To be eligible for this study, a facility had to serve a mainly elderly population. In addition, a facility had to have more than 10 beds.
There were several reasons for the size restriction. We expected that few small facilities would meet the study criteria related to services provided and population served. A 1993 survey funded by HHS/ASPE examined board and care homes in ten states (Hawes et al., 1995b). Two-thirds of the licensed board and care homes had 10 or fewer beds. Few of those facilities identified themselves as assisted living or provided personal assistance with two or more activities of daily living (ADLs). In addition, none of the states that had specific licensure categories known as assisted living had actually granted a license to an ALF that had fewer than 11 beds. As a result, project staff expected that few small facilities (i.e., <10 beds) would meet the service-related criteria. In addition, small homes tended to have significant numbers of non-elderly residents; they were more likely to have residents with mental retardation, developmental disabilities, and persistent and serious mental illness.
In addition to the two eligibility criteria based on population served (i.e., elderly) and size (i.e., >10 beds), the facility had to describe or represent itself as being an ALF or it had to be a place that offered at least a basic level of services thought to be consistent with assisted living. Those services were:
- 24-hour staff oversight;
- At least 2 meals a day; and
- Personal assistance, defined as help with at least two of the following: medications, bathing, or dressing.
To be eligible for the study, a facility had to:
Additional details on the selection of the FSUs can be found in the full report on the results of a telephone survey of administrators of a national probability sample of ALFs. What is important to know is that the 60 FSUs were randomly selected, with higher selection probabilities for those FSUs anticipated to contain larger numbers of expected ALFs. These FSUs consisted of 1,086 counties in 34 states. They contained 40 percent of the U.S. population aged 65 and older and 43 percent of the initial sample frame of expected ALFs.