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.
* STATE NOTES: |
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.
*/** STATE NOTES: |
TABLE 2-3. Requirements for Facilities Serving Residents with Dementia | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
AL | AK | AZ | AR | CA | CT | CO | DE* | FL | GA | HI | ID | IL | IN | IA* | KS | KY* | |
Training | x | x | x | x | x | x | x | x | x | x | x | ||||||
Staffing | x | x | x | x | x | ||||||||||||
Activities | x | x | x | x | x | x | |||||||||||
Environment | x | x | x | x | x | x | x | x | |||||||||
Disclosure | x | x | x | x | x | x | x | x | x | ||||||||
Other | x | x | x | x | x | x | |||||||||||
LA | ME | MD* | MA | MI | MN | MS | MO | MT* | NE* | NV* | NH | NJ | NM | NY* | NC | ND | |
Training | x | x | x | x | x | x | x | x | x | x | x | x | x | ||||
Staffing | x | x | x | x | x | x | x | x | |||||||||
Activities | x | x | x | x | x | x | |||||||||||
Environment | x | x | x | x | x | x | x | x | x | ||||||||
Disclosure | x | x | x | x | x | x | x | x | x | ||||||||
Other | x | x | x | x | x | x | x | x | |||||||||
OH | OK | OR | PA | RI* | SC | SD* | TN* | TX | UT | VA | VT | WA | WV | WI | WY* | ||
Training | x | x | x | x | x | x | x | x | x | x | x | x | x | ||||
Staffing | x | x | x | x | x | x | x | x | |||||||||
Activities | x | x | x | x | x | x | x | x | |||||||||
Environment | x | x | x | x | x | x | x | x | |||||||||
Disclosure | x | x | x | x | x | x | x | x | x | x | |||||||
Other | x | x | x | x | x | x | x | x | x | x | x | ||||||
* STATE NOTES: 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 Alzheimer’s 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 Alzheimer’s 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 | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
AL | AK | AZ | AR | CA | CT | CO | DE | FL | GA | HI | ID | IL | IN | IA | KS | KY | |
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 | |||
Accommodations included | x | x | |||||||||||||||
Terms of occupancy | x | x | x | x | |||||||||||||
Period covered | 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 | ||||||||||||
Payment/billing provisions | x | x | x | x | x | x | |||||||||||
Statement of resident’s rights | x | x | x | x | x | x | x | ||||||||||
Admission/discharge criteria | x | x | x | x | x | x | |||||||||||
Refund policy | x | x | x | x | x | x | x | x | x | x | x | ||||||
Provisions for changing rates | x | x | x | x | x | x | x | x | x | x | |||||||
Termination provisions | x | x | x | x | x | x | x | x | |||||||||
Purpose of deposits/advance payments | x | x | x | ||||||||||||||
Grievance process | x | x | x | x | x | x | x | ||||||||||
Other | x | x | x | x | x | x | x | x | x | x | x | x | x | ||||
LA | ME | MD | MA | MI | MN | MS | MO | MT | NE | NV | NH | NJ | NM | NY | NC | ND | |
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 |
Accommodations included | x | x | x | x | |||||||||||||
Terms of occupancy | x | x | x | ||||||||||||||
Period covered | x | x | 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 | |||||||||||||
Payment/billing provisions | x | x | x | x | x | x | x | x | x | x | |||||||
Statement of resident’s rights | x | x | x | x | x | x | x | x | |||||||||
Admission/discharge criteria | x | x | x | x | x | x | x | x | x | x | x | x | x | x | |||
Refund policy | x | x | x | x | x | x | x | x | x | x | x | ||||||
Provisions for changing rates | x | x | x | x | x | x | x | x | x | x | x | x | |||||
