PDF Version: http://aspe.hhs.gov/daltcp/reports/2007/07alcom2.pdf (21 PDF pages)
|TABLE 2-1. Comparison of State Residential and Assisted Living Regulations: Supply|
|AL||Assisted living facilities||307||9,509||335||9,876||327||9,738||N*|
|AK||Assisted living homes||229||1,912||162||1,650||143||1,497||N|
|AR||Residential long-term care facilities||92||3,616||111||4,369||122||4,647||Y|
|Assisted living facilities||27||1,402||6||275||NA||NA||Y|
|AZ||Assisted living facilities||1,951||27,000||1,509||24,500||1,524||24,002||N|
|CA||Residential care facilities for elderly||7,471||161,586||6,543||154,830||6,207||147,580||N|
|CO||Assisted living residences||495||14,237||525||13,799||538||14,291||N|
|CT||Assisted living service agencies||63*||NA||65||NA||63||NA||N|
|Residential care homes||100||2,808||101||2,753||109||2,949||Y|
|DC||Community residence facilities||22*||509*||200||1,866||NR||NR||N|
|DE||Rest residential homes||3||NR||3||NR||6||160||N|
|FL||Assisted living facilities standard||2,400||75,450||2,250||74,762||2,328||78,348||N|
|Limited nursing services|
|Assisted living extended congregate|
|GA||Personal care homes||1,860||26,500||1,687||25,434||1,648||25,563||Y/M|
|HI||Assisted living facilities||10||1,744||7||1,008||3||354|
|Adult residential care home||480||2,540||542||2,882||545||2,882||N|
|ID||Residential and assisted living facilities||278||6,819||266||6,160||253||5,815||N|
|IL||Assisted living facilities||184||8,988||120||5,830||24||1,667||N|
|Shelter care facilities||137||7,610||149||8,484||156||8,240||N|
|IN||Residential care facilities||190||14,665||147||11,767||140||11,555||N|
|IA||Assisted living programs||209||10,332||184||8,246||154||6,199||N|
|Assisted living dementia programs||18||468||NA||NA||NA||NA|
|Residential health care facility||49||1,647||98||2,918||N|
|KY||Assisted living communities||97||NA||83||NA||73||NA||N|
|Personal care homes||192||6,802||204||7,389||204||7,792||N|
|LA||Personal care homes||30||189||44||286||29||176||N|
|ME||Assisted living programs||34||1,624||30||1,429||24||1,133||N|
|Residential care facilities: I (I-IV 2004)||647||7,079||711||7,593||473||1,711||N|
|Residential care facilities: II-IV||192||5,220||N|
|MD||Assisted living programs||1,366||20,093||1,248||17,148||2,000||14,273||N|
|MA||Assisted living residences||190||11,900||171||10,585||139||9,796||Y|
|MI*||Homes for the aged||190||14,653||190||14,588||191||14,656||N|
|Adult foster care: family group homes||1,201||5,663||1,247||5,825||1,266||5,913||N|
|Adult foster care: small group homes||2,809||18,967||2,527||17,610||2,529||17,727||N|
|Adult foster care: large group homes||495||6,414||485||9,001||477||8,839||N|
|Adult foster care: congregate homes||11||398||13||491||13||491||N|
|MN||Housing with services establishments||1,239||NA||931||NA||600||NA||N|
|MO||Residential care facilities||502||15,661||280||6,363||285||6,533||Y|
|Assisted living facilities||114||5,505||363||15,434||363||15,106||Y|
|MS||Personal care homes||185||5,133||194||4,197||207||5,137||Y|
|MT||Personal care facilities||184||4,351||177||3,730||149||3,276||N|
|NE||Assisted living facilities||276||10,063||259||9,187||227||8,369||N|
|NV||Residential care facilities for groups||258||3,941||300||4,021||374||NR||N|
|NH||Assisted living residence: supported residential health care facilities||142||4,283||137||4,013||148||3,936||N|
