If you build it (properly) they will come!

Many administrators of Assisted Living Facilities do not have the opportunity to be included in the plans of developing the facilities they operate, meaning there is a possibility the design team is not thoroughly versed in the regulation concerning the communities they build. With that said, you should still have a good understanding of the following regulation provided by the MSDH to ensure you are compliant with the required physical environment for an ALF:


Rule 47.16.1 Required Areas/Rooms. The following areas/rooms are required to be provided in a licensed facility:


2.Living room;

3. Dining Area;

4.Toilet and bathing facilities:

5. Laundry; and

6. Kitchen.

Rule 47.16.2 Bedrooms.

1.Location.: All resident bedrooms shall have an outside exposure and shall not be below grade. Window areas shall not be less than one-eighth (1/8) of the floor area. The window sill shall not be over thirty-six (36) inches from the floor. Windows shall be operable.

  1. Resident bedrooms shall be located so as to minimize the entrance of unpleasant odors, excessive noise, and other nuisances.
  2. Resident bedrooms shall be directly accessible from the main corridor. In no case shall a resident bedroom be used for access to another resident bedroom nor shall a resident bedroom be used for access to a required outside exit. 29
  3. All resident bedrooms shall be so located that the resident can travel from his/her bedroom to a living room, day room, dining room, or toilet or bathing facility without having to go through another resident bedroom.
  4. Resident bedrooms shall house no more than four (4) persons each.


  1. Single beds shall be provided with good-grade mattresses at least four (4) inches thick. Cots and rollaway beds shall not be used.
  2. Each bed shall be equipped with a pillow and clean linens to include sheets, pillowcases, spreads, and blankets. An adequate supply of such linens shall be provided at all times to allow for a change of linen at least once a week.
  3. Chest of drawers or similar adequate storage space shall be provided for the clothing, toilet articles, and personal belongings of each resident.
  4. Adequate closet space shall be provided for each resident.
  5. An adequate number of comfortable, sturdy chairs shall be provided.
  6. At least one (1) mirror, a minimum of 18″ x 24″, shall be provided in each bedroom.
  7. The opportunity for personal expression shall be permitted.
  8. A resident shall be permitted to use personal furnishings in lieu of those provided by the licensed facility, when practical.
  9. Floor Area. The minimum usable floor area per bed shall be 80 square feet.

Rule 47.16.3 Living Room. Living rooms, daybooks, and/or recreation rooms shall be provided for residents and visitors. Each licensed facility shall provide at least two (2) areas for this purpose: one (1) for small groups such as a private visit with relatives and friends; and one (1) for larger group activities. The living room must be equipped with attractive, functional, and comfortable furniture in sufficient numbers to accommodate all residents. A minimum of 18 square feet per bed shall be provided.

Rule 47.16.4 Dining Area. A dining area shall be provided which shall be adequate to seat all residents at the same meal seating. The dining area may also be used for social, recreational, and/or religious services when not in use as a dining facility. A minimum of 15 square feet per bed shall be provided.

Rule 47.16.5 Toilet and Bathing Facilities.

  1. Separate toilet and bathing facilities shall be provided, on each floor, for each sex in the following ratios as a minimum.
  2. Bathtubs/showers 1 per 12 or fraction thereof for each sex
  3. Lavatories 1 per 6 or fraction thereof
  4. Toilets 1 per 6 or fraction thereof
  5. A lavatory with a mirror shall be provided in each toilet room or bedroom.

3.Bathtubs and showers shall be equipped with grab bars, towel racks, and non-glass shower enclosures. Commodes shall be equipped with grab bars.

Rule 47.16.6 Laundry. Laundry facilities shall be provided unless commercial laundries are used.

1.The laundry shall be located in a specifically designated area, and there shall be adequate room and space for sorting, processing, and storage of soiled material. Laundry rooms or soiled linen storage areas shall not open directly into a resident’s bedroom or food service area. Soiled materials shall not be transported through the food service area. The laundry area shall be kept clean and orderly.

2.If the commercial laundry is used, separate satisfactory storage areas shall be provided for clean and soiled linens.

  1. Provisions shall be made for proper mechanical ventilation of the laundry.
  2. Provisions shall also be made to prevent the recirculation of air through the heating and air-conditioning systems.
  3. Adequate and effective lint traps shall be provided for dryers.

6.When laundry chutes are provided, they shall have a minimum diameter of two (2) feet; and they shall be installed with a flushing ring, vent, and drain.

  1. An automatic sprinkler shall be provided at the top of the laundry chute and in any receiving room for a chute.
  2. A self-closing door shall be provided at the bottom of the chute.

9.Laundry equipment shall be of the type to adequately perform the laundry needs of the facility. The equipment shall be installed to comply with all local and state codes.

  1. There shall be a separate and designated area for the storage of clean linen.

Rule 47.16.7 Kitchen. In facilities with 16 or more residents, commercial cooking equipment must comply with NFPA 96, “Standard for Ventilation Control and Protection of Commercial Cooking Operations”. Licensed existing facilities shall be permitted to maintain and utilize existing equipment that is in service.