Termination provisions | x | x | x | x | x | x | |||||||||||
Purpose of deposits/advance payments | x | x | x | x | |||||||||||||
Grievance process | x | x | x | x | x | x | x | ||||||||||
Other | x | x | x | x | x | x | x | x | x | x | |||||||
OH | OK | OR | PA | RI | SC | SD | TN | TX | UT | VA | VT | WA | WV | WI | WY | ||
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 | ||
Accommodations included | x | x | x | x | |||||||||||||
Terms of occupancy | x | x | x | x | x | ||||||||||||
Period covered | 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 | * | |||||||||||||
Payment/billing provisions | x | x | x | x | x | ||||||||||||
Statement of resident’s rights | x | x | x | x | x | * | x | ||||||||||
Admission/discharge criteria | x* | x | x | x | x | x* | x | x | x | * | |||||||
Refund policy | x | x | x | x | x | x | x | x | |||||||||
Provisions for changing rates | x | x | x | x | x | x | x | x | |||||||||
Termination provisions | x | x | x | x | x | x | * | ||||||||||
Purpose of deposits/advance payments | x | x | x | x | |||||||||||||
Grievance process | x | x | x | x | x | x | x | ||||||||||
Other | x | x | x | x | x | x | x | x | x | x | x | x | |||||
*STATE NOTES: 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, staff’s right to enter a resident’s room, resident rights and obligations, temporary absence policy, interim service arrangement during an emergency, obligations of the facility, and a listing of the resident’s 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 resident’s and facility’s 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 resident’s 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 resident’s 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: Sponsor’s 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 resident’s 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 facility’s 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 resident’s 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 individual’s 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 | ||||||||
---|---|---|---|---|---|---|---|---|
State | Initial | Annual | State | Initial | Annual | State | Initial | Annual |
AL | Topics | Topics | KY | Topics | Not specified | ND | Topics | Topics |
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 |
DE | Topics | 12 hours | MS | Topics | Quarterly | SD | Topics | Topics |
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 test |
Not specified |
IN | Topics | Topics/hours* | NM | Complete course | Topics | WV | Topics | Topics |
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 |
* STATE NOTES: |
TABLE 2-6. Comparison of State Reimbursement Policy | |||||||||
---|---|---|---|---|---|---|---|---|---|
State | Coverage | Payment Method | Rates | Rates Include R&B |
R&B Limits | Family Supplement | Personal Needs Allowance |
SSI Payment Standard1 |
|
Date | Method | ||||||||
AL | NA | Withdrawn | $30.00 | $623.00 | |||||
AK | 1993 | Waiver | Tiered | $70.54 - $93.70 | N | No | No policy | $100.00 | $654.00 |
AZ | 1989 | Waiver | Tiered | $41.23-$143.78* | Y | $512.55 | Y | $90.45 | $623.00 |
AR | 1993 2003 |
State plan Waiver |
Care plan Tiered |
$885.76 cap $43.19-$54.61 |
N N |
No $566.00 |
No policy | $30.00 $57.00 |
$623.00 $623.00 |
CA | 2006 | Waiver | Tiered | $52-$82/day with add-ons | N | $936.00 | $119.00 | $1,035.00 | |
CO | 1984 1987 |
Waiver State funds |