|Assisted living residence: residential care facilities||N|
|NJ||Assisted living residences||170||15,571||152||13,696||129||11,645||Y|
|Assisted living programs||14||NA||13||NA||17||NA||Y|
|Comprehensive personal care homes||38||2,190||43||2,388||41||2,642||Y|
|NM||Adult residential care||284||NR||346||NR||305||NR||N|
|NY||Adult care homes||389||39,170||431||32,859||449||34,805||N|
|Enriched housing programs||105||90||7,227||83||5,308||N|
|Residences for adults||6||6||200||8||345||N|
|NC||Adult care homes||635||36,294||629||35,247||631||34,776||Y|
|Family care homes||647||3,612||648||3,642||682||3,816||N|
|Multi-unit housing with services||25||1,736||23||1,053||20||1,538||N|
|ND||Basic care facilities||55||1,529||46||1,490||47||1,490||N|
|Assisted living facilities||56||1,943||42||1,361||NA||NA||N|
|OH||Adult care facilities (3-16)||658||5,213||712||5,666||805||5,783||N|
|Residential care facilities (17+)||547||38,792||510||36,255||462||31,937||N|
|OK||Residential care home||91||2,809||103||3,358||210||8,620||N|
|Assisted living centers||115||6,493||115||6,308||8||1,253||N|
|OR||Assisted living facilities||202||13,589||190||12,566||180||11,998||M|
|Residential care facilities||227||8,541||236||8,504||220||8,227||M|
|PA||Personal care homes||1,550||71,831||1,718||76,385||1,786||79,929||N|
|RI||Assisted living facilities||63||3,574||73||3,676||68||3,270||N|
|SC||Community residential care facilities||480||16,279||504||16,641||545||17,761||N|
|SD||Assisted living centers||157||3,578||162||3,360||153||3,084||N|
|TN||Assisted care facilities||201||13,769||184||10,699||178||10,495||N|
|Homes for the aged||127||2,520||155||3,230||166||3,307||N|
|TX||Assisted living facilities||1,433||45,853||1,378||42,245||1,324||41,424||N|
|UT||Assisted living facilities type I||87||1,733||92||1,678||108||1,886||Y|
|Assisted living facilities type II||64||3,523||49||2,800||43||2,460||Y|
|VA||Assisted living facilities||577||31,964||636||34,598||669||34,200||N|
|VT||Residential care facilities||112||2,317||110||2,302||109||2,213||N|
|Assisted living residences||6||293||3||108||NA||NA||N|
|WV||Personal care homes||NA||NA||NA||NA||50||2,310||N|
|Residential board and care homes||NA||NA||NA||NA||82||1,498||N|
|Residential care communities||3||130||3||88||3||88||N|
|Assisted living residences||117||3,380||113||3,197||NA||NA||N|
|WI||Residential care apartment complexes||220||9,229||151||6,001||122||4,452||N|
|Community-based residential facilities||1,379||22,553||1,359||21,374||1,350||21,242||N|
|WY||Assisted living facilities||15||286||15||970||14||1,005||N|
Moratorium; NR = Not reported; NA = Not applicable. Units/Beds = the licensed
capacity reported by the state.
AL: A CON is required for specialty care facilities.
AZ: Figures represent combined supply for three categories.
CT: Not included in total.
DC: Previous reports included facilities and beds serving individuals with developmental disabilities. The 2007 report only includes facilities serving older adults.
GA: CON applies to facilities serving more than 24 residents.
IA: Previous reports included the number of units rather than the capacity.
MI: The number of licensed facilities and capacity was revised by the reporting agency for 2004 and 2002 from what was included in the previous report.
NM: Previous information reported may have included ADC providers.
