The National Center for Assisted Living (NCAL) recently released its 2012 edition of “Assisted Living State Regulatory Review,” finding that 16 states made changes to assisted living regulations, statutes, and policies during 2011.

Four states—Georgia, Nevada, North Carolina, and South Dakota—made major changes. Georgia created a second level of licensure for assisted living communities alongside the state’s existing licensure of personal care homes. “While the categories share many common requirements, assisted living community standards are more stringent or vary in a number of areas,” the report says.

Facilities with 25 or more beds can opt for either type of licensure.

In South Dakota, assisted living centers are now regulated under new rules that further define restrictions on accepting and retaining residents, as well as conditions under which hospice care may be provided.

New regulations for assisted living residences adopted last year in Nevada centered mainly on medication administration, including increased medication administration training for caregivers, from eight initial hours to 16 initial hours, and new refresher training requirements, from three hours every three years to eight hours annually.

In addition, Nevada administrators must take the same initial medication administration training and the same refresher training as their caregivers, regardless of whether or not the administrator is a licensed medical professional.

In North Carolina, the legislature approved changes that impact adult and family care home licensure, including penalties and remedies for violations, discharge of adult care home residents, frequency of inspections based on quality ratings, infection control standards, and training and competency evaluation of medication aides.

“Florida and several other states are considering major changes for 2012,” says Karl Polzer, NCAL’s senior policy director and the report’s author. “As in previous years, this year’s report found many states actively refining and developing regulations.”

The report is published every March. It is the only annual resource that summarizes state assisted living regulations across 21 categories, which include life safety, physical plan requirements, medication management, and move-in/move-out criteria.

The report also found that six states added or revised education and training requirements. For instance, Washington began requiring most new direct-care workers to take 75 hours of training within 120 days of being hired and then become certified as home care aides within 150 days.

Other focal points of state regulatory changes include disclosure of information to consumers, infection control, discharge/transfer between sites, and move-in and move-out criteria, as well as medication management.