Assisted Living Defined

Assisted Living is a viable housing option for many seniors requiring varying kinds of service and/or care. Assisted Living facilities may stand alone or be located contiguous to other kinds of senior living environments, including apartments or comprehensive care facilities. Since there are no federally classified or licensed living arrangements defining Assisted Living, each state may define assisted living for itself. The State of Indiana has defined Assisted Living in two ways.

INDIANA ASSISTED LIVING
An Indiana establishment that desires to use the term “assisted living” must file a disclosure form with the Family and Social Services Agency (FSSA) Division of Aging. They become a registered Housing with Services Establishment (HSE). Depending on the types and levels of services provided, they may also be licensed by the Indiana State Department of Health (ISDH). Therefore, assisted living is either unlicensed Housing with Services Establishment or a licensed Residential Care Facility (and registered as Housing with Services Establishment).

At a minimum, the disclosure form requires information on: the name and address of the owner and managing agent, description of services provided and the base rate, additional services available and their fees, the resident's designated representative, if any, referral procedures if the contract is terminated, the process for modifying and terminating the contract, description of the complaint resolution process, and criteria for determining who may continue to reside in the establishment.

Housing with Services Establishments (HSE)
Housing with Services Establishments (Indiana Code 12-10-15) are establishments that provide sleeping accommodations to at least five residents and offer or provide for a fee at least one regularly scheduled health-related service or at least two regularly scheduled supportive services, whether offered or provided directly by the establishment or by another person arranged for by the establishment. They cannot provide medication administration except to assist residents with administering their own medications. Home health agencies can be contracted with to provide medical care if the resident chooses to contract with them.
Payor Source: private pay

Residential Care Facilities (RCF)
A health facility that provides residential nursing care and administers medications prescribed by a physician must be licensed as a Residential Care Facility (410 IAC 16.2 Rule 0.5). They are licensed by the Indiana State Department of Health (ISDH). Each community must be administered by a Health Facility Administrator. The administration of medications and/or the provision of residential nursing services are decisions made by each organization. The ISDH conducts surveys of the community on a regular basis.
Payor Source: Private pay, Assisted Living Medicaid Waiver

Definitions
Health-related services include home health services, attendant and personal care services, professional nursing services, and central storage and distribution of medications.

Supportive services include assistance with personal laundry, handling or assisting with personal funds, arranging for medical services, health related services, or social services.

A Medicaid Waiver is available to pay for services to qualified individuals. They may be used in Residential Care Facilities that are certified to accept the waiver. These facilities must meet additional requirements for living space and a number of other service requirements to be considered for Medicaid Waiver certification.

Health Facility Administrator (HFA) license is obtained in the State of Indiana. There are a number of requirements to be met before a person is eligible to sit for the examination to obtain the HFA license. It is the same license required to administer a Comprehensive Health Facility (nursing home).

Please Note:
As of July 1, 2007, the Health Facility Administrator Board has began the process of revising the HFA license to add a Residential Care license category for the administration of Residential Care Facilities. IALFA is working closely with the board as the criteria, education, AIT and test requirements are developed.