|TABLE 2-2. Comparison of State Residential and Assisted Living Regulations: Characteristics|
|AL||Assisted living facilities||2||N||N||2||80*||130*||6||8|
|AK||Assisted living homes||3||N||Y||2||80||140||NS||NS|
|AR||Residential long-term care facilities||3||N||Y||2||100||160||6||10|
|Assisted living facilities||3||Y*||Y||2||150||230||2||2|
|AZ||Assisted living facilities||<10, >10||N||Y||2||80/220*||120/320||8||8|
|CA||Residential care facilities for elderly||NS||N||Y*||2||*||*||6||10|
|CO||Assisted living residences||3||N||N||2||100||120||6||6|
|CT||Assisted living service agencies||NS*||Y||Y||*||*||*||*||*|
|Residential care homes||2||N||Y||2||150||250||4||8|
|DE||Rest residential homes||NS||N||N||4||100||80||4||4|
|FL||Assisted living facilities (standard)||1||N||N||2*||80||60*||6||8|
|Limited nursing services||N||2*||6||8|
|Assisted living extended congregate care||Y||2||4||4|
|GA||Personal care homes||2||N||N||4||80||60||4||8|
|Community living arrangements||2||N||N||2||NS||NS||4||4|
|HI||Assisted living facilities||NS||Y||Y||NS||220||NA||1||1|
|Adult residential care home||<6, >6||N||N||4||90||70||8||14|
|ID||Residential and assisted living facilities||3||N||N||2||100||80||6||8|
|IL||Assisted living facilities||3||N*||Y||NS||NS||NS||1||NS|
|Shelter care facilities||NS||NS||NS||4||70||60||10||15|
|IN||Residential care facilities||NS||N||N||4||100||80||8||8|
|IA||Assisted living programs||6||N||Y||2||240/70*||340/70||1||1|
|KY||Assisted living communities||5||N||Y||2||200||200||NA|
|Personal care homes||NS||N||N||4||NS||NS||8||12|
|LA||Personal care homes||2-8||N||N||2||100||70||NS||NS|
|ME||Assisted living programs||NS||Y||Y||NA||NA||NA||NA||NA|
|Assisted living residential care I-IV||NS||N||N||2||100||160||6||10|
|MD||Assisted living programs||NS||N||N||2||80||120||4||8|
|MA||Assisted living residences||3||**||NS||2||NS||NS||**||**|
|MI||Homes for the aged||>20||N||N||4||100||160||8||15|
|Adult foster care: small group homes||<12||N||N||2||80||170||8||8|
|Adult foster care: larger group homes||13-20|
|MN||Housing with services establishments||1||**||**||**||**||**||10||20|
|MO||Residential care facilities I & II||3||N||N||4||70||70||6||20|
|MS||Personal care homes||NS||N||N||4||80||80||6||12|
|MT||Personal care facilities||NS||N||N||4||100||80||4||12|
|Assisted living facilities||4||N||N||2||100||80||1*||8*|
|NV||Residential care facilities for groups||3||N||N||3||80||60||4||6|
|NH||Assisted living residences/supported residential health care||2||N||N||2||100||160||6||6|
|Residential care home facilities||2||N||N||2||80||140||6||6|
|NJ||Assisted living residences||4||Y||Y||2||150||230||1||1|
|Assisted living programs||NS*||NA||Y||NA||NA||NA||NA||NA|
|Comprehensive personal care homes||4||N||Y||2||80||130||NS||NS|
|NM||Adult residential care||2||N||N||2||100||80||8||8|
|NY||Adult care homes||5||N||N||2||100||160||6||10|
|Enriched housing programs||5||Y||Y||NS||NS||NS||3||3|
|Residences for adults||NS||N||N||2||100||160||6||10|
|Assisted living programs||5||Y/N||Y/N||**||**||**||**||**|
|NC||Adult care homes||7||N||N||4||100||80||5||10|
|ND||Basic care facility||5||N||N||NS||100||80*||4||15|
|Assisted living facilities||5||**||**||2||**||**||**||**|
|Adult care facilities||3-16||N||N||2||80||60||8||8|
|OH||Residential care facilities||17+||N||N||3||100||80||8||8|
|OK||Residential care home||NS||N||N||NS||80||60||6||10|
|Assisted living centers||2||N||N||2||**||**||4||4|
|OR||Assisted living facilities||6||Y||Y||1||220||NA||1||1|
|Residential care facilities||6||N||N||2||70||120||6||10|
|PA||Personal care homes||4||N||N||4||80||60||6||10|
|RI||Assisted living facilities||2||N||N||2||100||80||8||10|
|SC||Community residential care facilities||2||N||N||4||80||60||8||10|
|SD||Assisted living centers||2||N||N||2||120||220||1||1|
|TN||Assisted living facilities||NS||N||N||2||80||160||6||6|
|Homes for the aged||1||N||N||2||80||80||6||6|
|TX||Assisted living facilities||4||N||Y||4||100*||80*||6||6|
|UT||Assisted living facilities type I||2||N||N||2||100||160||6||10|
|Assisted living facilities type II||2||N||Y||2||120||200||4||10|
|VA||Assisted living facilities||4||N||N||4||100||80||7||10|
|VT||Residential care facilities||3||N||N||2||100||80||8||8|
|Assisted living facilities||NS||Y||Y||2||225||NA||1||1|
|Assisted living facilities (Medicaid)||7||Y||NA||1||220||NA||1||1|
|WV||Assisted living residences||4||---||---||2||100||180||6||10|
|Residential care communities||17||Y||Y||2||300||*||NS||NS|
|WI||Residential care apartment complexes||NS||Y||Y*||2||250||NA||NS||NS|
|Community-based residential facilities||5||N||N||2||100||80||8||8|
|WY||Assisted living facilities||NS||N||N||2||120||80||2||10|
|NR = Not
reported; NA = Not applicable; NS = Not specified.
