On behalf of the Arlington Commission on Aging, we write in strong support of the proposed regulatory changes concerning involuntary discharge of residents.  The Commission on Aging serves as a key advisory body to the County Board of Arlington County with a mission to promote the quality of life for all older persons and to ensure their needs are included in all planning and activities. 

The proposed regulations provide a fundamental safeguard that will prevent serious harm to the highly vulnerable population of assisted living residents and their families who are currently at risk of inappropriate and unnecessary discharges.  Currently, while nursing home residents have access to discharge hearings and tenants have protections built into the eviction process, assisted living resident are left with little recourse.  As a result, involuntarily discharged residents may be shuffled into homeless shelters, hospital emergency rooms, or nursing homes where care costs may be unnecessarily heightened. 

Homelessness of older adults continues to spike in Arlington.  According to the 2025 annual point-in-time (PIT) survey of homelessness by the Metropolitan Washington Council of Governments, homelessness in Arlington increased for the fourth year in a row, with the 2024-2025 increase at 12 percent.  Adults represented the lion’s share of the homeless, with adults over age 55 representing 32% of all adults experiencing homelessness.  Improper assisted living discharges, especially of residents who require intensive supports, can only increase homelessness and the need for costly emergency protection measures.  

The regulation sets out a solid process for discharging residents only for allowable reasons, notifying residents of intended discharges, encouraging facilities to resolve issues short of discharge, and providing for facility assistance in relocation.  Further, the regulation provides that in involuntary and emergency discharge, the facility must provide a copy of the discharge notice to the licensing office and to the State Long-Term Care Ombudsman. This allows for intervention in cases of improper discharge, ensuring that such drastic action is in the best interest of the resident. It also enables the agency and ombudsman to track these discharges to discover trends and patterns on which to base improvements and training.

Currently there is scant data providing insight into how often discharges occur, under what circumstances, and in which facilities.  By requiring ALFs to notify the Department of all discharges, the regulation for the first time creates a needed mechanism to identify discharge patterns that may indicate facility-specific or system-wide issues.  Any additional administrative burden borne by facilities in carrying out the proposed regulation pales in comparison with the basic due process, safety, and dignity interests of residents.  

In 2024, the regulation was proposed to be fast-tracked, and many public comments identified ways in which the process could be improved to ensure the best interests of at-risk residents, as well as fairness to facilities. Changes responding to these comments have strengthened the regulation as it now stands.

The Arlington Commission on Aging urges the speedy adoption of the regulation to secure the most fundamental right of notice and opportunity to be heard in the face of pending discharge from care.  The regulation takes a major step in meeting the needs of assisted living residents in Virginia.