Residential Care/Assisted Living Compendium: Arkansas

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Compendium of Residential Care and Assisted Living Regulations and Policy: 2015 Edition

ARKANSAS

Licensure Terms

Assisted Living Facilities, Level I and Level II, Residential Long-Term Care Facilities

(referred to as residential care facilities)

General Approach

The Arkansas Department of Human Services (DHS), Division of Medical

Services, Office of Long Term Care (Office), licenses and regulates assisted living

facilities (ALFs) as either a Level I or Level II facility. Both levels provide services in a

home-like setting for elderly and disabled persons. The philosophical tenets of

individuality, privacy, dignity and independence, and the promotion of resident self-

direction and personal decision-making while protecting resident health and safety are

emphasized. All living units in ALFs must be independent apartments, including a

kitchen that is a visually and functionally distinct area within the apartment or unit.

Separate licenses are required for ALFs maintained on separate premises, even if they

are operated under the same management.

The Department also licenses residential care facilities (RCFs) to provide services

24 hours a day to individuals age 18 years or older who are not capable of independent

living and who require assistance and supervision. Separate licenses are required for

RCFs maintained on separate premises, even if they are operated under the same

management.

Alzheimer’s special care units (ASCUs) are specialized units of long-term care

facilities--including both nursing homes and ALFs--that offer services specifically for

individuals with Alzheimer’s disease and other dementias. Regulations for ASCUs are

part of the regulations for each type of facility that can house an ASCU.

Arkansas covers personal care services through the Medicaid State Plan, which

may be provided in a person’s home “or other setting” such as a residential long-term

care facility. The state also covers services in Level II ALFs under a single service

Medicaid 1915(c) Waiver program--the Living Choices Assisted Living Waiver program--

and covers services in adult family homes through the State’s Medicaid 1915(c) Elder

Choices Waiver program.

Facilities owned and operated by the Veteran’s Administration, or regulated or licensed by the Department of

Human Services’ Division of Developmental Disabilities Services or Division of Mental Health Services, or

regulated by the Bureau of Alcohol and Drug Abuse Prevention of the Arkansas Department of Health are excluded

from licensure.

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Adult Foster Care. Adult family homes are certified by the DHS Division of Aging

and Adult Services (DAAS). An adult family home provides a family living environment

for no more than three persons who are not related to the principal care provider and

who, owing to the severity of their functional impairments, are considered to be at

imminent risk of death or serious bodily harm and, as a consequence, are not capable

of fully independent living.

Regulatory provisions for these settings are not included in

this profile, but a link to various information can found at the end.

This profile includes summaries of selected regulatory provisions for ALFs and

RCFs. The complete regulations are online at the links provided at the end.

Definitions

Residential care facility means a building or structure that provides on a 24-hour

basis a place of residence and board for three or more individuals whose functional

capabilities may have been impaired, but who do not require hospital or nursing home

care on a daily basis but could require other assistance with activities of daily living

(ADLs).

Assisted living facility means a building or part of a building that undertakes,

through its ownership or management, responsibility to provide assisted living services

for a period exceeding 24 hours to four or more adult residents of the facility. Assisted

living services may be provided either directly or through contractual arrangement. An

ALF provides, at a minimum, services to assist residents in performing all ADLs on a

24-hour basis.

Alzheimer's special care unit means a separate and distinct unit within an

assisted living or other long-term care facility that segregates and provides a special

program for residents with a diagnosis of probable Alzheimer’s disease or another

dementia, and that advertises, markets, or otherwise promotes the facility as providing

specialized Alzheimer’s or dementia care services.

Resident Agreements

Residential Care Facilities. Residents must receive a copy of the resident

agreement at or prior to moving in that covers: (1) services, materials and equipment,

and food included in the basic charge; (2) additional services to be provided and their

charges; (3) residency rules; (4) conditions and rules for termination; (5) provisions for

changes in charges; and (6) refund policies.

Only four adult family homes were operating in 2013 and all four reported no clients. More information is

available from a DHS-commissioned report: Gap Analysis of the Capacity of Long-Term Care Providers of HCBS in

Arkansas, available online at the link provided at the end of this profile.

