Safety is one of the most important reasons families decide it is better for aging loved ones to reside in an assisted living facility than in their own homes. There are a number of things necessary for owners of assisted living facilities to understand to make good on this promise of safety. This includes what safety equipment should be available on the premises at all times.
Well-Stocked First Aid Supplies
It is vital to be proactive in your approach to handling any possible injuries and emergencies that might occur. One important first step is to make sure a well-stocked first aid kit is always on hand. Older people possess more brittle bones and thinner skin which makes it necessary for them to receive a higher level of care for minor injuries than other people. According to Family Resource Home Care, your first aid kit should at least include the following:
- transparent film dressing
- self-adhesive bandages
- butterfly closures
- rolled gauze
- paper tape
- nonstick gauze
Fall Prevention Equipment
Falls are a major cause of injuries for people of all ages but can be especially problematic for people who have reached an advanced age. The use of fall prevention equipment can be the determining factor in whether an incident is a minor inconvenience or a life-threatening injury. According to Bohn & Fletcher, assisted living facilities should provide things such as handrails, grab bars, bedding, safe and comfortable seating, and walkers or canes. Fall mats are also useful, especially alongside beds and in bathrooms. Fall management socks are excellent for providing extra traction when walking on slippery surfaces. The handrails and grab bars you purchase will be especially useful in the bathroom where the floor is often moist and residents will have to get in and out of the bathtub.
Your assistant home living facility will provide housing for vulnerable people. Because of this, it is extra important for you to take security measures that will ensure the safety of your residents. According to Keri Systems, perimeter access to the facility should be tightly controlled. This will prevent access by unauthorized people and keep residents from wandering off without the knowledge of you or your employees. There should be a point of contact at each door that makes communication with an employee inside the facility necessary. Only known visitors with a photo ID should be allowed inside. You and your staff will not be able to have eyes on patients at all times. In-patient monitoring systems will allow you to make sure residents do not need assistance while in their rooms. Also, be sure that your assisted living facility has a capable fire alarm system.
Providing for the safety of residents is job number one for you as the owner of an assisted home living facility. There are many things to consider as you work to improve safety standards for your residents. The three tips above will provide you with a solid foundation for making your facility as safe as possible.
If you’re looking to buy an assisted living facility, take a look at our listings!
The Different Types of
Assisted Living Facilities
What are the different types of assisted
living facilities? What are their specialties?
If you’re looking to start your own assisted
living facility, those are two questions you’ll need to ask (and answer).
Essentially, five different groups need
assisted living in some form or another:
- Dementia patients
- The developmentally disabled
- The mentally ill
- The brain-injured (traumatic brain injury,
spinal cord injury, etc)
In this article, we’re going to review exactly
what types of assisted living facilities cater to each group so that you can
have a better idea of the licensing, possible bed rates, demand, and level of
care required to service them.
The Different Types of Assisted Living
Facilities: Focus on the Demographic
“Assisted living” has come to mean a lot of
things. Naturally, it can get a little confusing.
We’ll use the term “assisted living,”
generally but, as you’ll see, you can just as easily replace it with any terms
that encompass the same level of medical care and assistance.
Nursing homes are still technically “assisted
living facilities” because they assist dementia patients with basic living
tasks, so people might refer to their grandparents’ nursing home as an
“assisted living facility.”
However, there’s also a specific name for
facilities that cater to an elderly crowd that doesn’t yet require serious
medical treatment or 24-hour supervision: literally titled an “assisted living
What’s even more confusing is that the name of the assisted living facility that you’re looking to start might vary from state to state – like we noted in our article on “Starting an Assisted Living Facility in Michigan.”
Thus, don’t get hung
up on the terminology. Focus, instead, on
the group of people you’re looking to help. The terminology will change from
state to state, but the people that you’re looking to help will stay the same.
Then, when you’ve found out the type of
facility you want, follow our guides on how to get started with financing for
Seniors: Assisted Living, Board and Care,
Adult Living, Supported Care
It’s a sad fact of life: With old age comes
decreased cognitive functioning and increased dependence on others – even for
the most basic tasks. Everyone, at some point, will reach the age where they
need someone to help take care of them. You and your loved ones are no
Assisted living facilities are designed with
this purpose in mind. Unless they’re connected to nursing homes, they typically
don’t assist people with dementia or other serious illnesses. Instead, they’re
focused on helping the elderly with everyday functioning; nursing homes would
provide too much care, in this instance, and therefore would
probably be too expensive for the care recipient. This way, with these senior
care facilities, the owners don’t need to pay for expensive services that the
recipients don’t actually need.
Some of these facilities are able to get
Medicare, and most of the patients in these types of facilities either pay
privately or they qualify for long-term care insurance.
