What is it called?

• Assisted Living Facility:
• Houses more than 3 adults
• Categorized as either Level I or Level II, based on the services offered 
• Residential Care Facility:
• Houses 3 or more adults who need help with daily activities, but do not need nursing home care or hospitalization

What services are provided?

• Minimum services include 24 hour supervision, with activities and transportation, meals, laundry, and medication assistance
• Level I Minimum services:
• Assistance in obtaining emergency care
• Social and recreational activities
• Level II Minimum services:
• Help with daily routines
• Limited help with medication administration
• Nursing home services

Who can be admitted?

• Level I:
• Adults needing assistance with daily activities

• Level II:
• Residents who need a nursing facility level of care
• Residents who need help with the administration of medication

Who is inappropriate?          

• All Facilities:
• Need a level of care that cannot be provided by the facility
• Level I:
• Need 24-hour nursing services
• Exception: The 24 hour nursing services are provided by a licensed home health agency for a period of up to 60 days, with the possibility of one 30-day extension.
• Are unable to get out of bed unassisted.
• Need help moving into and out of their wheelchair (or ‘transfer assistance’) that the facility cannot provide with their current staff
• Need the facility to administer medication.  The resident can be reminded to take medication, but they must take the medication themselves.
• The resident (or their representative) refuses to cooperate with an examination.  The examination is used to determine the resident’s health or mental status.  The examination may be performed by a physician, advance practice nurse, or licensed psychologist.  The resident’s health and mental status can be used to find out if it is good for the resident to stay at the facility.  If the facility cannot provide acceptable care, the resident may have to leave. 
• Are dangerous to others or engage in criminal activity
• Level II:
• Need 24-hour nursing services.
• Are unable to get out of bed without assistance
• Need help moving into and out of their wheelchair (or ‘transfer assistance’) that the facility cannot provide with their current staff
• Need the facility to administer medication.  The resident can be reminded to take medication, but they must take the medication themselves.
• Are dangerous to self or others or engage in criminal activities
• Exceptions to Eviction:
• If a condition that would make it otherwise impossible to remain in the facility is expected to last more than 14 consecutive days, or is terminal, the resident may stay if a service agreement is made by the resident, facility, and his or her personal physician

What training is required for direct care staff?

• Within 7 days of being hired:
• Complete training on topics of:
• Emergency and safety procedures
• Abuse recognition and reporting
• Resident’s rights
• Job requirements
• Within 30 days
• Complete training on topics including:
• Medication assistance and monitoring
• Communicable diseases
• Dementia
• Within 180 days:
• Complete training on topics including
• Communication skills
• A review of the aging process
• Continuing education:
• 6 hours per year on the areas that are required to be covered during the first seven days of hire.

Is nurse staffing required?

• In Level II facilities:
• At least 1 registered nurse who is employed by or contracts with the facility, who must be available at all times either by phone or pager.
• Contract with or employ licensed nurses to provide medical and direct care services

Is there any public payment available?

• Level II Facilities can receive reimbursement from Medicaid because they provide nursing home services

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