Flat | $47.58/day | N | $571.00 | Y | $97.00 | $668.00 |
CT | 2003 NR |
Waiver State funds |
Tiered | $27.33-$73.19/day | N | % of income* | Y | $164.10 | $1869 cap* |
DE | 1999 | Waiver | Tiered | $1,034-$1,154 | N | $598.00 | N | $114.00 | $763.00 |
DC | Approved | Waiver | Flat | $60/day | TBD | TBD | No policy | $70.00 | $623.00 |
FL | 1997 2001 |
Waiver State funds |
Flat Flat |
$32.20/day $9.28/day |
N | No | Y | $54.00 | $691.40 |
GA | 1981 | Waiver | Flat | $35.04/day | N | $528.00 | Y | $95.00 | $623.00 |
HI | 2000 | Waiver | AL-Flat EARCH-Tiered |
$66.77/day $24.98-$66.77 |
N | $418.00 | No policy | $50.00 | 623.00 |
ID | 1999 2000 |
Waiver State plan |
Care plan Tiered |
Capped/NF cost $125.30-$225.54 |
N N |
$542.00* $542.00* |
Y | $67.00 | $623.00 |
IL | 1999 | Waiver | Regional variations | $50.76-$66.92 | N | $533.00* | N | $90.00 | $623.00 |
IN | 2001 | Waiver | Tiered | $45.86-$61.68 | N | $512.00 | No policy | $52.00 | $623.00 |
IA | 1990 | Waiver | Care plan | Cap of $1,083 | N | No | Y | $50.00 | $623.00 |
KS | 1997 | Waiver | Care plan | Varies | N | No | Y | $30.00 | $623.00 |
ME | 1990 | State plan | Cost-based/ case-mix | Varies | Y | % income | Y | $50.00 | $623.00 |
MD | 1993 1986 |
Waiver State funds |
Tiered | $1,672-$2,109* | N | $420.00 | N | $64.00 | $623.00 |
MA | 1992 | State plan | Flat | $37.75 per day | N | N | No policy | NS | $1077.00 |
MI | 1983 | State plan | Flat | $184.50 | N | N | Y | $44.00 | $802.30* $780.50 |
MN | 1988 1991 |
Waiver State funds |
Case-mix | $1,086-$2,524* | N | $737.00 | Y | $82.00 | $811.00 |
MS | 2001 | Waiver | Flat | $33.18/day | N | $520.00 | No policy | $44.00 | $623.00 |
MO | 1993 1973 |
State plan State funds |
Care plan | Varies/capped at NF cost | N | N | Y | $25.00 | $779.00 $875.00 |
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 |
NM | 1996 | Waiver | Flat | $49.99/day | N | $1,024.00 | No policy | $30.00 | $664.00 |
NY | NA | State plan | Case-mix | Varies by county and case-mix | N | N | Y | $200.00 | $1,264.00 |
NC | 1995 | State plan | Case-mix | Varies | N | $1,083.00 | Y | $65.00 | $1,148.00 |
ND | NA | Waiver State funds |
Care plan Care plan |
$80/day cap $49.23/day cap |
N N | $375.00 NR |
Y Y | $60.00 NS |
$623.00 |
OH | 2006 | Waiver | Tiered | $49.98-$69.98/day | N | $573.00 | N | $50.00 | $850.00* |
OR | 1990 | Waiver | Tiered | $1,195-$2,493 | Y | $483.70 | N | $110.00 | $624.70 |
PA | Waiver authorized | $60.00 | $1,062.30 | ||||||
RI | 1999 | Waiver Waiver |
Flat Flat |
$36.32/day* $1800 |
N Y |
N N |
N | $100.00 | $1,218.00 |
SC | 2002 | State plan | Flat | $14.80/day | N | $1,003.00 | N | $53.00 | $1,056.00 |
SD | 1988 | State funds Waiver |
Flat Flat |
$1,212 $30.64/day |
Y N |
$583.00 | Y N |
$60.00 | $1,212.00 $623.00 |
TX | 1994 1985 |
Waiver State funds |
Tiered | $25.13-$67.76/day | N | $538.00 | N | $85.00 | $623.00 |
UT | 2006* | 1915(c) | Flat | $69.75 | Y | NA | Y | NS | $623.00 |
VT | 1996 1999 |
Waiver State plan |
Tiered Flat |
$48.76-$67.44 $34.25* |
N | $623.00 | N | $47.76 | $670.76 III $794.66 IV |
WA | 1991 | Waiver | Tiered | See summary | Y | $562.22 | N | $60.78 | $623.00 |
WI | 1997 | Waiver | Care plan | Cap $88.02* | N | $626.77 | Y | $65.00* | $802.77* |
WY | 2001 | Waiver | Tiered | $42-50/day | N | N | No policy | NS | $623.00 |
TBD = To be determined; NR = Not reported; NA = Not applicable; NS = Not specified.
* STATE NOTES: |
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