Assisted Living Facilities
Assisted Living licensing varies state by state, with some states still not having licensing that is titled “Assisted Living” that monitors facilities that provide a medical model for care of residents. When Assisted Living began to grow by leaps and bounded in 1993-1994, there were clearly two different types of Assisted Living models: i) hospitality and ii) medical. As time has moved on, most facilities are more of a medical model and in many states, depending on licensing, facilities can offer care like a Skilled Nursing Facility.
Assisted Livingoperators and managers have somewhat different philosophies and certainly approach the care modalities and fees associated with care under differently. Some Assisted LivingOperators including the majority of services within either a per diem or a monthly rate while other choose to have add-ons for a variety of services beyond board and care, including but not limited to the Activities of Daily Living (ADLs).
Clearly the number one factor in establishing the care needs of a resident and a fee schedule for a facility are ADLs that are defined routine activities that people tend do everyday without needing assistance. There are six basic ADLs: eating, bathing, dressing, toileting, transferring (walking) and continence.
Typically residents are assessed before admission to determine the number of ADLs and other care needs so the Director Nursing and/or Physician establish a care plan for the resident and a corresponding rate for services. Care plans are reassessed on a regular basis thereafter.
With Assisted Living Operators employing more nurses and sometimes offering a rehabilitation unit within an Assisted Living facility, much like what is offered in a Skilled Nursing Facility, a resident can remain in the Assisted Living facility versus being transferred to a Skilled Nursing Facility.
Existing facilities often have an opportunity to increase revenues by offering higher acuities and increased care levels or consider an expansion of the facility or new construction, and therefore it is critically important to have a senior living market analysis that addresses the competition and its care levels and fee schedules.