Considering assisted living as a long-term care option for an older adult in your life who is struggling to continue living solo, or for yourself in the future? Assisted living facilities all share the common goal of maximizing independence through personalized care. But individual communities often have their own eligibility requirements to help ensure every resident gets the care they need, explains Grace Ferri, chief marketing officer at United Hebrew of New Rochelle, a senior living community in New Rochelle, New York.
“Assisted living facilities offer a balance between independence and support, allowing residents to maintain their quality of life while receiving the help they need,” Ferri says. “Understanding requirements and assessment processes is important for families who want to ensure a smooth transition to an appropriate level of care for their loved one.”
Here, experts explain who qualifies for assisted living facility, common requirements for seniors and how new residents are assessed to ensure a good living situation.
In general, who qualifies for assisted living?
According to the National Center for Assisted Living (NCAL), assisted living communities serve individuals who need help with activities of daily living and some health care services but do not require 24-hour ongoing skilled nursing care services.
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This is because assisted living facilities aim to promote independence for all residents, explains Moti Gamburd, chief executive officer of CARE Homecare, an in-home senior care provider in Los Angeles. “Unlike nursing homes, which focus on medical care, assisted living communities emphasize creating a safe, social and stimulating environment,” Gamburd says.
For seniors who live alone and risk feeling isolated, moving into this type of environment can be life-changing. “Assisted living gives opportunities for residents to remain active and engaged,” Gamburd says. “For example, one resident at our community initially needed help with bathing and dressing but quickly thrived in group exercise classes and art workshops. The goal is not just providing care but creating a place where seniors feel valued and included.”
While assisted living residents have access to different levels of care services, typically they must be able to live on their own, Ferri notes. “By design, assisted living is for individuals who can live independently but require some assistance with daily activities,” Ferri says. In fact, the majority of residents often need help with only a few activities of daily living, according to NCAL, the most common being bathing.
What would disqualify someone from assisted living?
“Assisted living facilities are not equipped to handle complex medical conditions that require constant monitoring and specialized medical interventions,” Ferri says. For this reason, assisted living communities will not admit individuals who require the following, according to the experts we spoke to:
- Specialized medical interventions, such as a tracheostomy or ventilator.
- Intensive medical treatments, such as IV therapy, dialysis or specialized wound care.
- Full-time supervision and support due to cognitive impairment or mobility limitations.
Understanding assisted living facility requirements at the national, state and local level
In general, all requirements for assisted living are focused on the level of care residents need, but they come from different entities. Here’s a breakdown, according to the experts:
Nation-wide assisted living requirements
Taking into account the types of services they provide, there are several baseline qualifications for assisted living eligibility in the United States, explains Jessica Peters, associate executive director at The Trillium, a luxury senior living community in Tysons, Virginia. These include:
- Not requiring continuous skilled nursing care.
- Not being ventilator-dependent.
- Not needing special isolation due to infectious diseases.
- Not being at risk of harming oneself or others.
State-wide assisted living requirements
Aside from baseline requirements, the majority of requirements for assisted living facilities are set by state regulatory organizations. Each year, NCAL publishes a complete summary of these state-specific requirements in the “Assisted Living State Regulatory Review” which includes both licensure and certification requirements for communities, as well as eligibility requirements.
Facility-based assisted living requirements
While every state sets general standards for assisted living communities, individual facilities may have some discretion in the specific services they offer, Peters notes. “Some may be able to provide higher levels of care or make exceptions in unique situations,” she says.
For example, if a facility features a Hoyer lift (a medical device that helps caregivers safely move patients from one place to another), it may be able to accommodate residents with more mobility issues than one that does not.
How seniors are assessed to qualify for assisted living
To ensure residents meet all of the requirements, individual assisted living communities often have their own specific criteria for admission that must be met. “The application process for an assisted living facility generally involves an assessment to determine the prospective resident’s care needs and compatibility with the facility’s capabilities,” Peters explains.
In some states, an assessment may even be required, she notes. “For example, Virginia requires the completion of a Uniform Assessment Instrument (UAI), which helps determine exactly what type of help a resident needs,” Peters says. “This knowledge ensures that the facility can adequately meet the needs of its residents.”
Assisted living assessments tend to focus on identifying needs in the following categories, as are present in an official UAI:
- Activities of daily living: bathing, dressing, toileting or eating.
- Mobility: walking, wheeling or stair climbing.
- Instrumental activities of daily living: meal preparation, housekeeping and laundry.
- Physical health: medical history, current diagnoses and medications.
- Sensory function: vision, hearing and speech.
- Nutrition: special diets, supplements and allergies.
- Medical services requirements: rehabilitation and nursing needs.
- Cognitive function: orientation, recall, memory, judgement and behavior patterns.
- Emotional and social connections: mental health conditions and support networks.
A personality assessment may also be included in the admission process, Gamburd says, recalling his work with one resident in particular who benefited from this type of review when transitioning into his facility. “During her assessment, we discovered she thrived in small, quiet social groups, which led us to customize her activity schedule accordingly,” he says. “Without that understanding, she might not have adjusted as well.”
Tips for finding the right assisted living facility
“Overall, choosing the right assisted living facility involves thorough research, understanding the specific needs of the senior and assessing how well a facility can meet those needs,” Peters says. Here are a few tips, according to the experts we spoke to:
- Schedule multiple tours to compare and contrast different facilities.
- Read through activity offerings, menus and community newsletters.
- Ask about staffing ratios and emergency protocols.
- Observe how staff interact with residents.
- Join a community meal or event to get insights into the social environment and operational quality of the facility.
NCAL also offers this comprehensive guide to choosing an assisted living residence to help you get started. You can also use the search function on their website to find other resources that may be helpful in your search for local assisted living communities or programs.
The bottom line
In general, assisted living communities are designed to serve seniors who require support with daily activities, but can still live independently. They do not admit residents who require 24/7 supervision or complex medical treatments.
And while some requirements for assisted living are decided by regulatory organizations, many are decided by individual facilities based on services they provide. Experts recommend visiting facilities in your area to learn their resident eligibility specifics, as well as assessment protocol. “By understanding these requirements and engaging in the assessment process, families can make informed decisions about the best care options for their loved ones,” Ferri says.
