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Assisted Living Facilities

Assisted living facilities can provide a warm, congenial lifestyle.

When home health and community-based care, friends or family cannot fulfill the physical and emotional needs that provide seniors or persons with a disability a safe and productive lifestyle, an assisted living facility may be an appropriate solution. In an assisted living facility, general supervision of its residents as well as assistance with daily activities (such as bathing or dressing) is readily available. Assisted living facilities provide varying levels of service options.


What Assisted Living Facilities are...

The Code of Virginia broadly defines an assisted living facility as '...any congregate residential setting that provides or coordinates personal and health care services, 24-hour supervision, and assistance for the maintenance or care of four or more adults who are aged, infirm or disabled and who are cared for in a primarily residential setting...'

And what they are not:

  • Those facilities or portions of facilities that serve infirm or disabled children or adolescents
  • Those facilities dedicated to care only for persons that are related by blood or marriage. In other words, taking care of four elderly cousins doesn't qualify as an assisted living facility.
  • Assisted living facilities are NOT licensed to receive entrance fees from applicants or residents.

Levels of Service

There are many different types of facilities--from private homes to high-rise apartment complexes--within the classification of assisted living facility with two levels of service taking place within them.

Residential Living--Services provided at residential levels are intended to provide minimal assistance with ADLs or instrumental ADLs* for adults who have only minor physical or mental limitations. Residents with residential living status may receive some assisted living services on a regular or on an as-needed basis.

*An instrumental ADL--or IADL--is one that a resident needs to perform social functions such as meal preparation, housekeeping, laundry and money management.

Assisted Living--As defined in the Code of Virginia, this level of service in an assisted living facility provides moderate assistance to those who may need more help than those residents enjoying an independent lifestyle at residential living levels. Assisted living services are typically provided by aides and companions. Assisted living services may include assistance with ADLs, help with medications and assistance with the arrangements necessary when off-site medical services are needed.


Meals

Food service personnel prepare three primary daily meals--breakfast, lunch and dinner; and snacks are also served periodically during the day. Though meals and snacks are prepared to be served in a congregate dining room, when illness dictates, many assisted living facilities will arrange for residents to be served in their rooms or in the infirmary. When off-site infirmaries are used, meals and snacks are handled by the off-site facility when the resident's standing agreement with the primary assisted living facility covers this contingency.


Social Activities

Assisted living facilities have various forms of social, recreational and religious activities. Volunteers as well as activity directors or coordinators plan group social opportunities, which include special holiday activities for the residents.

State regulations currently require that a certain number of hours each week be set aside for social activity. In addition to meal times, no less than one hour each day must be devoted to planned socialization, recreation or religious activity.


Facility Amenities

Many assisted living facilities have on-site facilities that allow residents to take care of personal business. Some facilities may include services such as a small grocery or drug store, laundry/dry cleaner, beauty/barber shops and a small branch bank. Additionally, the following services and facilities are usually included as standard amenity services in the monthly fee. Some or all of these services and facilities may be added to the monthly payment as stipulated in the contract.

  • housekeeping services and/or some laundry services
  • group and/or individual transportation services
  • all facility maintenance and grounds keeping
  • most utilities (phone responsibility of residents)
  • security services

Admission Assessment

To provide the best service and appropriate level of care to the individual resident as well as prepare programs that contribute positively to the overall well-being of an assisted living facility's population, it is important for each facility to have a thorough understanding of each resident's physical and emotional needs. Therefore, as with other long-term care services and facilities, assisted living facilites require that an assessment be conducted prior to admission as part of the admission process. The assessment is reviewed and a reassessment is performed at least once a year and whenever there is a significant change in the resident's condition.

Homes that accept non-ambulatory residents are required to meet special building code requirements. Depending on a facility's compliance levels under the Uniform Statewide Building Code, assisted living facility residents may be:

  • ambulatory--in response to an emergency physically and mentally capable of exiting the facility without assistance
  • non-ambulatory--unable to exit the facility in an emergency without the assistance of another person.

When a resident is admitted from an institution for people with developmental disabilities or mental illnesses, an agreement between the assisted living facility and the local community services board, a state mental health clinic or a private facility or physician for the provision of appropriate services is required.


Staffing

In a small assisted living facility, staff members may do double duty, filling several roles depending on need; in large complexes, staffing may be quite extensive. Regardless of size, five critical areas must be adequately staffed to meet state requirements:

  • administrators who are responsible for the management of the home
  • aides and companions who assist the residents with daily activities
  • maintenance and housekeeping staff
  • food service personnel and
  • activities planners and facilitators.


Rights And Responsibilities Of Residents

We encourage you to review the Rights and Responsibilities document for assisted living facilities. It is part of the Code of Virginia. Facilities must make a copy available in an easily accessible place for review. The facility must also make its policies and procedures for implementing the Rights and Responsibilities available and accessible to the general public as well as residents, relatives and agencies. Read about your rights and responsibilities in this guide, then compare it to the assisted living facility's version.

A Fast-Growing, Popular Option

Affordability, coupled with the congenial, settled residential character of the facilities have boosted the popularity of assisted living facilities. Assisted living facilities offer a less-restrictive environment for individuals who need some assistance but do not need the level of care offered by a nursing facility.


Nursing Facilities And Skilled Nursing Facilities

With their 100-year-old history, nursing homes, now called nursing facilities and skilled nursing facilities, are one of the most recognized long-term care providers.