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four residents. Private rooms must be 80 square feet and shared rooms 60 square feet per resident.

Facilities that do not have the ECC license and were licensed after October 1999 may offer shared rooms (maximum of two per room), a bathroom for every six residents, and bathing facilities for every eight residents. Facilities licensed prior to October 1999 may allow four people to share a room.

Admission/Retention Policy

Admission. The regulations for “admissions” to all ALFs are specific (see matrix below).

Continued residency. Additional criteria affect continued residency. In standard ALFs, people who are bedridden more than seven days or develop a need for 24-hour nursing supervision may not be retained. Residents with Stage II pressure sores may remain if the facility has a limited nursing license or the resident contracts with a home health agency or RN.

In ECC facilities, residents may not be retained if they are bedridden for more than 14 days. Terminally ill residents may continue to reside in any ALF if a licensed hospice agency coordinates services, an interdisciplinary care plan is developed, all parties agree to the continued residency, and all documentation requirements are maintained in the resident’s file.

To receive services under the Assisted Living for the Elderly (ALE) Medicaid waiver, which covers assisted living services, case management services, and incontinence supplies, tenants must be 60 years of age or older and meet the following requirements:

  • 1.

    Medicaid eligible.

  • 2.

    Determined disabled according to Social Security standards if under 65 years of age.

  • 3.

    Deemed appropriate for ALF placement by the facility administrator.

  • 4.

    Moving out of a nursing facility or other institutional program, be an ALF resident

needing additional services in order to remain in the ALF, or be living at home and determined at risk of nursing facility placement and desiring to move into an ALF.

  • 5.

    Have a case manager employed by a waiver enrolled case management agency.

  • 6.

    Meet one or more functional criteria listed below: Require assistance with four or more ADLs or three ADLs plus supervision or administration of medications; Require total help with one or more ADLs; Have a diagnosis of Alzheimer’s disease or another type of dementia and require assistance with two or more ADLs;


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