private-pay and publicly subsidized assisted living residences; and
• Mandate all publicly subsidized and private-pay assisted living residences to post clear and detailed information about how and where residents, families and staff can access the complaints process of the assisted living registry, including public reporting on compliance.

Support the Seniors Advocate to work with a broad-based multistakeholder advisory committee to conduct a review of seniors’ assisted living residences

Recommendation 6: This would determine how to operationalize Bill 16 in ways that support a broad continuum of affordable seniors’ residences and care services and ensure access to high-quality assisted living services for all British Columbians who could benefit from them. This review would include an outreach plan to gather input from residents in assisted living, their families and friends, assisted living staff and community members on how this sector should be reconfigured, and on the services and staffing supports required to ensure a sustainable and viable relational model of care.

Support the Seniors Advocate to work with a broad-based multistakeholder advisory committee to conduct a review of seniors’ assisted living residences

Recommendation 7: The review would also address the oversight issues not covered by the assisted living registry (e.g., tenancy and quality-of-care issues), the need for provincial regulations or protocols for information sharing, and the need for assessment processes to determine if assisted living is the appropriate level of care for a resident.

Support the Seniors Advocate to work with a broad-based multistakeholder advisory committee to conduct a review of seniors’ assisted living residences

Recommendation 8: To ensure that the review reflects the current reality of both publicly subsidized and private-pay assisted living residences, the Seniors Advocate would begin by conducting three mini audits:

• To determine the proportion of residents currently living in assisted living residences who do not qualify for assisted living (as defined by the Bill 16 amendments) and identify the extent to which there are problems related to inappropriate prescribing and the lack of safeguards in medication storage;
• To determine the percentage of current residents in long-term care who do not require this level of support and who could be more appropriately supported in an assisted living residence (instead of relying on RAI-MDS data as is currently the case); and
• To determine the number of assisted living residents using emergency services, and the reason for and frequency of these visits and the costs to the system.