The level of skilled nursing varies from
facility to facility. Some seniors haven’t yet reached the point where they
need a licensed medical professional to insert a catheter into them, for
instance, while others have. Therefore, it’s important to keep in mind that
senior care facilities vary. Here are some of the different types of assisted
living facilities that are available for seniors who need a little bit of help
but haven’t yet reached the point where they need serious medical care:
- Assisted Living Facilities (also “board and
care,” “adult living,” and “supported care”). The key term here – what assisted living facilities actually
assist with – is called an “activity of daily living” (ADL for short).
According to MedicineNet, typical ADLs include feeding,
bathing, dressing, grooming, work, homemaking, and leisure. As we mentioned
above, the patients in assisted living facilities typically don’t require a
high degree of medical care, so assistance with these tasks can be performed by
anyone with a basic degree of training.
Dementia Patients: Memory Care, Long-Term Care, Skilled Nursing, Custodial Care
According to the World Health Organization, the percentage of adults 60 years and older
living with dementia at any given time is around 5-8%. The total number of
people with dementia is expected to reach 82 million in 2030 and 152 million in
2050. Just like assisted living facilities, there’s a growing market for
facilities that cater toward dementia patients.
And, when it comes to informal caregiving, the
jury is out: When friends, family members, and other relatives are tasked with
the assistance of a person suffering from dementia, both suffer. 98-99% of informal caregivers experienced
problems with trying to
take care of their loved one by themselves – and it ended up seriously
affecting their social lives in the later stages of the illness. A vast
majority of them ended up needing additional professional support anyway.
In fact, according to that same study published in The Open Nursing
Journal, “The amount of available professional care is, however, not
expected to rise in line with the growing demand in the ageing population.”
However, this is good news for those of you looking to start nursing homes and
other care facilities catered toward dementia patients.
Naturally, these facilities demand a higher
level of care: more skilled and more attentive. The facilities themselves are
usually on lockdown to prevent any patient from wandering off, and some of them
have amenities such as aromatherapy, pet therapy, and greenhouses – in order to
keep patients at ease.
- Memory Care Facility (also called “long-term care facilities,” “skilled nursing facilities,” and “custodial care facilities”). These types of facilities demand a higher level of care than simple assisted living facilities. Licensed medical professionals are typically on staff 24/7 to help with patients’ needs. Typically, these have higher bed rates than senior care facilities. Many researchers believe that professional care for those with dementia won’t scale in proportion to the level of demand, so opening a nursing home might be a smart investment.
The Developmentally Disabled: Facilities
Serving People With Developmental Disabilities (FDD), Intermediate Care
Facility for Individuals with Intellectual Disabilities (ICF/IID)
Alternatively, there are facilities designed
with no age requirements – for people of all ages who need some level of assisted
care with their daily activities. Just like most of the other types of
facilities designed for these different demographics, there are varying levels
of expertise required for those living in a facility for the developmentally
For instance, some members are relatively
high-functioning members of society. They might even have day jobs, so they’ll
leave at some point throughout the day. These members only need help with basic
tasks (the ALDs we mentioned above, on the bullet-point for “assisted living
facilities”): cooking, cleaning, keeping their medication organized, staying
above par when it comes to their personal hygiene, and so on.
FDDS: Facilities Serving People with
FDDs help patients learn new skills and
maintain their current skills. According to the Wisconsin Department of Health Services, an FDD:
- Provides active treatment, ongoing evaluation,
planning, 24-hour supervision, coordination, and integration of health or
rehabilitative services to help each individual function at his/her greatest
ICF: Intermediated Care Facility
As you can see, that’s a fairly high level of
care that will likely require licensed medical professionals. Meanwhile, an
Intermediate Care Facility (ICF) does exactly what it sounds like. It provides
an intermediate level of care between basic and intensive. It’s just a step
down from an FDD. From Highland Risk:
- An ICF is typically regarded as a lower-level
nursing care facility when compared to a skilled nursing facility, but its
residents require more care and attention than those in a residential care
facility for the elderly or an adult residential care facility.
As for funding, some pay private, some are
taken care of through Social Security, but most of them are placed in an FDD,
ICF, or lower, more basic facility for the developmentally disabled through
Bed rates are usually less than both senior
care and nursing homes, and facilities for the high-functioning developmentally
disabled, naturally, pay the least in comparison to the others.
- Developmentally Disabled Care Facilities:
Facilities Serving People With Developmental Disabilities (FDD), Intermediate
Care Facility for Individuals with Intellectual Disabilities (ICF/IID), and
other basic facilities for the high-functioning developmentally disabled. These facilities serve all types of people,
not just seniors. Some members of Developmentally Disabled Care Facilities are
high-functioning, so they have jobs that they go to during the day. Facilities
like that, which care for people who need some help but not a lot, don’t make
as much money as the others.
