Section 295.2000 – Residency Requirements

Assisted living programs are unable to admit or retain residents in assisted living that exceed assisted living level of care services. This includes if the assisted living provider doesn’t offer a particular service which may not be otherwise listed in the criteria or if the level of care exceeds the staffing level or skill set at the assisted living.

Residency requirements exclude individuals who are:

• Less than 18 years of age.
• They pose a serious threat to themselves or to others.
• They are unable to communicate their needs in any manner and don’t have a representative also residing in the building that has a prior relationship with the person and has been appointed to direct the provision of service.
• They require total assistance of 2 or more activities of daily living. Activity of daily living is defined as eating, dressing, bathing, toileting, transferring, or personal hygiene.
• They require more than one paid caregiver at any given time with an activity of daily living.
• They require more than minimal assistance to move to a safe area during an emergency. Minimal assistance is defined as the resident is able to respond, with or without assistance, in an emergency to protect themselves, given the staffing and construction of the building.
• The person has a severe mental illness which is characterized by the presence of a major mental disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, where the person has a substantial disability due to mental illness including self-maintenance, social functioning, activities of community living and work skills which is not including Alzheimer’s disease or other forms of dementia or physical disorder.
• They require intravenous (IV) therapy or feedings*.
• Require gastrostomy (G-tube) feedings*
• They require treatment of a stage 3 or 4 decubitus ulcers or exfoliative dermatitis.
• They require 5 or more skilled nursing visits per week for conditions other than the criteria immediately above for a period of 3 consecutive weeks or more except when the course of treatment is expected to extend beyond 3 weeks for rehabilitative purposes and is certified as temporary by a physician.
• When services are no longer adequate to meet the needs of the residents.

Individuals who are terminally ill and receive (or would qualify for) hospice care and such care is coordinated by a licensed hospice program or other licensed health care professional employed by a home health agency and all parties agree to continued residency shall not be discharged.

Criteria related to requiring 2 or more staff, maximal assistance with 2 or more ADLs, and more than minimal assistance in emergencies shall not apply to individuals who are quadriplegic, paraplegic, have neuro-muscular disease, or other chronic disease and condition if they are able to communicate their needs and does not require assistance with complex medical problems, and the program can accommodate their needs does not require discharge.

Prior to admission to an assisted living that does not provide medication administration, the resident must consult their physician to determine if they should obtain a pneumonia and/or influenza vaccination.

*Indicates that the resident may independently complete the tasks or they can be completed by a licensed health care professional who is not employed by the owner or operator of the establishment, its parent entity, or any other entity with common ownership to either the owner or operator of the establishment. However, that is not meant to limit a resident’s right to choose their health care provider.