Residential Care and Assisted Living Compendium: 2007. SECTION 2. Comparison of State Policies

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.

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.

1. Rules specifying a number of hours also include topics that are covered. Rules listing topics only do not specify how many hours of training are needed.

* STATE NOTES:
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 Department’s curriculum.
OK: For residential care homes (RCHs).
RI: Medicaid waiver: one hour orientation; 12 hours annual.
VT: For RCHs.

1. SSI payment standard includes a state supplement, if available. The standards include an amount retained by the beneficiary as a PNA. The PNA varies by state.

* STATE NOTES:
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.