With our aging population, personal care homes and assisted living residences have become popular housing options. There are approximately 1,200 licensed personal care homes in Pennsylvania and nearly 35 licensed assisted living residences. Assisted living is a fairly new category of care in Pennsylvania but one that is sure to grow in the coming years. Assisted living differs from personal care in three main ways: concept, construction and level of care. Assisted living embodies the concept of allowing a resident to “age in place” without having to move to a licensed long-term care facility when their needs increase. Both personal care homes and assisted living residences can design programs to meet individual needs — for short-term stays when support services are required and for permanent residency when chronic conditions exist.
The construction of an assisted living residence may be different from a personal care home. Assisted living residences are required to offer living units with kitchenettes and private bathrooms. Personal care homes on the other hand offer living units with varying amenities.
The level of care provided in an assisted living can be higher than that in a personal care home. A person who needs the level of care of a nursing facility is not permitted to reside in a personal care home and must transfer somewhere else when their needs become too great. That same person, however, will be able to remain in an assisted living residence where they will be provided with the services they need to age in place.
Personal care homes and assisted living residences often offer these services and activities:
- 24-hour supervision;
- Three meals a day, often served in a group dining room; and
- A range of services that promote the quality of life and independence of the individual such as:
- Personal care services (help with bathing, dressing, toileting, etc.)
- Medication management, or assistance with self-administration of medicine;
- Social services;
- Supervision and assistance for persons with Alzheimer’s or other dementias and disabilities;
- Recreational and spiritual activities;
- Exercise and wellness programs;
- Laundry and linen service;
- Housekeeping and maintenance; and,
- Arrangements for transportation.
Choosing Assisted Living/Personal Care
When you are looking for an assisted living residence, personal care home or other residential care setting for yourself or a loved one, please consider the following checklist to help you make the best choice. Thank you to the American Health Care Association/National Center for Assisted Living for providing this valuable information.
Checklist For Consumers and Prospective Residents
- Are the family and the resident involved in the service planning process? How often are residents’ needs assessed? Who completes the assessment?
- Are there special programs for memory-impaired residents and residents with dementia? Are there accommodations for memory-impaired residents to be outside and exercise?
- Are there special programs for residents with disabilities?
- How are emergency situations managed? What is the protocol for such events?
- What happens if the health-care needs of a resident change? Under what conditions are residents asked to move if there is a change in health status?
Services and Activities:
- Does staff assist residents in administration of medication? If so, what kind of staff?
- Does the residence generally use a particular pharmacy? If applicable, does that pharmacy participate in the individual’s Medicare Part D prescription drug plan or private insurance?
- Are there professional nursing services on site? If not, does the staff assist residents and families in making arrangements?
- Are the services of a physical, occupational or speech therapist available or arranged?
- Does the facility provide laundry service?
- Are there beauty shop services available on site?
- What recreational and spiritual activities are available? Obtain or review a copy of the activities calendar.
- Are the activity supplies available for resident use outside of scheduled programs?
- Is transportation provided for medical appointments and recreational purposes? Is there a fee?
- Are there resident and family councils? How often do they meet?
- What are the suggestion, complaint or grievance procedures?
- Can hospice care be offered? If so, does the facility coordinate that care with the physician and family?
- Ask about the residence’s staffing patterns and philosophy about staffing.
- What training and qualifications are required for staff? Are there ongoing training programs provided for staff?
- Observe staff and resident interactions. Are they positive? Courteous?
- Does staff handle resident requests in a timely way?
- Can private duty companions be hired? What is the procedure for that type of service?
- Does the facility have a volunteer program? If yes, what types of activities do the volunteers perform?
- Does the administrator/director practice an “open door” policy?
- What does the moving in process entail? What are the paperwork requirements and the timeframes involved?
- How is the initial assessment managed? Who completes the assessment?
- Is the residence affiliated with a hospital or nursing home should acute or long-term care be needed? If so, is there a priority admission process?
- If you need hospital or nursing home care, is your room held? What are the associated fees? Is there a discount for unused services (e.g. meals)?
- Does the residence subscribe to a set of resident rights and responsibilities? Are printed copies of resident rights and responsibilities available?
Costs and Fees:
- What is included in the basic monthly cost?
- Are there charges for additional services?
- Is there a security deposit? What is the refund policy?
- Can service agreements and or contracts be amended or modified?
Dining and Food Services:
- Does the residence accommodate special diets?
- How often do the menus rotate? Are residents and families involved in the menu planning?
- Are residents allowed to have guests for meals? Is there a separate guest dining room?
- What are the criteria for residents to eat meals in their rooms?
Living Space and Accommodations:
- Are there adequate community areas for resident use?
- Are the resident rooms furnished or unfurnished?
- What is the policy about personal belongings?
- What is the policy for overnight guests? Are there guestrooms available? What are the guest fees?
- Is additional storage space available? Is there an extra fee?
- Does the residence meet the rules for people with disabilities?
- Can residents have automobiles? Is there assigned parking? Is there an extra fee?
- Are there patios and courtyards available for resident use? Is there an area for resident gardening?
- Does the residence provide security?
- Are pets allowed to reside in the residence? If so, are there additional fees and or deposits? If not, are pets allowed to visit?
Licensure and Certification:
- Is the residence licensed? Ask to review the last inspection report.
- Does the facility participate in a professional association, such as the Pennsylvania Health Care Association?
- Does the facility have a fire sprinkler system throughout the facility?
- Where are smoke detectors located?
- How often does the facility have fire drills?
- Does the facility have an emergency preparedness plan?
- How are emergency and evacuation plans reviewed with resident after admission to reinforce their memory?
- What systems are used to keep residents with dementia or Alzheimer’s secure from successful exit strategies?
- Is the location of the residence convenient to shopping, medical services, and entertainment areas?
- Can family members and visitors easily locate the residence for visiting?
Final Checklist Prior to Signing the Service Contract:
This checklist is provided to the family and prospective resident as a final tool once an assisted living residence has been chosen. Use this as a reminder for issues that need to be addressed and fully understood.
Make sure you:
- Know what the basic service package includes
- Know all costs associated with your service package
- Know about additional services and their associated fees (e.g., medication management)
- Know the circumstances why fees might change and how much notice is given to families and residents
- Understand the services planning process
- Understand the service contract
- Know about the criteria and policies associated with discharge
- Understand resident rights and responsibilities
- Know the residence’s grievance policy and procedure
- Understand how many staff are available and their qualifications
- Have the name and telephone number of the staff contact person