The Department of Public Health, Facility Licensing and Investigations Section,
licenses assisted living services agencies that provide assistance to residents of
managed residential communities, state-funded congregate housing facilities, and
apartments subsidized by the U.S. Department of Housing and Urban Development.
Assisted living services agencies are required to be licensed, but managed residential
communities are not; instead, they must register with the Department of Public Health.
The operator of a managed residential community may also be licensed as an assisted
living services agency.

Residential care homes (RCHs), also licensed by the Department of Public Health,
are another type of community-based care for adults. Renovated private homes can be
used as small RCHs. These homes used to be called boarding homes, homes for the
aged, and rest homes–terms that are used in the regulations and policy documents.
Alzheimer’s special care units (SCUs)/programs provide specialized care or
services for people with Alzheimer’s disease or dementia and have separate licensure

Adult Foster Care. Adult family living, regulated by the Department of Social
Services, is a program that matches one or two adults who require room, board, and
personal care services with approved host families or individuals. In exchange for a
monthly allowance, the host family provides 24-hour supervision and assistance with
activities of daily living (ADLs), housekeeping, shopping, and meals. Regulatory
provisions for adult family living are not included in this profile but a link to the provisions
can found at the end.

This profile includes summaries of selected regulatory provisions for assisted living
services agencies that provide services in managed residential communities, and
RCHs. The complete regulations can be viewed online using the links provided at the


Assisted living services agency means an agency that provides, among other
things, nursing services and assistance with ADLs to the residents in managed
residential communities whose conditions are chronic and stable. A managed
residential community means a facility consisting of private residential units primarily for
persons age 55 or older who might need assisted living services.
Residential care home means a facility that is staffed to furnish food, shelter, and
laundry for two or more persons unrelated to the proprietor, and to provide services that
do not require the training or skills of a licensed nurse, including personal care, special
diets, and medication services.

Alzheimer’s special care unit/program means a nursing facility, RCH, assisted
living facility, adult congregate living facility, adult day care center, hospice, or adult
foster home that: (1) locks, secures, segregates, or provides special programs or units
for residents diagnosed with probable Alzheimer’s disease, dementia, or a similar
disorder; and (2) prevents or limits a resident’s access outside the designated or
separated area.

Resident Agreements

Assisted Living Services Agencies. The agreement, which must be signed by
the resident at move-in, must include information about services available; charges and
billing policies and processes; admission and discharge criteria; resident rights and
responsibilities; the complaint process; and Medicare-covered services.
Residential Care Homes. No provisions identified.

Disclosure Provisions
An Alzheimer’s SCU or program that advertises or markets itself as providing
specialized care or services for people with Alzheimer’s disease or dementia must
provide a written disclosure, updated annually, which includes at a minimum,
information about: (1) the program’s philosophy; (2) pre-admission, admission and
discharge policies and procedures; (3) assessment; (4) service planning and
implementation; (5) staffing patterns and training requirements; (6) physical
environment; (7) resident’s activities; (8) the family’s role in care; and (9) program costs.
Admission and Retention Policy

Assisted Living Services Agencies. The rules do not specify specific admission
or discharge criteria; however, each agency must develop written policies for the
discharge of residents. The policies must include change in a resident’s condition and
definitions of routine, emergency, financial, and premature discharge. Assisted living
services may be provided to residents with chronic and stable health, mental health,
and cognitive conditions as determined by a physician or health care practitioner. An
attending physician must annually provide written certification that a resident’s condition
is chronic and stable.
Residential Care Homes. Individuals are admitted if they are able to evacuate
independently in an emergency.