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Assisted Living Facilities. Prior to or on the day of admission, the ALF and the

resident, or his or her responsible party, must enter into an occupancy admission

agreement. The agreement must provide information about core services (listed below

under Services). Other required information includes: (1) optional services; (2) health

care services available through home health agencies; (3) medication policies; (4) fees,

charges, and payment and refund policies; (5) facility rules; (6) provisions for

emergency transfers; and (7) discharge criteria.

Disclosure Provisions

Residential Care Facilities. No provisions identified.

Assisted living facilities must provide each prospective resident, or the

prospective resident’s representative, with a comprehensive disclosure statement

describing the form of care offered, treatment, staffing, the emergency preparedness

plan, special services and related costs provided by the facility, and other information as

required by law before the prospective resident signs an admission agreement. The

facility disclosure statement is reviewed annually.

Facilities that have an ASCU must provide a facility-prepared statement to

individuals or their families or responsible parties prior to admission that describes how

care, services, and activities are provided; the pre-admission screening and the

assessment processes; implementation of the individual support plan; admission,

discharge and transfer criteria and procedures; training topics, policies, and procedures;

and the minimum number of direct care staff assigned to the ASCU each shift. They

must also provide a written copy of the residents’ rights.

Admission and Retention Policy

Residential Care Facilities. Facilities may not admit or retain individuals who are

not independently mobile (physically and mentally capable of vacating the facility within

3 minutes), able to self-administer medications, or capable of understanding and

responding to reminders and guidance from staff.

Additionally, individuals cannot have specific medical conditions or needs,

including the following:

• A feeding or intravenous tube.

• Total incontinence of bowel and bladder.

• A communicable disease that poses a threat to the health or safety of others.

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• Nursing services exceeding a level that can be provided by a certified home

health agency on a temporary or infrequent basis.

• A level of mental illness, intellectual disability, dementia, or addiction to drugs or

alcohol that requires a higher level of medical, nursing, or psychiatric care or

active treatment than the facility can safely provide.

• Religious, cultural, or dietary regimens that cannot be met without undue burden.

• A need for physical restraints.

• Current violent behavior.

A resident may be discharged only when the resident’s medical needs cannot be

met by the facility or a certified home health agency on a temporary or infrequent basis;

or the resident presents a danger to the health, safety, or welfare of himself or others.

Waivers of the admission/retention policy are not available. Residents who require

frequent skilled nursing services from a home health agency must be assessed by the

Office to determine if a nursing home placement is needed.

Assisted Living Facilities. A facility must not admit or retain residents whose

needs are greater than the facility is licensed to provide.

Level I ALFs cannot serve nursing home-eligible residents or residents who:

(1) need 24-hour nursing services, except as certified by a licensed home health agency

for a period of 60 days with one 30-day extension; (2) are bedridden; (3) have transfer

assistance needs that the facility cannot meet with current staffing, including assistance

to evacuate the building in case of an emergency; (4) present a danger to self or others;

and (5) require medication administration performed by the facility.

Level II facilities are allowed to serve nursing home-eligible residents but cannot

serve residents who are bedridden or have certain conditions or needs, including a

need for 24-hour nursing services; a temporary (more than 14 consecutive days) or

terminal condition (unless a physician or advance practice nurse certifies that the facility

can meet the resident’s needs); need transfer assistance, including but not limited to

assistance to evacuate the facility in case of emergency, that the facility cannot meet

with current staffing; or who present a danger to self or others.

Services

Residential Care Facilities. Facilities may provide personal care; supportive

services (occasional or intermittent guidance, direction, or monitoring for ADLs);

activities and socialization; assistance securing professional services; meals;

housekeeping; and laundry.

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Residents have a choice of providers for receiving personal care services. RCFs

may not provide medical or nursing services. Home health services may be provided by

a certified home health agency when ordered by a physician.

