Protecting LGBTQ+ Long-Term Care Residents in the United States: Comparisons of 9 Laws Regarding Scope, Jurisdiction, Training, and Enforcement

OBJECTIVE: LGBTQ+ older adults have a higher anticipated need for residential long-term care. A rise of recent anti-LGBTQ+ bills has raised new concerns about discrimination. This study analyzes 9 laws in the United States that explicitly protect LGBTQ+ residents in long-term care by identifying and comparing the law's scope of coverage, jurisdictional variations, training and compliance requirements, and enforcement. DESIGN: This community-engaged study incorporates a qualitative content review and comparative analysis of all 9 laws explicitly protecting sexual and gender minorities in residential long-term care in the United States. SETTINGS AND PARTICIPANTS: This study examines 8 bills of rights and 1 antidiscrimination law explicitly protecting sexual and gender minorities in residential long-term care. METHODS: The research team identified and reviewed policy language in all 9 laws explicitly outlining rights for LGBTQ+ residents in residential long-term care and employed directed content analysis to analyze and compare data. RESULTS: The analysis of US laws with explicit protections for LGBTQ+ long-term care residents reveals substantial differences in definitions, scope of protections, training standards, and enforcement mechanisms that provide varying levels of protection. Overall, these bills shared similar structures that allowed for robust comparisons regarding to whom the law applies, what the law does, and how the law is enforced. However, protections varied widely with inconsistent definitions, training, and enforcement, creating significant gaps and opportunities to best serve LGBTQ+ residents in long-term care. CONCLUSIONS AND IMPLICATIONS: By comparing all 9 laws aiming to protect sexual and gender minorities in residential long-term care, this study illuminates strengths and challenges posed by these laws, and opportunities for refinement moving forward that could further alleviate concerns about discrimination toward LGBTQ+ residents in long-term care.