How Does an Assisted Living Community Make Decisions About Suitability of Placement and Continued Residency?

An assisted living community is required by law in each state – including in California – to provide regular assessments of what technically is known as the suitability of placement for continued residency in an assisted living community. An issue might arise that prompts the need for an assessment regarding the suitability of placement for continued residency in an assisted living community. In addition, suitability for placement assessment is undertaken when an individual seeks to reside in a particular assisted living community. In this article, we provide an overview of how an assisted living community makes determinations associated with the suitability of placement in regard to the continued residency of a particular resident as well as in regard to an initial placement in a particular assisted living facility.

Transmissible Diseases and Suitability of Placement

Each prospective resident and actual resident of an assisted living facility must be free from transmissible illnesses that would likely pass between residents and facility staff. With that noted, a prospective resident or actual resident may be admitted to an assisted living facility if that individual is HIV positive. (Such an individual must meet other conditions for acceptance or continued residency.)

Activities of Daily Living

One of the reasons a person is apt to seek residency in an assisted living community is because he or she needs assistance with activities of daily living. These include such things as:

  • Dressing
  • Bathing
  • Grooming
  • Toileting
  • Meal preparation
  • Transportation
  • And so forth

In order to be accepted into an assisted living community in the first instance and in order to maintain placement in a facility, an individual must be able to complete activities of daily living with the supervision or assistance of a staff member. If the condition of an individual is such that assistance with activities of daily living is not reasonably possible, assisted living is not the right type of long-term care placement.

Ability to Transfer

Another issue that is examined in regard to the suitability of the placement and continued residency is what is known as the ability to transfer. Ability to transfer is a technical term that refers to a resident’s ability to do such things as get out of bed, get out of a chair, and so forth. An individual need not be able to do this solely on his or her own in order to be suitable for placement in the first instance, as well as for continued residency. Rather, the ability to transfer must be possible with assistance and support from a staff member or other appropriate caregiver. 

Medication Management

An assisted living community is not a medical facility. Therefore, for an individual to move into a community in the first instance and maintain residency going forward, that person must be able to take medication via self-administration. With that said, a staff member can supervise the administration. In addition, an assisted living community can provide medication management assistance to a resident, provided that the individual is capable of self-administration of medication.

If a resident cannot self-administer, there are situations in which a third-party healthcare professional can undertake this task for a resident. For example, a duly certified visiting healthcare aide could come to an assisted living facility to provide this assistance to a resident. The resident is responsible for contracting with such a healthcare aide and paying for that assistance.

Nutritional Needs

With regularity, an individual seeking admission to an assisted living facility or an existing resident may have specific nutritional needs. For example, a prospective or actual resident may have diabetes, a condition that calls for a special diet. As long as an assisted living facility can satisfy the requirements of a specifically needed diet, admission and continuing residency in a community are acceptable. 

As an aside, dietary issues can extend beyond those associated with nutrition. For example, a person who seeks admission to an assisted living community of an existing residence may have dietary requirements that arise from religious beliefs. One of the most commonplace is kosher meals. Usually, an assisted living community is able to accommodate something like making kosher meals and snacks available to residents. 

Mental Health Issues

Certain types of mental health issues do not impede admission or continuing placement at an assisted living community. For example, oftentimes, one of the reasons a person might seek to live in assisted living is to address loneliness and a lack of social contact. This may have resulted in a person suffering from depression. With that said, an individual who is deemed to be a threat to his or herself and others is not appropriate for placement or continued residency in an assisted living community.

Bedridden Issues

Generally speaking, a person who is bedridden is not eligible for placement in an assisted living community. If an individual becomes bedridden while residing in assisted living, he or she is no longer eligible for continued placement. 

There is a caveat to this general rule. If a person is temporarily bedridden because he or she is recovering from a surgical procedure or is ill as the result of a noncommunicable medical condition, that person is eligible for residency (or continued residency) provided:

  • The length of the period of being bedridden is within a specific period of time, typically up to 30 days
  • The resident contracts with a licensed home health agency or nurse to deliver necessary medical services while bedridden

As a final note, the state regulatory that oversee assisted living facilities do compliance checks or audits in regard to admissions into a community as well as continuing resident placements. This is done to ensure that an assisted living community is capable of providing sufficient care and assistance to its residents.