Residential Care and Assisted Living Compendium: 2007


HHS Logo: bird/facesU.S. Department of Health and Human Services

Residential Care and Assisted Living Compendium: 2007

Robert Mollica and Kristin Sims-KasteleinNational Academy for State Health Policy

Janet O'KeeffeRTI International

November 30, 2007

This report was prepared under contract #HHS-100-03-0025 between the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy and Research Triangle Institute. For additional information about this subject, you can visit the DALTCP home page at or contact the ASPE Project Officers, Gavin Kennedy and Emily Rosenoff, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201. Their e-mails address are: and

The opinions and views expressed in this report are those of the authors. They do not necessarily reflect the views of the Department of Health and Human Services, the contractor or any other funding organization.

Below are the sections and tables associated with Residential Care and Assisted Living Compendium: 2007. Each section is a separate file (available in both PDF and HTML), as well as each state's Section 3 summary is available as a separate PDF file. To view the material, simply clink on the PDF or HTML link beside it.

NOTE: A Portable Document Format (PDF) file requires Acrobat Reader [] in order to view it.


Table of Contents [HTML:]
Acknowledgments [HTML:]
Acronyms [HTML:]
Introduction to the Current Edition [HTML:]
Overview of Policy Developments Since 2004 [HTML:]
Increased State Use of Websites to Provide Information [HTML:]
Defining Assisted Living [HTML:]
Assisted Living Philosophy [HTML:]
Occupancy Requirements and Privacy [HTML:]
Disclosure Requirements and Residency Agreements [HTML:]
Admission and Retention Criteria [HTML:]
Services [HTML:]
Quality Assurance and Monitoring [HTML:]
Training Requirements [HTML:]
Provisions for Residents with Alzheimer’s Disease and Dementia [HTML:]
Public Financing of Services [HTML:]
SECTION 1 Boxes, Figures and Tables
BOX 1-1. State Licensing and Regulatory Approaches [HTML:]
BOX 1-2. Examples of Definitions of Assisted Living [HTML:]
FIGURE 1-1. Supply Changes [HTML:]
TABLE 1-1. Information Provided on States’ Websites [HTML:]
TABLE 1-2. Summary of Major Activities in Residential Care Policy Since 2004 [HTML:]
TABLE 1-3. States with Regulations that Include an Assisted Living Philosophy [HTML:]
TABLE 1-4. Residency Agreement Provisions [HTML:]
TABLE 1-5. Disclosure Requirements for Facilities Serving Residents with Dementia [HTML:]
TABLE 1-6. Medicaid Long-Term Care Spending [HTML:]
TABLE 1-7. Nursing Home Supply and Occupancy Rates and Residential Care Supply, 2003 [HTML:]
TABLE 1-8. States Using Medicaid to Cover Services in Residential Care Facilities [HTML:]
TABLE 1-9. Sources of Public Funding for Services in Residential Care Settings [HTML:]
TABLE 1-10. Differences Between State Plan and Waiver Services [HTML:]
TABLE 1-11. States That Limit Room and Board Charges [HTML:]
