Abstract
As a result of the Centers for Medicare & Medicaid Services’ (CMS) interest in creating a unifying definition of “community living” for its Medicaid Home- and Community-Based Services and Supports (HCBS) programs, it needed clarifying descriptors of person-centered practices in assisted living to distinguish them from institutional ones. Additionally, CMS’s proposed language defining “community living” had the unintended potential to exclude many assisted living communities and disadvantage residents who receive Medicaid. This article describes the consensus process through which clarifying language for “community living” and a framework for HCBS person-centered domains, attributes, and indicators specific to assisted living were developed. It examines the validity of those domains based on literature review, surveys, and stakeholder focus groups, and identifies nine domains and 43 indicators that provide a foundation for defining and measuring person-centered practice in assisted living. Ongoing efforts using community-based participatory research methods are further refining and testing person-centered indicators for assisted living to advance knowledge, operational policies, practices, and quality outcomes.
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