Frequently Asked Questions
About residential assisted living
1. What Is Residential Assisted Living?
It's a more personal residence in a neighborhood setting, ideally suited for those with cognitive and physical needs. The residences are licensed and monitored by state agencies. Compared to assisted living communities, they're typically:
- Smaller, with a low resident-to-staff ratio
- More affordable
- Known for attentive, individualized care
2. What’s the difference between residential assisted living and an assisted living community?
Size is one big difference. The number of residents in an assisted living community generally ranges from 30 to several hundred. Residential settings have between 4 and 16 residents—so it’s easier for the staff to get to know everyone well.
The smaller home-like space of residential settings can benefit residents who may become overwhelmed by long hallways and confusing layouts. For those who can’t always initiate their own activities, residential settings reduce the chance for isolation.
Residential homes can also pair with attending adult day care to increase socialization options. And they can personalize activities for individuals, rather than aim to please large groups.
While services are generally the same in both settings, service delivery varies greatly. Large communities often do well serving residents with fixed routines and scheduled needs—regular times for bathing and getting dressed, scheduled meals and activities, etc.
Residential settings can customize service delivery for each resident, each day. And because there are so many residential homes in the area, you can usually find homes that cater to residents who share similar health needs, interests, backgrounds and more.
The licensing regulations and oversight are typically the same for both types of assisted living options.
3. How much do these homes charge?
Costs differ depending on the level of care required and the type of room (private vs. semi-private).
Other features and services can affect the overall rate, including activity professionals, medical services, transportation, private bathrooms and the age/aesthetic quality of the building. Loving Decisions will never compromise on quality of care, but we can find the best fit for your budget.
4. Are they covered by insurance or Medicare/Medicaid?
Many long-term care insurance policies will cover assisted living services. Policies vary widely on the amount of reimbursement per day, how long they will pay and how they define qualifications.
Medicare does not pay for assisted living under any circumstances. Medicaid may pay under very specific circumstances. We can talk with you further about Medicaid reimbursement.
5. What services do these residences provide?
They assist with activities of daily living, which include bathing, dressing, using the bathroom, eating and mobility, as well as medication management.
They provide all meals, including snacks and accommodations for special diets/preferences.
Other services typically include:
- Housekeeping and laundry
- Oversight of medical needs
- Coordination/provision of transportation to medical appointments
- Activities and special outings
You and your loved one can speak directly to the owner and create a flexible service arrangement.
6. Can they handle special needs associated with dementia, incontinence, diabetes and other conditions?
Yes. In fact, these residences are often the best choice for loved ones with special, high-level health care needs. (Licensing regulations sometimes prohibit homes from delivering more advanced treatment, such as trachea care, IV therapy and Stage 4 wound care.)
You can work with the delegating nurse to establish personal care plans. Nurses oversee all medical care and medication—both of which require a physician order. Staff members receive continual training as required by state regulations and the needs of their residents. Most residences will also work with hospice if required/requested.
7. Who owns the residences? Do the owners live there?
Ownership varies, but the majority of owners come from a background of nursing, physical therapy or social work. Many have worked in larger communities and/or experienced other care options with their own family members and felt they could provide a better level of care. Owners are often involved in day-to-day operations but rarely live at the home. Professional caregivers stay on site to focus on the residents.
8. What about the staff members—what is their training?
Staff members must have a minimum amount of training before they can work in assisted living. General training areas include medication management, CPR, first aid and dementia. They must also receive continuing education for as long as they work in assisted living.
9. Do I have to sign a long-term contract? What if we don’t like the home after our loved one moves in?
Most contracts allow you to leave with no further obligation if you provide 30 days written notice. If someone must leave for medical reasons, the contracts generally require payment for as long as the person’s things occupy a room.
If you do not like the home, we would first recommend talking with the owner to discuss possible changes. If you are ever extremely unhappy or feel your loved one is in danger or is receiving inadequate care, you should call the ombudsman (through your local Area Agency on Aging). You can also contact Loving Decisions to help you find a more suitable option.