Assisted Living Defined

Assisted Living is a viable housing option for elders that require varying kinds of service and/or care. Assisted Living communities 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. It is then considered a registered Housing with Services Establishment (HSE). This type of community will provide three meals per day and a number of additional services.

If a community desires to provide residential nursing care and medication administration, it must be licensed by the Indiana State Department of Health as a Residential Care Facility.

Therefore, an Assisted Living community may provide minimum supportive services as Housing with Services Establishment or provide more services including health care related services as a Residential Care Facility; licensed by the Indiana State Department of Health.

For the sake of a well-informed consumer, the required disclosure form includes 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). It is licensed by the Indiana State Department of Health (ISDH). Each community must be administered by a licensed administrator. The administration of medications and/or the provision of residential nursing services are decisions made by each organization. The ISDH conducts compliance surveys of the community on a regular basis.
Payor Source: Private pay, Aged & Disabled Assisted Living Waiver

The Indiana Home and Community-Based Services Waivers
This program allows Indiana Medicaid programs to pay for services that are provided in a person’s home or other community setting like a Residential Care Facility* rather than a Medicaid funded institution (nursing home). Persons must qualify for institutional care in order to be eligible for home and community-based services. Waiver refers to the waiving of certain federal requirements that otherwise apply to Medicaid program services. The Aged and Disabled (A&D) Waiver provides an alternative to nursing facility admission for adults and persons of all ages with a disability. The waiver is designed to provide services to supplement informal supports for people who would require care in a nursing facility if waiver or other supports were not available. Waiver services can be used to help people remain in their own homes, as well as assist people living in nursing facilities to return to community settings such as their own homes, apartments, assisted living or adult foster care. For further information about the waiver visit Aged and Disabled Waiver (A&D).

Waivers are obtained through the regional Area Agency on Aging offices. There are 16 located in Indiana. Obtain additional information from this comprehensive web site.

*The Medicaid Waiver may be used in Residential Care Facilities that are certified to accept the waiver. These communities choose to participate in the program and must meet additional requirements for living space and a number of other service requirements to be considered for Medicaid Waiver certification.