NAOSA Gold Standards of Professional PracticeTM

Senior Living Communities



Each member profession of the National Association of Senior Advocates has a standard of guidelines that our members must abide. We call these the NAOSA Gold Standards of Professional Practice.

Senior Living Communities



The goal of the NAOSA Gold Standard of Professional Practice™ for Senior Living Communities is to be clear and concise in all communications regarding the price of services as well as ensure all member communities strive to offer an outstanding quality of life to its residents. Although senior living communities are generally regulated by a state’s Department of Aging, as well as federal regulations, there still remain many opportunities for improvement.

In addition to state and federal requirements already in place, the National Association of Senior Advocates member communities have identified several business practices that would help ensure confidence in accuracy of pricing as well as establish a clear measurement of quality resident care. With the goal of always acting in utmost good faith when working with clients, all NAOSA Members agree to the following:


NAOSA Gold Standards of Professional Practice™

1: Truthful in All Communications: All communications, both verbal and written, will be 100% accurate.

2: Communities Will Fully Disclose All Anticipated Monthly Costs for Care and Assistance: NAOSA members will disclose all anticipated monthly living costs over and above a community’s base price. Although applicable in independent living, most issues occur in either an assisted living or skilled nursing setting. Assisted living and skilled nursing communities generally have a base monthly fee, an additional fee based on level of assistance required and potential ala carte service fees, such as medication management or additional meals.

The majority of individuals residing in an assisted living and skilled nursing community will require services over and above the base monthly fee. In order to receive an accurate estimate of the monthly living costs, it is critical that a thorough needs assessment is performed. As part of this assessment, the client and/or family must be an active part of this process, providing exact detail of service expectations, current medications, and other needs. This assessment will help to establish a realistic cost of living in the community. 


All NAOSA member communities are required to perform a thorough needs assessment and disclose in writing the full anticipated monthly fee. This quote will include the base price, charges for additional assistance as well as any anticipated ala carte services.


3: Skilled Nursing Facilities (Nursing Homes) Will Maintain an Average Overall Medicare Rating of Four Stars Over a Five Year Period. The Medicare star rating system, Nursing Home Compare, features a star rating system that gives each facility a rating between one (1) and five (5) stars. The nursing home star ratings are derived from data regarding health and safety risks, staffing ratios, and quality of resident care measures. The Centers for Medicare & Medicaid Services (CMS) calculates a star rating for each of these three sources, along with an overall rating. An overall rating of three (3) stars is considered average, while a rating of four (4) and five (5) stars is considered “above average” and “much above average” respectively.


Why is This Information Important?
Per the CMS website “Nursing homes vary in the quality of care and services they provide to their residents. Health inspection results, staffing data, and quality of resident care information are three important ways to measure the quality of nursing homes. This information, combined in the star rating, gives you a "snapshot" of the quality of each nursing home.”


The Medicare star rating system can give you important information and should be used in conjunction with a personal visit to a nursing home. Star ratings, personal visits, the NAOSA Gold Standards of Professional Practice and additional guides provided by Medicare should be utilized to determine whether the community fits you or your family members’ needs.


Are you a senior living professional? We welcome your constructive input to assist in the protection of all consumers. Please contact us.



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