Assisted Living and Nursing.

In summary, some Nebraska ALFs are admitting people on Medicaid waivers and people with relatively advanced dementia. They are retaining people on hospice care. Many employ and even advertize that they have RNs, yet regulations prevent these RNs from using their judgment, from practicing professional nursing. This is a total disregard of what RNs, exercising their full scope of professional practice, can bring to a setting, and of what many of the residents in ALFs need. It is time Nebraska ALFs stepped up to meeting the care needs of the residents they admit and retain by providing RN care and oversight to those who need it. They also should provide more than one level of care so that those who only need help with ADLs do not have to pay for a level of care they do not need. Now that there is a group studying the future of AL in Nebraska, is the time to make the changes in regulations--to no longer interfere with professional nurses' legal scope of practice in a setting where they are employed, and to meet the needs of the residents they are admitting and retaining. Other states should do likewise.