Assisted Living Facilities
Assisted Living or Assisted living facilities (ALF) usually refers to a non-medical facility that is used by people who are not able to live on their own, but do not need the level of continuous nursing care that a nursing home offers.
People who live in newer model assisted living facilities usually have their own private apartment. There is usually no special medical monitoring equipment, nor 24-hour nursing staff, that you would find in a nursing home. However, trained staff are usually on-site around the clock to provide other needed services. Where provided, private apartments generally are self contained; ie; having their own small kitchen, bathroom, living area, and bedroom. Alternatively, individual living spaces may resemble a dormitory or hotel room consisting of a private or semi-private sleeping area and a shared bathroom. There are usually common areas for socializing, as well as a central kitchen and dining room for preparing and eating meals.
A typical assisted living facility resident would be a woman in her mid to late 80s who does not need the intensive care of a nursing home but prefers more companionship and needs some assistance in day to day living.
Someone who lives at an assisted living facility would not have to be concerned with having to prepare meals every day because there is a central kitchen and dining facility that they can take advantage of. The central dining facility also allows for visiting with others without having to leave home. This greatly reduces the isolation that elderly, disabled or handicapped people suffer when living alone and who are afraid (usually for physical reasons) to leave their homes.
More recently built facilities are designed with an emphasis on ease of use by disabled people. Bathrooms and kitchens are designed with wheelchairs and walkers in mind. Hallways and doors are extra-wide to accommodate wheelchairs. These facilities are by necessity fully compliant with the Americans with Disabilities Act of 1990 (ADA) or similar legislation elsewhere.
The socialization aspects of Assist Living faclities are very beneficial to the occupants. Normally the facility has many activities scheduled for the occupants, keeping in mind different disabilities and needs.
Residential Care Facilities for the Elderly
Residential Care Facilities for the Elderly (RCFEs) serve persons 60 and older. They provide room, board, housekeeping, supervision, and personal care assistance with basic activities like personal hygiene, dressing, eating, and walking. Facilities usually centrally store and distribute medications for residents to self-administer.
This level of care and supervision is for people who are unable to live by themselves but who do not need 24 hour nursing care. They are considered non-medical facilities and are not required to have nurses, certified nursing assistants or doctors on staff. Other terms used to refer to this level of care are board and care homes, rest homes and assisted living facilities.
How does an RFCE differ from an assisted living facility?
From a licensing standpoint, there is no difference. In some states facilities describing themselves as assisted living and offering personal care and supervision are licensed as Residential Care Facilities for the Elderly.
Residential Care Facilities for the Elderly are dominated by smaller (i.e., 6 to 15 beds), locally owned facilities with shared rooms. "Assisted Living" is used to describe a philosophy of care (e.g., freedom to choose among service plans and "aging-in-place") and as a marketing slogan. Assisted Living Facilities usually offer private apartments in larger, corporately owned facilities (e.g., 75 to 100 plus beds) with different fee options depending on the level of care needs.
Are RFCEs regulated?
Yes. Residential Care Facilities for the Elderly or Assisted Living Facilities must meet care and safety standards set by the State and are licensed and inspected by the Department of Social Services, Community Care Licensing (CCL).
Senior housing complexes, retirement villages or retirement hotels that provide only housing, housekeeping and meals are not required to be licensed as Residential Care Facilities for the Elderly.
Can an RFCE care for persons with dementia?
Maybe. Some facilities offer special services to persons with dementia if they meet certain licensing requirements. Make sure that the facility has experience in providing dementia care and meets all of the state licensing standards to provide dementia care.
Will an RFCE accept or retain someone with medical care needs?
It will depend on the type and severity of the medical condition(s) and whether the facility meets the state licensing standards for restrictive health conditions. Some medical conditions are not allowed in a Residential Care Facility for the Elderly (e.g., tube feeding, or treatment of open bedsores). Check the facilities license to see if they have met the requirements to serve persons who need help in leaving the building in case of emergency (i.e., non-ambulatory) or with certain medical conditions (e.g., hospice waiver).
What do RFCEs cost?
The cost will depend on a variety of factors such as the type of accommodations (e.g., apartment, private room, shared room), the range of services needed, and the geographic area. The average monthly cost is from $2,500 to $3,000, with costs ranging from a low of around $900 a month for a resident on Supplemental Security Income (SSI) to over $5,000 a month. Specialized services like dementia or hospice care are more costly.
Who pays the bill for RFCEs?
Most people must pay privately for care. Long-term care insurance only covers a very small percentage of people. There is very limited public funding through Supplemental Security Income (SSI) for this level of care. Unfortunately, the SSI rate is so low that fewer and fewer facilities will accept persons on SSI. If you would like more information on financing options, visit our financing section.
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Assisted Living", and information from The RCFE Consumer Project.