Are Assisted Living Facilities Regulated?

Assisted Living

You bet, and each state has its own set of regulations for Assisted Living Facilities

Although many federal laws impact assisted living facilities, oversight occurs primarily at the state level. According to the 2013 Assisted Living State Regulatory Review, published March 2013 by the National Center for Assisted Living (NCAL), assisted living can be defined as:

“A major long term care option preferred by many individuals and their families because of its emphasis on resident choice, dignity, and privacy. Assisted living facilities provide housing, 24-hour staffing, and a growing variety of services including assistance with activities of daily living (ADLs), such as bathing and dressing, and medication administration. Many assisted living facilities provide specialized services for people with Alzheimer’s disease and other dementias.”

Similar to the regulation and licensing of employees and conditions in any industry in the U.S., assisted living regulation is important to help assure the safety and well-being of residents as well as the workers. With no doubt, safety and care is the number one priority of assisted living facilities and the state administrations that regulate them.

What kind of regulations are there?

As stated above, the oversight of assisted living facilities occurs primarily at the state level. Continually, states review their regulations. Regulations are amended when necessary. A thorough summary of each state’s 2013 regulations, along with contact information for the state’s regulating agency, can be found within the Assisted Living State Regulatory Review. Here, we present a few examples of the types of rules that govern assisted living facilities:

  • Resident Assessment — The facility must assess all residents. In the case of private pay residents, the facility may develop an assessment form or use the uniform assessment tool developed by the Department of Health and Welfare. In the case of residents whose costs are paid by state funds, the uniform assessment developed by the Department of Health and Welfare must be used. The facility must develop an interim care plan to guide services until the assessment can be completed. (Idaho)

  • Life Safety — Assisted living homes of all sizes must have a smoke detector in each bedroom and each level of the home. A carbon monoxide detector is required outside of each sleeping area and on each level of the home. Evacuation drills are required quarterly for each employee shift. Homes that provide services to six or more residents must have a fire safety inspection completed every two years and follow the recommendations of that inspection. The height of window sills, size of openable window areas, and emergency exit time requirements with or without a suppression system are specified in regulation. State and municipal fire authorities have adopted International Fire Code Standards. Some municipalities have different requirements for sprinkler systems based on occupancy. (Alaska)

  • Residents Allowed Per Room — Assisted living facilities and shared housing units are individual units except in cases in which residents choose to share a unit. (Illinois)

  • Bathroom Requirements — Assisted living units shall have a bathroom that provides privacy and contains an operational toilet, sink, mirror, means of ventilation or operable window, and assistive devices, if identified in the resident’s service plan. Shared housing establishments shall provide one tub or shower for every six residents and one operational toilet and sink for every four residents. (Illinois)

  • Staffing Requirements — In addition to staff training requirements, homes for adults are required to have adequate and sufficient number of staff who are awake, fully dressed, and capable of providing for resident needs consistent with the resident service plans on duty at all times. The home shall also designate one person on each shift to be supervisor of resident care. The supervisor of resident care shall be on the premises and is to supervise resident care, assure that residents are treated with kindness and respect, protect residents from accidents and injuries, and be responsible for the safety of residents in case of emergency. Employees are required to have background checks completed including fingerprinting for criminal record clearance. (Michigan)

  • Administrator Education/Training — Administrators must be 21 years of age and meet one of the following criteria: be licensed as a nursing home administrator; have 3,000 hours of direct operational responsibility; complete 100 credit hours of post-high school education in the field of gerontology or health care; be a licensed health care professional; or hold a college degree. (Ohio)

  • Continuing Education Requirements — Administrators must complete nine hours of continuing education in gerontology, health care, business administration, or residential care administration per year. Staff that provides personal care services must have eight hours of continuing education annually which may include the specialized training for those caring for specialized populations. (Ohio)

Again, the above are just a sample of the state regulations that govern assisted living facilities. There are also federal regulations as well as self-imposed rules applied by each facility, each with the goal of making sure workers and senior residents are ensured proper care and safety every day.

If you’re presently seeking a senior apartment, independent-living, assisted-living, or other continuing-care community, where seniors can remain active and safe with the help of trained and dedicated staff, visit to assist you with your search.

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Blog Date: August 6, 2013

Writer: Ryan Allen