Assisted Living Facilities. Level I facilities provide 24-hour supervision by awake

staff; assistance in obtaining emergency care 24 hours a day (this provision may be met

by an agreement with an ambulance service or hospital or emergency services through

911); assistance with social, recreational, and other activities; assistance with ADLs;

assistance with obtaining transportation; linen service; and medication assistance.

Level II facilities provide 24-hour available staff to respond to residents’ needs

identified in the direct care services and health care services plan portions of residents’

occupancy admission agreements.

Direct care services help residents with certain routines and ADLs, such as

assistance with mobility and transfers; hands-on assistance with feeding, grooming,

shaving, trimming or shaping fingernails and toenails, bathing, dressing, personal

hygiene, bladder and bowel requirements, including incontinence; and assistance with

medication only to the extent permitted by the State Nurse Practice Act. A registered

nurse (RN) must complete the assessment for residents with health needs.

Health care services are available that assist in achieving and maintaining

functional status and well-being (e.g., psychological, social, physical, and spiritual).

They may include nursing assessments and the monitoring and delegation of nursing

tasks by RNs pursuant to the Nurse Practice Act, care management, and the

coordination of basic health care and social services.

Service Planning

Residential Care Facilities. The facility must interview prospective residents prior

to admission to determine if the facility can meet their needs.

Assisted Living Facilities. An initial needs assessment must be completed for

each resident to identify all needed services, and a reassessment must be completed at

least annually and more often as changes occur. Facilities must develop compliance

agreements that address any situation or condition that is or should be known to the

facility that involves risk, the probable consequences of taking risks, the resident or his

or her responsible party’s preference concerning how risks will be handled and the

possible consequences of action on that preference, what the facility will and will not do

to meet the resident’s needs and comply with the resident’s preference to the identified

course of action, alternatives offered to deal with the risk, and the agreed-upon course

of action.

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Third-Party Providers

Residential Care Facilities. If a service required under the licensing regulations

is not provided directly by the facility, the facility must have a written agreement/contract

with an outside program, resource, or service to furnish the necessary service.

An RCF that admits or retains persons with a diagnosis of mental illness/disorder

in need of active treatment must make arrangements with a mental health service

provider for the development and provision of an active treatment plan. This provision

applies to all facilities regardless of size.

Assisted Living Facilities. In Level I facilities, home health services may be

provided by a certified home health agency on a short-term basis. In both Level I and

Level II facilities, other individuals or agencies may furnish care directly or under

arrangements with the ALF. Such care must be supplemental to the services provided

by the ALF and not supplant, nor be substituted for, the requirements of service

provisions by the facility.

Medication Provisions

Residential Care Facilities. Residents must be familiar with their medications

and the instructions for taking them. Aides may remind residents to take medications,

read label instructions, and remove the cap or packaging, but the resident must remove

the medication from the package or container. RCF personnel may not administer or

attempt to administer medications.

Assisted Living Facilities. Staff of Level I facilities may assist a resident in the

self-administration of oral medication by taking the medication in its container from the

area where it is stored and handing the container with the medication in it to the

resident. In the presence of the resident, facility staff may remove the container cap or

loosen the packaging. If the resident is physically impaired but cognitively able (has

awareness with perception, reasoning, intuition, and memory), facility staff, upon

request by or with the consent of the resident, may assist the resident in removing oral

medication from the container and in taking the medication. If the resident is physically

unable to place a dose of oral medication in his or her mouth without spilling or dropping

it, facility staff may place the dose of medication in another container and place that

container to the mouth of the resident. Facility staff cannot administer medications.

In Level II facilities, licensed nursing personnel may administer medications to

residents who are assessed as being unable to self-administer medication. Facilities

must employ a consulting pharmacist.

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Food Service and Dietary Provisions

Residential care facilities and must provide three balanced meals and between

meal snacks. Fluids must be available at all times and meals must be served at

approximately the same time each day. There must be no more than 5 hours between

breakfast and lunch and between lunch and the evening meal, and no more than 14

hours between the evening meal and breakfast.

Assisted Living Facilities. Three balanced meals, snacks, and fluids are

required.