TABLE 1-12. Family Supplementation Policy [HTML:]
TABLE 1-13. State Rate Setting Approaches [HTML:]
TABLE 1-14. New Jersey Rate Schedule [HTML:]
TABLE 1-15. Oregon Service Priority Categories and Monthly Payment Rates: Assisted Living [HTML:]
TABLE 1-16. Texas Daily Reimbursement Rates Effective September 1, 2007 [HTML:]
SECTION 2 Tables
TABLE 2-1. Comparison of State Residential and Assisted Living Regulations: Supply [HTML:]
TABLE 2-2. Comparison of State Residential and Assisted Living Regulations: Characteristics [HTML:]
TABLE 2-3. Requirements for Facilities Serving Residents with Dementia [HTML:]
TABLE 2-4. Requirements for Resident Agreements [HTML:]
TABLE 2-5. Staff Training Requirements [HTML:]
TABLE 2-6. Comparison of State Reimbursement Policy [HTML:]
SECTION 3: STATE SUMMARIES [PDF:, complete section] [HTML:]
Notes on State Summaries [HTML:]
Alabama [PDF:, this state only] [HTML:]
Alaska [PDF:, this state only] [HTML:]
Arizona [PDF:, this state only] [HTML:]
Arkansas [PDF:, this state only] [HTML:]
California [PDF:, this state only] [HTML:]
Colorado [PDF:, this state only] [HTML:]
Connecticut [PDF:, this state only] [HTML:]
Delaware [PDF:, this state only] [HTML:]
District of Columbia [PDF:, this state only] [HTML:]
Florida [PDF:, this state only] [HTML:]
Georgia [PDF:, this state only] [HTML:]
Hawaii [PDF:, this state only] [HTML:]
Idaho [PDF:, this state only] [HTML:]
Illinois [PDF:, this state only] [HTML:]
Indiana [PDF:, this state only] [HTML:]
Iowa [PDF:, this state only] [HTML:]
Kansas [PDF:, this state only] [HTML:]
Kentucky [PDF:, this state only] [HTML:]
Louisiana [PDF:, this state only] [HTML:]
Maine [PDF:, this state only] [HTML:]
Maryland [PDF:, this state only] [HTML:]
Massachusetts [PDF:, this state only] [HTML:]
Michigan [PDF:, this state only] [HTML:]
Minnesota [PDF:, this state only] [HTML:]
Mississippi [PDF:, this state only] [HTML:]
Missouri [PDF:, this state only] [HTML:]
Montana [PDF:, this state only] [HTML:]
Nebraska [PDF:, this state only] [HTML:]
Nevada [PDF:, this state only] [HTML:]
New Hampshire [PDF:, this state only] [HTML:]
New Jersey [PDF:, this state only] [HTML:]
New Mexico [PDF:, this state only] [HTML:]
New York [PDF:, this state only] [HTML:]
North Carolina [PDF:, this state only] [HTML:]
North Dakota [PDF:, this state only] [HTML:]
Ohio [PDF:, this state only] [HTML:]
Oklahoma [PDF:, this state only] [HTML:]
Oregon [PDF:, this state only] [HTML:]
Pennsylvania [PDF:, this state only] [HTML:]
Rhode Island [PDF:, this state only] [HTML:]
South Carolina [PDF:, this state only] [HTML:]
South Dakota [PDF:, this state only] [HTML:]
Tennessee [PDF:, this state only] [HTML:]
Texas [PDF:, this state only] [HTML:]
Utah [PDF:, this state only] [HTML:]
Vermont [PDF:, this state only] [HTML:]
Virginia [PDF:, this state only] [HTML:]
Washington [PDF:, this state only] [HTML:]
West Virginia [PDF:, this state only] [HTML:]
Wisconsin [PDF:, this state only] [HTML:]
Wyoming [PDF:, this state only] [HTML:]


