Do Assisted Living Facilities Need Special Licensing?

If you are considering assisted living for yourself or for a member of your family, you may be wondering whether or not this type of facility is required to have special licensing. At this point in time, the regulation of assisted living communities and all other long-term care facilities is left up to the individual states. With that said, all states in the country do require assisted living and all other types of long-term care facilities to be duly licensed. Indeed, assisted living communities are closely regulated by the state.

State of California Service Requirements for an Assisted Living Community

The state of California delineates the type of assistance and services an assisted living community can provide and charge a resident. According to regulations in the state of California, the types of services and assistance an assisted living community licensed by the state can provide include:

  • Living quarters that can take the form of a private room, a shared room, or an apartment
  • Assistance with bathing, dressing, grooming, ambulating/transferring
  • Meals and snacks
  • Housekeeping and laundry
  • Transportation
  • Activities
  • Assistance with medication or medication management
  • Supervision and available staff around the clock

The state of California allows additional monthly fees for more extensive care based on the resident’s assessed care needs on an individual or case-by-case basis.

The state of California goes on to note:

An RCFE provides non-medical care and supervision for persons 60 years or older who may need assistance with activities of daily living. RCFE residents should not require ongoing medical assistance from facility staff. RCFEs may also serve persons under the age of 60 who have similar needs. RCFEs may care for individuals with dementia if the facility is adequately equipped and the staff are trained and sufficient to meet the needs of all residents.

Hospice Services at a California Assisted Living Facility

The state of California permits an assisted living facility to obtain what technically is an exemption regarding hospice services. This exemption permits an assisted living community in California to set aside a specific number of beds for residents who end up in need of hospice services.

According to California law:

Hospice services are provided to individuals in many care settings, ranging from one’s own home or apartment to a residential care facility (if the facility has approval from the California Department of Social Service) or congregate living facility for a skilled nursing facility. Residential care facilities, including assisted living communities, can receive approval to provide hospice services and care for residents who are terminally ill if the facility is in substantial compliance with existing licensing requirements. In addition, the resident is required to obtain appropriate medical care from a licensed hospice agency.

Ownership of an Assisted Living Facility

An assisted living facility needs to be transparent in regard to its ownership. As part of a due diligence process before you or a loved one moves into a particular assisted living community, you will want to ascertain whether the facility is privately owned, part of a corporation, or a franchise operation. Determining whether or not a particular assisted living facility is locally owned may also be something that you want to explore during the investigatory process.

Finances of an Assisted Living Community

An assisted living facility needs to demonstrate to state regularity authorities that it has the financial wherewithal to operate. At the outset, an applicant for licensing to operate an assisted living facility needs to show independent financial proof that there exist necessary funds to launch an assisted living community, that there is sufficient operating capital, and that the company or individual that will own an assisted living facility has contingency financing available that is accessible if needed.

In addition, before opening an assisted living community, a company or individual will need to provide the following to the state regulatory authority:

  • Projected financial statements
  • Balance sheet
  • Income and expense statement for the first two years
  • Cash flow for the first two years

This type of financial data is crucial inasmuch as one of the most common reasons (if not the most common) an assisted living facility reaches a point where it needs to close its doors is because of financial issues. The theory is that by ensuring that a company or individual intent on opening and operating an assisted living community is required to prepare and provide this type of financial information, that operator will be less likely to face some sort of financial issue in the future that would warrant the shutter of a facility.

In summary, there are special licensing and other requirements that must be satisfied when an assisted living facility community is proposed and then opened. Moreover, there are ongoing requirements that must be satisfied in order for an assisted living facility to be able to continue to operate in any state, including the state of California.