Staffing Requirements

Residential Care Facility

Type of Staff. Each facility must have a full-time (minimum 40 hours per week)

certified (State-approved certification program) administrator on the premises during

normal business hours who has responsibility for the facility’s daily operation. The

administrator must not leave the RCF premises during the day without first delegating

authority to a qualified individual who will manage the facility temporarily during the

administrator’s absence. Each facility must hire direct care staff to provide assistance

with certain ADLs. RCFs located in a multi-building facility must provide at least one

direct care staff person on duty and awake during all hours.

Staff Ratios. Ratios for the number of direct care staff vary by the time of day and

the number of residents (see table below). Sufficient staff must be present at all times to

meet residents’ needs. Staffing requirements are based on current census rather than

licensed capacity.

Number of Direct Care Staff to Residents Required Per Shift

Residents

Day Staff

Evening Staff

Night Staff

1-16

17-32

33-49

50-66

67-83

84-above

For small facilities (16 or fewer beds), each staff person on duty may be counted

as direct care staff even if they are currently involved in administrative, housekeeping,

or dietary activities; and the night staff person may be asleep in the facility.

Additional staff requirements for large facilities (over 16 beds) are as follows:

(1) the staffing table shown above applies to direct care staff only and does not include

administrative, housekeeping, or dietary staff; (2) the facility administrator must not be

scheduled as direct care staff for purposes of meeting minimum staffing requirements

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during normal business hours; (3) staff involved in food and dietary services are not

permitted to perform non-food or non-dietary services during the same shift; and (4) in a

multi-building facility, at least one direct care staff person must be on-duty and awake

during all hours. A relief direct care staff person must be available in the facility to

relieve direct care staff for meals and breaks and to cover if a direct care staff person

must leave the facility in an emergency.

Assisted Living Facility

Type of Staff. Each facility must have a full-time (minimum 40 hours per week)

certified administrator. Administrators must be certified as an ALF, RCF, or nursing

home administrator through a State-approved certification program. The administrator is

responsible for the facility’s daily operation and must be on the premises during normal

business hours. If the administrator has to leave the facility during the day, he or she

must delegate authority to a qualified individual who will manage the facility temporarily

during the administrator’s absence. A second administrator must be employed either

part-time or full-time depending on the number of beds in the facility.

Level II facilities must designate a full-time (40 hour per week) administrator who

must be on the premises during normal business hours. Sharing of administrators

between ALFs and other types of long-term care facilities is permitted. The facility may

employ an individual to act both as administrator and as the facility’s registered nurse.

At no time may the duties of administrator take precedence over, interfere with, or

diminish the responsibilities and duties associated with the RN position.

Level II facilities must employ or contract with at least one RN and also employ or

contract with licensed practical nurses (LPNs) to provide nursing or direct care services

to residents. The facility must employ certified nursing assistants (CNAs) to provide

direct care services to residents. CNAs are permitted to perform the nurse aide duties

set forth in Part II, Unit VII of the Rules and Regulations governing Long-Term Care

Facility Nursing Assistant Training Curriculum. The facility may employ personal care

aides (PCAs) to provide direct care services.

The RN is responsible for the preparation, coordination, and implementation of the

direct care services plan portion of the resident’s occupancy admission agreement, and

must review and oversee all LPN, CNA, and PCA staff. (An RN employed by DAAS who

works with the Assisted Living Medicaid Waiver Program is responsible for Medicaid

waiver residents’ direct care services plan portions of the occupancy admission

agreement.)

The RN does not need to be physically present but must be available to the facility

by phone or pager. Level II facilities must employ a consulting pharmacist.

Staff Ratios. The facility must have as many personnel/staff/employees awake

and on-duty at all times as is needed to properly safeguard the health, safety, and

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welfare of the residents. At least one administrator, on-site manager, or a responsible

staff person must be on the premises and awake 24 hours per day.

Level I facilities must meet the staffing ratios specified in regulation. The ratios are

based on number of residents and are designated for “day,” “evening,” and “night.” (See

table under RCF staff ratios above). Each staff person on-duty may be counted as direct

care staff even if they are currently involved in housekeeping, laundry, or dietary

activities as long as universal precautions are followed. For facilities with more than 16

residents, a relief staff person must be available to relieve staff and to cover if a staff

person must leave the facility in an emergency or for any other reason.