AL: Private room with sitting areas, 160 square feet. Double room with sitting area, 200 square feet.
AR: Rules for assisted living require apartments.
AZ: Unit size figures are for rooms/apartment units. Apartments are required in centers that contract with the ALTCS (Medicaid) Program.
CA: Choice whenever possible. No requirements for size of bedrooms.
CT: Rules only address requirements for ALSAs. Unit requirements are specified by the housing funding source.
DE: Space requirements are not specified.
FL: Facilities licensed after October 1999. Four persons may share a room in standard facilities licensed prior to 1999.
IA: Additional habitable rooms in any unit must be at least 70 square feet.
IL: Nursing homes converting a portion of a facility to supportive living must offer apartments with 160 square feet for single occupancy and 320 square feet for units shared by two persons.
LA: Rules require 250 square feet of living space. Units with two bedrooms must have 190 square feet of living/dining/kitchen space and 120 square feet for each bedroom.
MA: New construction requires private bathroom and kitchenette or access to cooking capacity. Existing construction requires private half bathroom. Full bathrooms may be shared by up to three residents. Bedrooms may be shared.
MN: Licensing rules apply to service providers. Local codes apply to the building based on its use.
NE: New construction facilities must have a toilet and sink adjoining each bedroom. Existing or new facilities may have shared toilet rooms provided the following: one toilet for every six beds in existing facilities; one toilet per four beds in new facilities. Facilities must provide a bathing facility consisting of a tub and/or shower adjacent to each room or provide a central bathing room. In existing facilities, rooms must have 80 square feet and in multiple occupancy rooms 60 square feet per bed with no more than four persons occupying a room. In new construction, apartments must have 150 square feet for one resident and 110 square feet for each additional resident. In existing facilities, apartments must have 120 square feet for one resident and 100 square feet for each additional resident.
NJ: ALPs operate in conventional publicly subsidized senior housing complexes.
NH: Apply to units in facilities serving 17 or more residents; smaller facilities must offer 80 and 160 square feet for single and semi-private occupancy respectively.
NY: ALPs comply with the relevant requirements under which the contracting facility is licensed(i.e., adult home or enriched housing program (EHP)).
ND: Rooms for three or more, 70 square feet per bed. There are no unit requirements for ALFs. New rules define a living unit as a portion of an ALF occupied as the living quarters of an individual who has entered into a lease agreement with an ALF.
TX: Type A facilities require 80 square feet for single occupancy and 60 square feet per resident in multiple occupancy rooms.
UT: A single occupant unit without additional living space shall be a minimum of 120 square feet. A double occupant unit without additional living space shall be a minimum of 200 square feet. A single occupant bedroom in a unit with additional living space shall be a minimum of 100 square feet. A double occupant bedroom in a unit with additional living space shall be a minimum of 160 square feet.
WV: Multi-occupancy apartments must have at least 80 square feet of bedroom space per resident and no more than two residents may occupy an apartment.
WI: Allows sharing with a spouse or a roommate chosen by the tenant.
|TABLE 2-3. Requirements for Facilities Serving Residents with Dementia|
CA: Some provisions are included in the disclosure statement.
