ASSISTED LIVING TERMINOLOGY

Assisted Living – Any Indiana community using the term “assisted living” to describe itself must be registered with the Indiana Family and Social Services Administration (FSSA) Division of Aging as a Housing with Services Establishment. This is a state law requirement (IC 12-10-15-3).

Entities who meet the definition of a Housing with Services Establishment but have not registered with the FSSA Division of Aging cannot enter into contracts with residents. Depending on the services provided, these communities may also be required to be licensed by the Indiana State Department of Health (ISDH) as Residential Care Facilities.

Housing with Services Establishment – A Housing with Services Establishment houses 5 or more residents and provides at least 1 health related service and at least 2 supportive services. These services may be provided by the operator or through an arrangement the operator has with another company or entity.

• Health related services– This means home health services, attendant and personal care services, professional nursing services, and the central storage and distribution of medications.
• Supportive Services –This means help with personal laundry, handling or assisting with personal funds of the residents, or arranging for medical services, health related services, or social services. The term does not include making referrals, assisting a resident in contacting a service provider of the resident’s choice, or contacting a service provider in an emergency.

Housing with Services Establishments must include certain provisions in their contracts with residents, file annual disclosure statements with FSSA, publically post their identity as a housing with services establishment, and publically post a statement of resident rights.

Independent Living – These communities typically provide meals and a number of additional supportive services such as housekeeping, laundry or transportation. While residents may contract with outside entities to provide nursing care or medication administration, the independent living community does not provide this service. Independent living communities typically cost less than those subject to greater regulatory requirements. Independent living communities must follow Indiana laws governing landlord tenant relationships but registration as a Housing with Services Establishment is not required.

Indiana Family and Social Services Agency-Among its divisions are the Division of Aging and the Office of Medicaid Policy and Planning. Housing with Services Establishments register and file disclosure statements with the Division of Aging.

Indiana Office of Medicaid Policy and Planning –Administers Indiana’s Medicaid programs, including eligibility for Medicaid.

Indiana State Department of Health- Licenses and accepts complaints about entities it licenses as Residential Care Facilities. Its website is www.in.gov/isdh

Residential Care Facilities –These entitities are licensed by ISDH. They are also registered as Housing with Services Establishments and must meet all of the Housing with Services Establishment. A license as a residential care facility is required if the entity provides residential nursing care.

Residential nursing care has a meaning defined in Indiana’s Administrative Code 410 IAC 16.2-1.1-62) but in general it means being able to execute certain care regiments as prescribed by a health care professional.  Those could include:

• Assistance with catheter care and intermittent catheterization for a chronic condition.
• Prophylactic and palliative skin care, including application of creams or ointments for treatment of minor skin problems and routine dressing for abrasions, skin tears, closed surgical wounds, and chronic skin conditions.
• General maintenance care of ostomy bags.
• Restorative nursing assistance, including passive and/or active assisted range of motion.
• Toileting care including assistance in use of adult briefs and cues for bowel and bladder.
• Routine blood glucose testing involving a finger-stick method.
• General maintenance care in connection with braces, splints, and plaster casts and observation of self-maintained prosthetic devices.
• Administration of subcutaneous or intramuscular injections.
• Metered dose inhalers, nebulizer/aerosol treatments self-administered by a resident, and routine administration of oxygen after a therapy regimen has been established.