Level II facilities must have a minimum of one staff person per 15 residents from

7:00 a.m. to 8:00 p.m. and one staff person per 25 residents from 8:00 p.m. to 7:00

a.m., but at all times, there must be no fewer than two staff persons on-duty, one of

whom must be a CNA. Staff persons who live on-site but are sleeping may not be

counted for minimum staffing requirements.

Training Requirements

Residential Care Facilities. Each employee must receive orientation to include

but not be limited to: job duties, resident rights, abuse/neglect reporting requirements,

and fire and tornado drills. Four hours of in-service training or continuing education

pertinent to the operation of an RCF must be provided on a quarterly basis for all

employees who have direct contact with residents. Training must include but not be

limited to: resident rights, evacuation of building, safe operation of fire extinguishers,

incident reporting, and medication supervision. In-service training on facility medication

policies and procedures must be provided at least annually for all facility employees

supervising medications.

Assisted Living Facilities. All staff, including contracted personnel who provide

services to residents (excluding licensed home health agency staff), must receive

orientation and training on the following topics:

• Within 7 calendar days of hire: building safety and emergency measures and

appropriate response to emergencies; abuse, neglect, and financial exploitation

and reporting requirements; incident reporting; sanitation and food safety;

resident health and related problems; general overview of the job’s specific

requirements; philosophy and principles of independent living in an ALF; and the

Residents’ Bill of Rights.

• Within 30 calendar days of hire: medication assistance and monitoring,

communicable diseases, and dementia and cognitive impairment.

• Within 180 calendar days of hire: communication skills, review of the aging

process, and disability sensitivity training.

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All staff must receive 6 hours per year of ongoing education and training.

Provisions for Apartments and Private Units

Residential Care Facilities. The state does not require private rooms or private

bathrooms. Facilities may provide single-occupancy or double-occupancy rooms. A

minimum of one toilet/sink is required for every six residents and one tub/shower for

every ten residents.

Assisted Living Facilities. All units must be apartments of adequate size and

configuration to permit residents to carry out, with or without assistance, all the functions

necessary for independent living, including sleeping; sitting; dressing; personal hygiene;

storing, preparing, serving, and eating food; storing clothing and other personal

possessions; doing personal correspondence and paperwork; and entertaining visitors.

Each apartment or unit must be accessible to and useable by residents who use a

wheelchair or other mobility aids consistent with accessibility standards.

Each apartment must have a lockable door. Separate bathroom and kitchen areas

are required. Apartments may not be occupied by more than two persons. Each unit

must provide a small refrigerator as well as a microwave oven, except as may otherwise

be provided in the regulations, and must have a call system monitored 24-hours a day

by staff.

A Level II facility must maintain physically distinct parts or wings to house

individuals who receive, or are medically eligible for, a nursing home level of care

separate and apart from those individuals who do not receive, or are not medically

eligible for, a nursing home level of care.

An apartment or unit must be single-occupancy except in situations where

residents are husband and wife or are two consenting adults who have requested and

agreed in writing to share an apartment or unit. An apartment or unit may be occupied

by no more than two persons.

Provisions for Serving Persons with Dementia

Residential care facilities may not admit or retain individuals with dementia.

Each assisted living facility that advertises or otherwise holds itself out as having

one or more special care units for residents with a diagnosis of probable Alzheimer’s

disease or other dementia must provide an organized, continuous 24-hour-per-day

program of supervision, care, and services in a separate unit specifically designed to

accommodate residents’ complex and varied needs and comply with the following

requirements.

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Dementia Care Staff. An ASCU is subject to the same staffing requirements as

set forth in the rules and regulations for the licensure of Level I ALFs, but staffing must

be determined separately from the ALF based upon the census for the ASCU only. In

addition, a social worker or other professional staff (e.g., physician, RN, or psychologist)

must be utilized to perform several functions, including assisting in the development of

an individual service plan. Nursing, direct care, and personal care staff cannot perform

the duties of cooks, housekeepers, or laundry staff during their direct care shifts.