DE: Facilities must develop policies to prevent wandering and safe storage of medications.
IA: Resident agreements includes a description of the services and programming that is available.
IL: Manager qualifications, minimum service hours and others.
KY: Lease agreements contain a description of special programming, staffing or training for serving clients with special needs.
MD: Training, staffing, activities and environment provisions are included in the disclosure statement.
MA: Must have a plan to operate the residence that covers specified areas.
MT: Requirements for administrators.
NE: Admission and discharge criteria.
NV: Administrators have three years experience serving people with Alzheimers disease or equivalent education and training.
NY: See state summary. May not operate dementia units without a special needs assisted living certificate. Must submit a special needs plan that includes staffing, training, and environmental modifications.
NC: Must develop policies that address specific features of a SCU.
OH: Must describe specific features of the SCU in the application.
SD: Also have fire safety/evacuation provisions.
TN: An interdisciplinary team must review residents with early stage Alzheimers disease to examine appropriateness of placement on a quarterly basis.
UT: See state summary.
WI: RCACs must have training. Other licensed facilities offering dementia special care must complete a disclosure form.
WY: Facilities must provide cuing with guidance for ADLs for people who are intermittently confused and/or agitated and require occasional reminders to time, place, and person.
|TABLE 2-4. Requirements for Resident Agreements|
|Services included in the basic rate||x||x||x||x||x||x||x||x||x||x||x||x||x||x||x||x||x|
|Cost of the basic service package||x||x||x||x||x||x||x||x||x||x||x||x||x||x|
|Terms of occupancy||x||x||x||x|
|Services beyond basic rate||x||x||x||x||x||x||x||x||x||x||x||x|
|Cost of additional services||x||x||x||x||x||x||x||x||x|
|Services not available/not covered||x|
|Temporary absence policy||x||x||x||x||x|
|Statement of residents rights||x||x||x||x||x||x||x|
|Provisions for changing rates||x||x||x||x||x||x||x||x||x||x|
|Purpose of deposits/advance payments||x||x||x|
|Services included in the basic rate||x||x||x||x||x||x||x||x||x||x||x||x||x||x||x||x|
|Cost of the basic service package||x||x||x||x||x||x||x||x||x||x||x||x||x||x||x||x||x|
|Terms of occupancy||x||x||x|
|Services beyond basic rate||x||x||x||x||x||x||x||x|
|Cost of additional services||x||x||x||x||x||x||x||x||x||x|
|Services not available/not covered||x||x||x||x|
|Temporary absence policy||x||x||x||x|
|Statement of residents rights||x||x||x||x||x||x||x||x|
|Provisions for changing rates||x||x||x||x||x||x||x||x||x||x||x||x|
|Purpose of deposits/advance payments||x||x||x||x|
|Services included in the basic rate||x||x||x||x||x||x||x||x||x||x||x||x||x||x||x||x|
|Cost of the basic service package||x||x||x||x||x||x||*||x||x||x||x||x||x||x||x|
|Terms of occupancy||x||x||x||x||x|
|Services beyond basic rate||x||x||x||x||x||x||x|
|Cost of additional services||x||x||x||x||x||x||x||x||x||*|
|Services not available/not covered||x||x|
|Temporary absence policy||x||x||x||*|
|Statement of residents rights||x||x||x||x||x||*||x|
|Provisions for changing rates||x||x||x||x||x||x||x||x|
|Purpose of deposits/advance payments||x||x||x||x|
AL: A statement that the facility is not staffed to provide skilled nursing or care for residents with severe cognitive impairments.
AK: Duties and obligations of the resident.
AR: Health care services available through home health agencies; parameters for pets; policy on acceptance of responsibility for personal funds and valuables; responsibility for medication; a copy of facility rules; and provisions for emergency transfers.
