{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T22:13:04Z","timestamp":1775599984908,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Assisted living facilities (ALFs) are plagued with quality issues but there are limited studies on the quality of ALFs. In Florida, state surveyors conduct inspections of ALFs and cite and\/or fine facilities that are in violation of regulations. Yet, we do not know the types of quality problems identified and the extent to which facilities repeat such problems. In this study, we begin to fill this gap in our understanding of ALFs quality by summarizing the deficiency citations in Florida ALFs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We obtained inspection citation data on 957 large ALFs (bed size\u2009\u2265\u200925) in Florida from 2012 to 2018. Citation data are summarized at the facility\u2010year level and classified into different groups such as resident care, admissions, medication, staffing, and training. We examined the trends in citations over time and stratified citations by profit status, license type, and facility size. We also assessed repeat citations among the ALFs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 957 large ALFs operating in Florida, 87% of the facilities were cited one or more times from 2012 to 2018. In 2018, the most common citations were related to medications (26.2%), resident care (25.3%), training (25.3%), admissions (21.1%), and staffing (20.8%). For\u2010profit facilities, facilities with beds over 100, and facilities with limited mental health license tended to be cited more often across most types of deficiencies. Repeat citations are common with over 40% of facilities cited in two or more years for resident care and medication from 2012 to 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that repeat citations are common and ALFs do not improve quality on a long\u2010term basis after citations. If we want to improve ALFs quality, we may need to provide appropriate incentives and resources to ALFs along with stringent enforcement of regulations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17466","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T22:59:33Z","timestamp":1631660373000},"page":"150-157","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence and persistency of deficiency citations in Florida assisted living facilities"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7857-8545","authenticated-orcid":false,"given":"Hari","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Health Management and Policy The University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,14]]},"reference":[{"issue":"43","key":"e_1_2_9_2_1","first-page":"1","article-title":"Long\u2010term care providers and services users in the United States: data from the National Study of Long\u2010Term Care Providers, 2015\u20132016","volume":"3","author":"Harris\u2010Kojetin L","year":"2019","journal-title":"National Center for Health Statistics\u2014Vital Health Stat"},{"key":"e_1_2_9_3_1","unstructured":"Government Accountability Office.Medicaid Assisted Living Services\u2014Improved Federal Oversight of Beneficiary Health and Welfare is Needed. In. Vol GAO\u201018\u2010179.2018."},{"issue":"4","key":"e_1_2_9_4_1","first-page":"776","article-title":"State regulatory approaches for dementia care in residential care and assisted living","volume":"57","author":"Carder PC","year":"2017","journal-title":"Gerontologist"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.03.021"},{"key":"e_1_2_9_6_1","unstructured":"KuhlmanMS.MN lawmakers consider new protections against elder abuse.Public News Service. April 10 2019 2019."},{"key":"e_1_2_9_7_1","unstructured":"RauJ.Dementia patients fuel assisted living's growth. Safety may be lagging.The New York Times. 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