Dementia Staff Training. Staff must have 30 hours of training on: (1) policies (1

hour); (2) etiology, philosophy, and treatment of dementia (3 hours); (3) stages of

Alzheimer’s disease (2 hours); (4) behavior management (4 hours); (5) use of physical

restraints, wandering, and egress control (2 hours); (6) medication management (2

hours); (7) communication skills (4 hours); (8) prevention of staff burn-out (2 hours);

(9) activities (4 hours); (10) ADLs and individual-centered care (3 hours); and

(11) assessment and individual service plans (3 hours).

Staff must receive 2 hours of ongoing in-service training each quarter to include

such topics as positive therapeutic interventions and activities, developments and new

trends in the fields of Alzheimer’s disease and other dementias and treatments for

same, and environmental modifications to minimize the effects and problems associated

with these conditions.

The individual providing the training must have a minimum of 1 year uninterrupted

employment in the care of residents with dementia, or training in the care of individuals

with dementia, or is designated by the Alzheimer’s Association or its local chapter as

being qualified to provide training.

Dementia Facility Requirements. The regulations specify standards for the

physical design of ASCUs and for locking devices. Facilities must also have policies for

egress control.

Background Checks

Residential Care Facilities. The administrator must be of good moral character

and of sound physical and mental health. “Character“ and “health“ may be determined

by an investigation conducted by the Office that may include such information as

criminal records, doctor statements, and any other information as requested by the

Office. The administrator must have no prior conviction pursuant to the Arkansas Code

or relating to the operation of a long-term care facility and must not have been convicted

of abusing, neglecting, or mistreating individuals. No person who has been convicted of

abusing, neglecting, or mistreating individuals may be employed in the facility.

Assisted Living Facilities. Administrators must successfully complete a criminal

background check; must have no conviction pursuant to the Arkansas Code or relating

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to the operation of a long-term care facility; and must not have been convicted or have a

substantiated report of abusing, neglecting, or mistreating persons, or misappropriation

of resident property. The adult abuse register maintained by DHS/DAAS will be checked

prior to employment. The operator of the facility and all employees and other applicable

individuals utilized by the facility as staff must successfully complete a criminal check.

Verification is also required that an employee has not been convicted or does not

have a substantiated report of abusing or neglecting residents or misappropriating

resident property. The facility must, at a minimum, prior to employing any individual or

for any individuals working in the facility through contract with a third party, make inquiry

to the Employment Clearance Registry of the Office of Long Term Care and the Adult

Abuse Register maintained by DHS/DAAS, and must conduct re-checks of all

employees every 5 years.

Inspection and Monitoring

Residential Care Facilities. Annual renewal is required for all RCF licenses and,

on average, inspections are conducted annually. All areas of the licensed facility and all

records related to the care and protection of residents, including resident and employee

records, must be open for inspection by the Department for the purpose of enforcing the

licensing regulations.

Assisted Living Facilities. Annual renewal is required for all ALF licenses. The

Office of Long Term Care conducts a standard comprehensive survey of each facility on

average every 18 months. To receive and maintain a license, a facility must submit to

regular and unannounced inspection surveys and complaint investigations.

Public Financing

Arkansas covers personal care services through the Medicaid State Plan, which

may be provided in a person’s home “or other setting” such as a RCF.

The state covers services in ALFs under a single service 1915(c) Waiver program

--the Living Choices Assisted Living Waiver program. Waiver “assisted living services”

providers must be licensed as a Level II ALF or a licensed Class A Home Health

Agency that has a contract with a licensed Level II ALF to provide waiver services and

pharmacy consultant services. Waiver services include personal care and supportive

services (e.g., homemaker, chore, attendant care, companion, transportation, and

medication oversight).

Room and Board Policy

The state does not provide a supplement to the federal Supplemental Security

Income (SSI) payment, but limits the room and board payment for Medicaid-eligible

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residents to the SSI payment less a personal needs allowance (PNA) that is retained by

the resident. In 2014, the SSI payment was $721 and the PNA was $65, leaving $656

per month to pay for room and board.