CA: A monthly statement of services and charges; a statement acknowledging the acceptance or refusal to purchase the additional services shall be signed and dated by the resident or the resident's representative and attached to the admission agreement; an explanation of the use of third-party services within the facility that are related to the resident's service plan, including, but not limited to, ancillary, health, and medical services, how they may be arranged, accessed, and monitored, any restrictions on third-party services, and who is financially responsible for the third-party services; the facility's policy concerning family visits and other communication with residents; refund policy; conditions under which the agreement may be terminated; and an explanation of the resident's right to notice prior to an involuntary transfer, discharge, or eviction, the process by which the resident may appeal the decision and a description of the relocation assistance offered by the facility.
CO: Transportation services; therapeutic diets; and whether the facility will be responsible for providing bed and linens, furnishing and supplies. There must also be written evidence that the facility has disclosed the policies and procedures (admissions; discharges; emergency plan and fire escape procedures; illness, injury or death; smoking; management of residents funds; investigation of abuse and neglect allegations; and restrictive egress devices); method of determining staffing levels and the extent to which certified or licensed health professionals are available on-site; whether the facility has an automatic sprinkler systems; if the facility uses restrictive egress alert devices and the types of individual behaviors exhibited by persons needing such devices.
DE: Transfer procedures, security, staffs right to enter a residents room, resident rights and obligations, temporary absence policy, interim service arrangement during an emergency, obligations of the facility, and a listing of the residents personal belongings. The financial areas include the party responsible for handling finances, obtaining equipment and supplies, arranging services not covered by the contract, disposing of belongings.
FL: Statement of any religious affiliation; notice of transfer if the facility is not able to serve the resident.
GA: Copy of house rules; provisions for on-going resident assessments; provisions for transportation services; authorization to release medical records.
ID: Staffing patterns and qualifications; liability insurance carried; the residents and facilitys role and responsibilities for assistance with medication administration; statement regarding managing personal funds; conditions for emergency transfers; permission to transfer information.
IL: Statement of the annual licensing on-site review process; statement that Medicaid is not available for payment of services; description of the process for terminating or modifying the contract; the admission, risk management, and termination procedures; and policy concerning notification of relatives of changes in the residents condition.
IA: Statement regarding the impact of the fee structure on third-party payments and whether they are accepted; emergency response policy; staffing policy and whether staff are available 24-hours-a-day; whether nurse delegation will be used and staffing will be adapted to meet changing needs.
KS: Negotiated service agreement; provider of services; agreement supports individual dignity, choice, privacy, etc.; addresses services refused by resident and residents acceptance of risk.
KY: ALRs: 30-day notice of move-out for nonpayment, assistance finding appropriate housing, other community rights, practices and procedures, policy concerning the ability to contract directly with outside agents, professionals, providers, or other individuals.
LA: Authority of the licensing agency to review records; responsibilities for overseeing medical care; purchasing supplies and equipment. Must allow review by an attorney.
MD: Includes a clear and complete reflection of commitments and actual practices; LOC for which the facility is licensed; obligations of all parties for arranging for medical care and other provisions (see summary).
MA: Sponsors covenant to comply with applicable laws; reasonable rules for staff, management, and resident behavior, and limits on what the residence will as well as policy on self-administration of medication.
MI: AFC: Assurance of provision of care, supervision, and protection; agreement to provide necessary intake information and current health appraisal; statement of how funds and valuables are handled; statement that the home is licensed to provide care.
MO: Some provisions are included in the residents rights section -- right to make treatment decisions; provisions in a medical emergency; state laws relating to advance directives.
MT: Availability of skilled nursing and other professional services from third-party payers; policies concerning pets and smoking.
NE: Included in the terms of occupancy requirement.
NH: Responsibility for discharge planning; information about nursing, supplies and other health care services not included in the core services (availability of services; the facilitys responsibility for arranging services; and the fee and payment for services if known); policies and procedures regarding arranging/providing transportation, arranging for third-party services (i.e., television, hairdresser); handling resident funds, bed hold, storage and smoking; medication management services; and the list of grooming and personal hygiene supplies providing as part of the basic rate.
NJ: Some information is provided during admission interviews.
NC: Policy on smoking, alcohol consumption, and visitation.
OH: A statement is included about discharge of residents when skilled nursing needs exceed their capacity.
OK: Conformity with state law.
OR: Uniform disclosure form and other topics -- see summary.
PA: Amount of PNA; method of payment for long distance calls; financial management arrangements; explanation of annual screening and medical evaluation requirements.
