You are completely right! Your post identifes a MAJOR problem in LTC care today: ALFs are not regulated and no one is watching them. Admission and discharge criteria are flexible and seldom defined. The ALF industry will be nailed with a few lawsuits and then they will have the regulations that SNFS have and we have ruined a good thing. The majority of ALFs are simply private pay nursing homes disguised as a lower level of care, who get to avoid OBRA and state regulations and "cherry pick" the better residents! I am speaking not as Nurse, but as I LNHA who competes with assisted livings for good residents.