WHEN IT COMES TO GENERATING REFERrals from assisted living facilities, home medical equipment providers need to remember one thing: They'll be dealing not only with the resident and his or her needs, but the resident's family, as well, say ALF officials.

"All families are very involved in all medical-related decisions," says Ruth Keilen, regional director of resident relations at Blythe House Assisted Living in Rumson, N.J. She adds that the facility is often contacted by family members wanting to know what kind of equipment their loved ones are getting. "We'll also make suggestions in accordance to what the doctors tell us and then relay that to the families," she says. "But ultimately it's the decision of the family, the physician and the resident."

ALFs can be good sources of business for HME providers. According to the Assisted Living Federation of America, based in Fairfax, Va., more than 1 million people reside in some 20,000 assisted living centers nationwide. Typically, they need standard durable medical equipment such as wheelchairs, walkers and beds, and sometimes oxygen. And they tend to be particular about the equipment they get, officials say.

Residents - or their families - generally pay ALF bills out of their own pockets. And although Medicare or insurance might pay for their devices, they still want their money's worth, officials say. They want to know more about the product, that it is the best available and that it is what the doctor prescribed.

"Assisted living is very customer - service - driven," says Sheela Frisch, central division quality assurance director at Atria, a Louisville, Ky.-based company that owns and/or manages ALFs nationwide. "It's a little bit different than working with a strict Medicare or Medicaid patient since assisted living is mostly private pay. So when it comes to customer service - such as timeliness - ALF residents expect to have it. That's why [this business] is so consumer-driven."

Before targeting such centers as potential referral sources, HME providers should find out what their state's policies are regarding assisted living centers' involvement in their residents' medical affairs. Regulations vary widely from state to state, Frisch notes. In some states, the centers can make medical and therapeutic interventions for the residents, such as ordering equipment. In other states, such medical involvement is not allowed - it must be initiated by the residents or their families.

"These policies reflect a lot of the moods and themes [that] each individual state projects and the intention of every state," says Frisch. "And they depend on what the state will allow and what [it believes] the assistive community to be and should look like, because assistive living looks different in every state."

For more information about assisted living facilities, access ALFA's Web site at www.alfa.org.