RI: Also includes shared space and facilities, special care provisions, resident responsibilities and house rules, and evaluation and service plan. A general provision called financial terms would cover cost of services, additional charges, and refunds.
SC: Transportation policy.
SD: Policies for protection of personal funds; list of names, addresses, and numbers of client advocates; how to contact the residents physician; how to apply for Medicare/Medicaid.
TN: Information on the cost of services is provided to residents but it is not part of the agreement. The agreement includes the procedure for handling transfers and discharges.
TX: See summary. Some provisions are part of the disclosure requirement or part of the written policies of the facility.
UT: Notice that the state has the authority to examine resident records.
VT: See state summary.
VA: Stipulation about the transfer of ownership of any property, real estate, or money to the facility; description of the type of staff, services available and the hours of service.
WA: Rules of operation.
WV: (1) PCHs: house rules; how emergencies are addressed; arrangement for transportation; procurement and payment for medications; storage and administration of medications. (2) Residential board and care homes: how health care will be provided; provide copies of all inspection reports; how to access activities and assurances that the home offers services to meet identified needs. (3) Residential care communities: procurement and payment for medications; storage and administration of medications; assurance that the resident is not liable for undisclosed costs; assurance that the individuals needs will be met.
WI: (1) CBRFs: bed hold fee. (2) RCAC: Some of the requirements are posted and others are included in a service agreement. Activity and social connections the resident will be assisted in maintaining.
WY: Managers are required to establish policies in the specified areas that are available to residents and staff on items that are normally specified in resident agreements.
|TABLE 2-5. Staff Training Requirements1|
|AK||Topics||12 hours||LA||Topics||Annual plan||OH||Training course||6 hours/topics|
|AZ||Topics/hours*||12 hours||ME||Complete course||8 hours/2 years||OK*||8 hours||8 hours|
|AR||Topics||6 hours||MD||Topics*||Topics||OR||Topics||Not specified|
|CA||10 hours/Topics||4 hours/topics||MA||7 hours/topics||10 hours/topics||PA||Topics||12 hours|
|CO||Topics||Topics||MI||Topics||Not specified||RI*||10 hours/topics||Not specified|
|CT||10 hours/topics*||6 hours||MN||Competency test||Not specified||SC||Topics||General|
|DC||40 hours||12 hours||MO*||1 hour/topics||Not specified||TN||Not specified||Not specified|
|FL||26 hours*||Not specified||MT||Topics/16 hours*||Not specified||TX||16 hours||6 hours/topics|
|GA||Topics||16 hours||NE||4 hours||12 hours||UT||Topics||Topics|
|HI||Topics||6 hours||NV||4 hours||8 hours||VT*||Topics||20 hours|
|ID||16 hours||8 hours||NH||Topics||Topics||VA||Topics||8 hours|
|IL||Topics||8 hours||NJ||Complete course||20 hours/2 years*||WA|| Topics/competency
|IA||Plan on file||Not specified||NY||40 hours*||12 hours||WI||Topics||Not specified|
|KS||Topics||Topics||NC||80 hour course||Not specified||WY||Topics||Not specified|
AZ: Hours/topics vary by level of licensing.
CT: Aides must pass a competency exam.
FL: Core training for staff is 26 hours. Additional hours are required for specific tasks or settings (e.g., medication assistance (4) and ECC (2)).
IN: Nursing staff, eight hours per year; non-nursing staff, four hours per year.
MD: For Medicaid waiver programs, 8 hours on medication administration is also required.
MO: Complete course for medication administration. Additional topics required for ALF staff.
MT: Topics are listed for category A and 16 hours of training in services provided by category B facilities.
NV: Three hours additional training every three years for staff who assist with medications.
NJ: 20 hours every two years; medication aides, ten hours every two years.
NY: Topics are specified in the Departments curriculum.
OK: For residential care homes (RCHs).
RI: Medicaid waiver: one hour orientation; 12 hours annual.
