The problem with Assisted Living communities is that there are no federal standards. In one state, an Assisted Living community may be a house modified for multiple occupancy. Another may consist of individual dwellings where the residents are all provided with help with activities of daily living (ADLs). Still another may be comprised of apartments with public spaces for hair salons, dining, and fitness. Assisted Living communities may be called personal care homes, board and care homes, adult foster care, group homes, supportive living arrangements, and community residential settings. Nearly all of the communities in a Health and Human Services survey of Assisted Living offer basic health monitoring, incontinence care, social and recreational activities, special diets, and laundry services.
Differences Among States
However, each state has different rules and regulations. For example, in Massachusetts, each community or group of communities with the same ownership must provide an operating plan that includes the following information:
- Fee structure for lodging, meals and services
- Type and extent of services to be offered, including arrangements for providing such services
- Plan for self-administered medication management for residents
- Means for residents to communicate urgent or emergency assistance
- Plan to provide timely assistance to residents who request urgent or emergency assistance
- Number of staff and minimum qualifications
- Copy of the residency agreement that meets state codes
- Quality improvement and assurance program
- Policies and procedures designed to ensure a safe environment for residents
- Assurance of resident rights, which include privacy, confidentiality, ownership of property, a safe environment, the exercise of civil and religious liberties, and reasonable response to requests
- Mandatory provision of housekeeping, dining services, housekeeping, medication management, laundry services, provision of help with ADLs, and opportunities for socialization
- Express prohibition for any staff member or anyone associated with the community to manage funds or property of residents with a value of over $200
- State-mandated guidelines for admission and retention of residents
- Periodic review of resident care plans
- Resident assessment requirements
The state also requires that all Assisted Living communities:
- Meet fire and safety codes
- Provide private bathrooms for residents
- Provide lockable doors for all residences
- Provide kitchenette or access to cooking facilities for residents
- Maintain 24-hour-a-day on-site staff
- Employ trained staff including licensed nurses, certified nursing assistants (CNAs), certified home health aides, qualified personal care homemakers or staff who have completed a 54-hour training course (7-hour general orientation and additional training, including 10 annual hours of continuing education, are also specified)
- Provide a service plan for each resident based on information from the resident’s physician or authorized practitioner
Massachusetts also has special provisions for memory care and other special units. The state of Massachusetts’ Executive Office of Elderly Affairs also inspects each community every 2 years, although they are permitted to inspect at any time. Massachusetts also provides a website with contact information to determine if a community is or has been in violation of state law. A Place for Mom provides contact information for every state.
Why Is Assisted Living Certification Important?
Because state regulations vary from state to state, not only is certification important, the breadth and rigor of state requirements may result in major differences in resident quality of life and, indeed, survival. For example, Alabama, South Carolina and three other states, on the other hand, mandate no requirements for inspections at all. Requirements for training vary from state to state, too. In Minnesota and 13 other states, administrators don’t need high school diplomas. Facilities in Colorado and other states are not required to have a licensed nurse on staff. Unfortunately, there is no national ranking system for Assisted Living communities. Caring.com does offer a rating for Assisted Living communities based on customer reviews.
Want to Know More about Assisted Living?
If you are a caregiver for your parent or an older adult, please take a moment to see if any of these informative articles can improve their and your life. At The Arbors Assisted Living Residential Communities, we believe in creating an engaging, stimulating environment that benefits the mind, body and spirit of our residents. We promote a lifestyle of health and wellness, with programs that benefit brain health, physical fitness and more. If you have questions about how The Arbors can help older adults live independent, active, fulfilling lives, please contact us.