We would like to acknowledge the following for their contributions to this project: the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services for its financial support; and the many people in state agencies throughout the country who answered questions and provided copies of the statutes, regulations, and reports needed to update this compendium. We greatly appreciate the willingness of these dedicated professionals to share their knowledge and expertise.


AAA   Area Agency on Aging
AC   Alternative Care program (Minnesota)
ACCS   Assistive Community Care Services (Vermont)
ACF   Alternative Care Facility
ACLF   Assisted Care Living Facility
ACS   Assistive Care Services
ADA   Americans with Disabilities Act
ADC   Adult Day Care
ADL   Activity of Daily Living
ADSA   Aging and Disability Services Administration (Washington State)
AFC   Adult Foster Care
AFCH   Adult Foster Care Home
AFH   Adult Family Home
AGH   Adult Group Home
AHCCCS   Arizona Health Care Cost Containment System
ALC   Assisted Living Community
ALE   Assisted Living for the Elderly waiver (Florida)
ALF   Assisted Living Facility
ALP   Assisted Living Program
ALR   Assisted Living Residence
ALR-RC   Assisted Living Residence-Residential Care (New Hampshire)
ALR-SRHC   Assisted Living Residence-Supported Residential Health Care (New Hampshire)
ALS   Assisted Living Score
ALSA   Assisted Living Service Agency
ALTCS   Arizona Long-Term Care Systems
ALU   Assisted Living University
ALW   Assisted Living Workgroup
ALWPP   Assisted Living Waiver Pilot Project (California)
ARM   Administrative Rules of Montana
ASCU   Alzheimer’s Special Care Unit
BCU   Background Check Unit (Alaska)
BDS   Department of Behavioral and Developmental Services (Maine)
CARE   Client Assessment Referral Evaluation (Kansas)
CARES   Comprehensive Assessment and Review for Long-Term Care Services (Florida)
CARF   Commission on Accreditation of Rehabilitation Facilities
CBA   Community-Based Alternatives waiver (Texas)
CBRF   Community-Based Residential Facility
CFC   Choices for Care (Vermont)
CIP   Community Integration Program (Wisconsin)
CMS   HHS Centers for Medicare and Medicaid Services
CNA   Certified Nursing Assistant/Aide
CON   Certificate of Need
COP   Community Options Program (Wisconsin)
COP-W   Community Options Program Waiver (Wisconsin)
COPD   Chronic Obstructive Pulmonary Disease
COPES   Community Options Program Entry System (Washington State)
CPCH   Comprehensive Personal Care Home
CPR   Cardiopulmonary Resuscitation
CRCF   Community Residential Care Facility
CVA   Cerebrovascular Accident
DAIL   Department of Disabilities and Independent Living (Vermont)
DHSS   Department of Health and Social Services (Alaska, Delaware)
DMAS   Department of Medical Assistance Services (Virginia)
DNR   Do Not Resuscitate
DON   Determination of Need
DQA   Division of Quality Assurance (Wisconsin)
DRI   Dietary Reference Intake
E-ARCH   Extended Adult Residential Care Home
EARC   Enhanced Adult Residential Care
ECC   Extended Congregate Care (Florida)
EHP   Enriched Housing Program (New York)
ERC   Enhanced Residential Care (Vermont)
EXSPED   Expanded Service Payments for Elderly and Disabled program (North Dakota)
FBI   U.S. Federal Bureau of Investigation
FDLE   Florida Department of Law Enforcement
FHA   Fair Housing Act
FY   Fiscal Year
GAFC   Group Adult Foster Care (Massachusetts)
GAO   Government Accountability Office (previously called the U.S. General Accounting Office)
GED   General Educational Development/General Equivalency Diploma
HCBS   Home and Community-Based Services
HHS   U.S. Department of Health and Human Services
HUD   U.S. Department of Housing and Urban Development
IADL   Instrumental Activity of Daily Living
IBC   International Building Code
ICF   Intermediate Care Facility
ICF-MR   Intermediate Care Facility for Persons with Mental Retardation
IDR   Informal Dispute Resolution
ISP   Individualized Service Plan
IV   Intravenous
JCAHO   Joint Commission on the Accreditation of Health Care Organizations
LMA   Limited Medication Administration (Massachusetts)
LNS   Limited Nursing Services
LOC   Level of Care
LPN   Licensed Practical Nurse
MDS-ALS   Minimum Data Set-Assisted Living Services
MFP   Money Follows the Person
MMSE   Mini-Mental State Examination
MR/DD   Mental Retardation and Other Developmental Disabilities
MRC   Managed Residential Community
MSQ   Mental State Questionnaire
NA   Not Applicable
NAS   National Academy of Sciences
NIC   National Investment Conference
NR   Not Reported
NS   Not Specified
OFC   Oregon Fire Code
OMH   Office of Mental Health (New York)
ORS   Office of Regulatory Services (Georgia)
OSHA   Occupational Safety and Health Administration (South Carolina)
OSS   Optional State Supplementation
OSSC   Oregon Structural Specialty Care
PACE   Program for All-Inclusive Care for the Elderly
PCA   Personal Care Assistant/Aide
PCH   Personal Care Home
PNA   Personal Needs Allowance
PNMI   Private Non-Medical Institution (Maine)
PRN   Pro re nata (commonly used to mean “as needed” in Latin)
QI   Quality Improvement
RCAC   Residential Care Apartment Complex (Wisconsin)
RCF   Residential Care Facility
RCFE   Residential Care Facility for the Elderly (California)
RCH   Residential Care Home
RFP   Request for Proposal
RN   Registered Nurse
RTF   Residential Treatment Facility
RUG   Resource Utilization Group
SAMM   Self-Administered Medication Management (Massachusetts)
SCU   Special Care Unit
SCU-A   Special Care Unit for Persons with Alzheimer’s and Related Disorders (North Carolina)
SIS   Special Income Standard
SLF   Supportive Living Facility
SPD   Seniors and People with Disabilities
SPED   Service Payments for Elderly and Disabled program (North Dakota)
SSDI   Social Security Disability Insurance
SSI   Supplemental Security Income
SSL   Social Service Law (New York)
SSP   State Supplemental Payment
TB   Tuberculosis
TBD   To Be Determined
USDA   U.S. Department of Agriculture
WEARC   Waiver for the Elderly in Adult Residential Care (Nevada)
  • Main Table of Contents --
  • SECTION 1. Overview of Residential Care and Assisted Living Policy --
  • SECTION 2. Comparison of State Policies --
  • SECTION 3. State Summaries --