VT: For RCHs.
|TABLE 2-6. Comparison of State Reimbursement Policy|
|R&B Limits||Family Supplement||Personal
|AK||1993||Waiver||Tiered||$70.54 - $93.70||N||No||No policy||$100.00||$654.00|
|CA||2006||Waiver||Tiered||$52-$82/day with add-ons||N||$936.00||$119.00||$1,035.00|
|Tiered||$27.33-$73.19/day||N||% of income*||Y||$164.10||$1869 cap*|
|IA||1990||Waiver||Care plan||Cap of $1,083||N||No||Y||$50.00||$623.00|
|ME||1990||State plan||Cost-based/ case-mix||Varies||Y||% income||Y||$50.00||$623.00|
|MA||1992||State plan||Flat||$37.75 per day||N||N||No policy||NS||$1077.00|
|Care plan||Varies/capped at NF cost||N||N||Y||$25.00||$779.00
|MT||1994||Waiver||Care plan||$63.35 per day cap*||N||$495.00||Y||$100.00||$717.00|
|NE||1998||Waiver||Flat (rural/urban variations)||$1,641-$2,310*||Y||$563.00||N||$60.00||$623.00|
|NV||1993||Waiver||Tiered||$20, $45, $60/day||N||N||No policy||$102.00||$1014.00|
|NH||1999||Waiver||Flat||$50/day $1,250/month*||N Y||N Y||Y||$56.00||$817.00|
|NJ||1997||Waiver||Flat bv setting*||$50-$70/ day||Y||$680.55||Y||$92.50||$773.05|
|NY||NA||State plan||Case-mix||Varies by county and case-mix||N||N||Y||$200.00||$1,264.00|
|WI||1997||Waiver||Care plan||Cap $88.02*||N||$626.77||Y||$65.00*||$802.77*|
|TBD = To be
determined; NR = Not reported; NA = Not applicable; NS = Not specified.
AK: Figures include an augmented factor. The basic rate ranges from $44.52 to $67.68 a day.
AZ: Payments vary by three levels of care and by setting: adult family care, assisted living homes, assisted living centers.
CT: Pilot program with the Housing Finance Agency to create affordable assisted living. The SSI rate in RCHs is based on the rate for the facility but cannot exceed $1,869 less a PNA of $90.70. The payment is lower in the assisted living pilot. The PNA is $164 and there is a meal allowance of $300 and up to a $400 allowance for rent.
ID: The room and board amount is a suggested cap.
IL: In addition to the Medicaid payment, participating facilities receive an average of $97 a month in food stamp benefits.
MD: Additional amounts are allowed for assistive equipment.
MI: Payment rate for Homes for Aged is $802.30; Adult Family Care, $780.50. PNA is the same for both categories.
MN: Statewide average costs with caps that vary by county.
MT: Actual rate depends on a scoring of functional needs.
NE: Rates vary by urban/rural and single/double occupancy.
NH: Elderly housing with services sites receive $50 a day; licensed facilities receive $1,250 a month.
NY: Payment standards and the PNA varies by groupings of counties.
NC: Rate varies using a base rate and additional components determined by the combination of ADL needs.
OH: The SSI payment rate listed is available for individuals who are not enrolled in a Medicaid waiver. The payment standard for waiver participants is $623 a month.
RI: A regular waiver and a pilot program are operating. The room and board charge for both programs is set by the facility. The regular waiver pays the difference between $1,400 and the room and board charge. Room and board is not related to the Medicaid payment under the pilot waiver. SSI beneficiaries participating in the two waivers retain a PNA of $100. SSI beneficiaries not in the waiver retain a PNA of $55. Facilities receive one month prospective payment and would hold the unit for the remainder of the month.
UT: The state covered services in licensed settings through a Medicaid section 1915(a) managed long-term care program prior to the 2006 waiver.
VT: $34.25 for residents receiving ACCS; the higher tiers include ACCS and Medicaid waiver services. Room and board of $623 is allowed in facilities participating in the ACCS program. The SSI rates for Level III and IV are in facilities that do not participate in ACCS.
WI: Actual rates negotiated by counties. Cap is based on 85% of the cost of nursing facility care. Family supplementation allowed by the state agency; counties set their own policy. PNA amounts are also set by counties. Residents in certified RCACs may qualify for an additional state supplement of $95.99 if they have exceptional needs.
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