Residential Care and Assisted Living Compendium: 2007

SECTION 2. COMPARISON OF STATE POLICIES

November 30, 2007

PDF Version: http://aspe.hhs.gov/daltcp/reports/2007/07alcom2.pdf (21 PDF pages)


SECTION 2, TABLE OF CONTENTS

LIST OF TABLES
TABLE 2-1. Comparison of State Residential and Assisted Living Regulations: Supply
TABLE 2-2. Comparison of State Residential and Assisted Living Regulations: Characteristics
TABLE 2-3. Requirements for Facilities Serving Residents with Dementia
TABLE 2-4. Requirements for Resident Agreements
TABLE 2-5. Staff Training Requirements
TABLE 2-6. Comparison of State Reimbursement Policy


TABLE 2-1. Comparison of State Residential and Assisted Living Regulations: Supply
  State     Category   2007 2004 2002   CON  
  Facilities     Units/Beds     Facilities     Units/Beds     Facilities     Units/Beds  
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
Assisted living 29 1,804 29 1,738 27 1,300 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
Shared housing 25 202 13 92 NR NR 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  
KS Assisted living 120 5,539 191 7,971 129 5,658 N
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
Assisted living 75 4,700 67 4,157 66 3,906 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
WA Boarding homes 551 26,829 538 24,498 525 23,830 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
Boarding homes 20 1,150 17 315 NR NR  
TOTAL   38,373 974,585 36,2181 935,3642 36,2781 908,4882  
M = Moratorium; NR = Not reported; NA = Not applicable. Units/Beds = the licensed capacity reported by the state.
  1. The totals reflect revisions reported by Michigan for 2004 and 2002 and other adjustments.
  2. Totals for 2004 and 202 were adjusted to include the capacity of Iowa’s units and other adjustments.
* STATE NOTES:
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
  State     Category   Size
  Definition1  		 Apt
  Required  		   Sharing by  
Choice?2		 Max #
  Occupants  		   Sq Foot  
Single		   Sq Foot  
2+3		   #/Toilet     #/Bath  
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
Assisted living NS N Y 2 NS NS NA NA
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
Shared housing <12 N NS NS NS NS 4 6
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
KS Assisted living 6 Y Y NS 200 NS 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
Assisted living 2 Y Y 2 250 250* 1 1
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
WA Boarding homes 7 N N 2 80 70 8 12
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
Boarding homes
NR = Not reported; NA = Not applicable; NS = Not specified.
  1. This column presents the number of units/beds included in the definition of the licensing category (e.g., serving four or more individuals).
  2. Indicates whether residents share units by choice.
  3. Square footage in shared units is total square footage for two residents or square footage per resident in rooms for two or more.
*/** STATE NOTES:
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
    AL     AK     AZ     AR     CA     CT     CO     DE*     FL     GA     HI     ID     IL