Strengthening Assisted Living Regulations: Impact on Resident Safety and Urinary Incontinence Care

The Maine Department of Health and Human Services (DHHS) has proposed major updates to assisted living and residential care regulations, increasing staffing requirements for the first time in over 15 years. This follows an investigation by The Maine Monitor and ProPublica, which uncovered widespread violations, including neglect, medication errors, and residents wandering away unsupervised.

The proposed changes include doubling direct care staff overnight, raising daytime staffing ratios, and enforcing stricter rules in memory care units. Experts argue that current staffing levels are inadequate, leaving vulnerable residents, such as those with dementia, at risk. The proposal also mandates assessments for "elopement risk" to prevent residents from leaving facilities unsupervised.

However, the regulations face opposition from facility owners, who argue they will lead to significant financial strain—requiring thousands of additional workers and millions in extra costs. Many providers warn that passing these costs to residents may be unavoidable without increased Medicaid reimbursement. Workforce shortages further complicate implementation.

Despite concerns, advocates stress that higher staffing levels are essential for resident safety and well-being. Legal Services for Maine Elders emphasized that these reforms could prevent neglect and improve health outcomes. The final proposal is set to be reviewed by lawmakers in January.

Connection to Male Patients with Urinary Incontinence

Many male residents in assisted living facilities suffer from urinary incontinence due to conditions like dementia, stroke, and neurological disorders. The proposed regulations directly impact their care, as increased staffing levels can improve hygiene, reduce infections, and prevent neglect-related complications like pressure sores. Additionally, stricter monitoring of wandering behavior (elopement risk) is crucial for incontinent patients, who may face greater health risks if they leave facilities unsupervised. Ensuring adequate staffing can also enhance timely changes of absorbent products, reducing discomfort and preventing infections such as UTIs.

Lundy, R. (2024, November 27). Maine proposes major staffing increases for assisted living and residential care facilities. ProPublica. https://www.propublica.org/article/maine-care-facilities-staffing-increases