Legal Limits of Care in Assisted Living Facilities

When aging parents come to the point whenlaw. Even if a nurse is employed by the assisted living
assisted living seems like the best choice, it is usuallyfacility, the nurse cannot give hands-on care in the
their baby boomer children who see it first. Perhapsform of dressing a wound, administering
the adult children live in another state. Perhaps theyaround-the-clock insulin, administering oxygen, or
are unable to visit Mom or Dad often enough to feelother tasks that are defined by the federal and state
comfortable leaving them alone. The death of agovernments as "skilled nursing care." Skilled nursing
spouse or a gradual loss of independence in selfcare may only be administered within a facility that is
care-any of these reasons may lead to the adultlicensed to do so. Legally, this kind of facility is
child's decision to move the parent. As an assistedlicensed as a skilled nursing facility, although it may
living facility representative is likely to tell you, it ishave a different business name that it markets itself
often the adult children who first come to look theas, such as an "extended care" or "long-term care"
place over, later bringing their parents to see thefacility. Medicare and Medicaid also designate these
place for themselves. These adult children are thehomes as skilled nursing facilities. Because skilled
hidden consumers of services. Assisted vs Nursingnursing facilities bill Medicare and/or Medicaid for skilled
Home As the hidden consumers, what do the adultnursing care, they must comply with many complex
children of aging parents need to understand aboutlegal regulations and requirements. Assisted living
these facilities? Very simply: what the facility can't do.facilities are regulated by the state Department of
Invariably, the sales pitch tells you what the facilitySocial Services, not the Department of Health, which
can do, which is fine, and to be expected. But as aregulates nursing homes. Assisted living facilities do
consumer, you must understand the differencenot have the same safety or administrative
between assisted and nursing care. First, an assistedrequirements as a skilled nursing facility, and they are
living facility is not a nursing home with fancyprohibited from giving care they are not licensed to
furniture. Assisted living is not licensed to give nursinggive. Limitations to Specialized Care Waivers There
care. Typically, assisted living facilities are placesare exceptions to some of the federal and state
where elders live in a supervised community, withgovernment's licensing requirements. For example, a
some personal care services available. Meals, sociallicensed assisted living facility may take care of
activity, and help with the activities of daily living suchresidents with dementia, including Alzheimer's disease,
as bathing and dressing are all usually offered at suchif it has a waiver to accept this kind of resident. The
facilities. The focus is on providing a healthy socialfacility must also have certain protections in place to
environment and preventing social isolation. It is aprevent injury to its demented residents. However, it
worthy focus, as isolation is dangerous, andis still prohibited from restraining a demented resident
widespread among elders whose independence iswho has a tendency to wander. There are many
declining. If your parent is in fragile health and seemsother limitations to what an assisted living facility can
to be steadily declining physically or mentally, bedo, even with waivers. Taking care of residents with
cautious about choosing an assisted living facility overdementia can be unpredictable, and skilled nursing can
a nursing home (also known as a skilled nursingbecome necessary as the disease progresses. When
facility). No one chooses a nursing home first. Nursingan aging parent has to move out of the family home,
homes are more like hospitals, as they must be toor out of a long-term residence of any kind, the
deliver skilled care to frail seniors. But if your agingmove can be difficult, even traumatic. If you are
parent needs nursing care, and must be watched dayconsidering assisted living as an option for your loved
and night, or you believe that he or she is likely toone, be sure your focus is on the long run. Carefully
need such supervision in the near future, it is the onlyconsider what he or she will need a year down the
choice. Assisted living facilities are not licensed byroad. Moving an elder twice within a short period can
Medicare or Medicaid to give skilled care. Some havebe extremely hard on both of you, so make your
a separate skilled nursing facility on-site or nearby,decisions based on the overall picture, not just on
but it will have its own license to deliver skilled nursingwhat the assisted living facility can do for him or her
care. That license does not apply to the assistedright now. As hidden consumers, adult children must
living component, even the two facilities are locatedbe fully aware of the limits of assisted care. Assisted
on the same campus or are operated by the samecare facilities can be wonderful and supportive
parent company. Doctors & Nurses Not Requiredenvironments for residents who don't need skilled
Many assisted living facilities do not have any licensedcare. If you are considering assisted living for your
nurse on staff, and may have no nurse connected toaging parent, be sure this kind of place is a match for
them at all. Because they are considered non-medicalyour parent's needs.
facilities, having a licensed nurse is not required by