The study results reported here deal with the effects of regulation on the quality of care in board and care, or domiciliary care, facilities. The database for the study included data gathered in 512 board and care facilities in 10 States. This report presents the analysis of the effect of regulation and licensure on the quality of care in board and care homes. As the data surninarized in that exhibit demonstrate, this inquiry found substantial and widespread positive effects of regulation on quality in board and care homes. Reducing Prevalence of Unlicensed Homes First, we found that States with extensive regulatory systems had a significantly smaller proportion of unlicensed facilities.
Regulation seems to reduce the prevalence of unlicensed homes.
Improving Quality of Care Second, we found that extensive regulatory systems were associated with better quality of care. Several findings suggest that homes in States with extensive regulatory systems were better prepared to cope with needs of residents who are frail and disabled. For example, homes operating under more extensive regulatory systems were more likely to have operators trained in care of the elderly and disabled, to have lower use of psychotropic drugs, and to have lower use of inappropriate prescriptions for the elderly. Also, staff in licensed homes in States with extensive regulatory systems were more knowledgeable about and more willing to refer residents and families to the longterm care ombudsmen programs. In addition, licensed homes made a wider array of key supportive services available to residents.