By: Shawn Rader: On February 4th, the New York Times had an article which should give the ALF industry pause. It reported that at the request of four senators, the Government Accountability Office commissioned a two-year investigation of the use of Medicaid payments to ALFs around the country, and reported back that there is a dearth of federal oversight of the ALF industry, with little to no supervision for the Medicaid funds by the federal government, and a patchwork of oversight by the states. (Assisted living was not originally part of Medicaid, but many states now use it to cover it under waivers intended to encourage ALF use as an alternative to the more expensive nursing home option.) The report points out that unlike nursing homes, for which the federal government adopted an oversight law in 1987 and exercises legal oversight of the use of federal funds, there is no such oversight of ALFs. Moreover, the 1987 law promulgated rules and regulations to protect residents’ rights, but no comparable federal rules exist for ALF residents. The Trump administration agrees that federal officials should clarify the requirement for states to report on the abuse or neglect of ALF residents, and is now studying whether additional reporting requirements are needed. In short, the camel’s nose is now under the tent. It would be naïve to believe that any federal law would limit its oversight of ALFs to monitoring Medicaid funding alone. Perhaps Florida would be better off following the example of California, Oregon, Rhode Island and Virginia, and adopting its own enhanced program for reporting and regulation in the hope of heading off a national law imposed from Washington (if it is not too late).