Family supplementation of room and board payments is not allowed, but families

can pay for other items that are not included in the room and board rate, such as phone

and cable TV service.

Location of Licensing, Certification, or Other Requirements

Rules and Regulations for Assisted Living Facilities Level I. Arkansas Department of Human

Services, Division of Medical Services, Office of Long Term Care. [August 1, 2011]

http://humanservices.arkansas.gov/dms/oltcDocuments/alfi.PDF

Rules and Regulations for Assisted Living Facilities Level II. Arkansas Department of Human

Services, Division of Medical Services, Office of Long Term Care. [August 1, 2011]

http://humanservices.arkansas.gov/dms/oltcDocuments/alfii.pdf

Rules and Regulations for Residential Long Term Care Facilities. Arkansas Department of

Human Services, Division of Medical Services, Office of Long Term Care. [August 1, 2007]

http://humanservices.arkansas.gov/dms/oltcDocuments/rcf.pdf

Arkansas Department of Human Services website: Links to various information about Adult

Family Care, including a report called Gap Analysis of the Capacity of Long-Term Care

Providers of HCBS in Arkansas. Division of Aging and Adult Services, Department of Human

Services. [May 2013]

http://humanservices.arkansas.gov/Pages/siteSearch.aspx?q=Adult%20Family%20Home

Information Sources

Stephenie Blocker, RN-BC

Assistant Director of Home and Community-Based Services

Division of Aging and Adult Services

Sherri Proffer, RN

Nurse Manager, Office of Long Term Care

Division of Medical Services

Department of Human Services

COMPENDIUM OF RESIDENTIAL CARE AND ASSISTED

LIVING REGULATIONS AND POLICY: 2015 EDITION

Files Available for This Report

FULL REPORT

Executive Summary http://aspe.hhs.gov/execsum/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-executive-

summary

HTML http://aspe.hhs.gov/basic-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition

PDF http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition

SEPARATE STATE PROFILES

[NOTE: These profiles are available in the full HTML and PDF versions, as well as each state

available as a separate PDF listed below.]

Alabama

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-alabama-profile

Alaska http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-alaska-profile

Arizona http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-arizona-profile

Arkansas http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-arkansas-profile

California

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-california-profile

Colorado http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-colorado-profile

Connecticut http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-connecticut-profile

Delaware

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-delaware-profile

District of Columbia http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-district-columbia-

profile

Florida

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-florida-profile

Georgia http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-georgia-profile

Hawaii

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-hawaii-profile

Idaho

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-idaho-profile

Illinois http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-illinois-profile

Indiana http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-indiana-profile

Iowa http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-iowa-profile

Kansas

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-kansas-profile

Kentucky http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-kentucky-profile

Louisiana

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-louisiana-profile

Maine

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-maine-profile

Maryland http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-maryland-profile

Massachusetts http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-massachusetts-

profile

Michigan http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-michigan-profile

Minnesota http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-minnesota-profile

Mississippi http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-mississippi-profile

Missouri http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-missouri-profile

Montana http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-montana-profile

Nebraska

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-nebraska-profile

Nevada http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-nevada-profile

New Hampshire http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-new-hampshire-

profile

New Jersey http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-new-jersey-profile

New Mexico http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-new-mexico-profile

New York http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-new-york-profile

North Carolina http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-north-carolina-

profile

North Dakota http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-north-dakota-

profile

Ohio

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-ohio-profile

Oklahoma http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-oklahoma-profile

Oregon http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-oregon-profile

Pennsylvania

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-pennsylvania-

profile

Rhode Island

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-rhode-island-

profile

South Carolina

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-south-carolina-

profile

South Dakota http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-south-dakota-

profile

Tennessee

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-tennessee-profile

Texas http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-texas-profile

Utah

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-utah-profile

Vermont

http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-vermont-profile

Virginia http://aspe.hhs.gov/pdf-report/compendium-residential-care-and-

assisted-living-regulations-and-policy-2015-edition-virginia-profile