The Mentally Ill: Psychiatric Hospitals, Day
Treatment Mental Health Facilities, Residential Mental Health Treatment
Facilities for Adults or Children, and Separate Inpatient Units in a Hospital
When most people think about mental health
facilities, they assume it’s something like One Flew Over the Cuckoo’s
Nest. Less like a hospital and more like a prison: constantly on lockdown
with a variety of people suffering from severe, debilitating mental
illness – and maybe you could even add electroshock therapy in there, for good
High Demand for Psychiatric Hospitals
Of course, this couldn’t be further from the
truth. In fact, only 6.2% of mental health facilities are
full-out psychiatric hospitals, and psychiatric hospitals, in actuality, are nothing like the
movies. (Sidenote: of that 6.2%, over half are privately owned).
The trend, over the past fifty years, has been
to eliminate psychiatric hospitals in favor of outpatient care – and the data
shows the demand for inpatient care is actually at an all-time high, with
some patients struggling to even find a bed.
The National Association of State Mental
Health Program Directors has this to say:
“The shortage of psychiatric inpatient beds
has become a major national issue, with the lack of availability identified as
a major issue by policy makers, states, mental health families, academics, and
popular media. Many reports regarding these shortages start with the major
decline in inpatient capacity in state psychiatric hospitals—a decrease of over
500,000 beds since the 1950s.”
Meanwhile, mental health problems in the US
are on the rise: Gen Z is more likely than any other generation
before it to suffer from serious mental health issues.
Outpatient Care Facilities: Day Treatment
Naturally, though, just like every other type
of facility on this list, there are varying levels and demands of care. Most
mental health facilities are day facilities. According to the National Mental
Health Services survey, roughly 60.8% of facilities are outpatient, day
treatment, or partial hospitalization facilities.
Thus, each of these facilities will have
different bed rates and qualifications for licensing. Because of the high
demand, psychiatric hospitals will have high bed rates, while others will have
much lower bed rates.
Also, according to Mental Health America, fewer youth are insured for mental health
treatment: “The proportion of youth with private insurance that did not cover
mental or emotional difficulties nearly doubled, from 4.6 percent in 2012 to
8.1 percent in 2017.”
So, there’s a variety of payment methods for
inpatient and outpatient mental health recipients: private, Medicare, and
through a family insurance plan.
- The Mentally Ill: Day Treatment Mental Health
Facilities, Psychiatric Hospitals, Residential Mental Health Treatment
Facilities for Adults or Children, and Separate Inpatient Units in a Hospital. Of these listed, psychiatric hospitals
are the highest in demand. However, because of the rise of mental health issues
across the country (along with care being socially destigmatized), all of them
are viable options for your own assisted living facility.
The Brain Injured: Transitional Care and
Assisted living facilities designed for those
suffering from traumatic brain injury, spinal cord injury, and multiple trauma
are typically labeled as “transitional care.”
Every year, an estimated 1.5 million people suffer from traumatic brain injury. Of
that 1.5 million, 230,000 are hospitalized. That also means there are over 5.3
million people living with a permanent TBI-related disability. The demand for
transitional care (and even occasional outpatient care) is, therefore, fairly
Also, pay can be collected in a number of
ways. Some patients pay privately, some pay through Medicare (depending on the
situation and length of stay), and others pay through auto insurance. Auto
insurance can be difficult to collect on, so be warned.
- The Brain Injured: Transitional Care and
Conclusion: The Different Types of Assisted
Over the years, “assisted living” has come to
mean a lot of different things, so if you’re looking to start an assisted living
facility, it can be difficult to gather research on the different types of
assisted living facilities.
In this article, we clarified that confusion
by focusing on the demographics that each facility serves:
- Dementia patients
- The developmentally disabled
- The mentally ill
- The brain-injured (traumatic brain injury,
spinal cord injury, etc)
You can quickly go through our list and find
names for the type of facility that caters toward each group.
Anyway, we hope our data on the different
types of assisted living facilities will help you narrow down your research.
If you have any
questions, comments, or concerns, contact us today.
Starting an Assisted
Living Facility in Michigan: A Guide
Are you looking to start an assisted living facility in Michigan?
What unique problems might you run into? What’s special
about assisted living facilities in Michigan? What steps can you take today to
make your business idea a reality?
In this article, we’ll show you the specific laws and
regulations surrounding assisted living facilities in Michigan – including the
difference between an “assisted living facility,” an “adult foster care
facility,” and a “home for the aged,” – and we’ll guide you toward the best
course of action.
Different About Michigan Assisted Living Facilities?
Isn’t assisted living the same everywhere? Why should
starting an assisted living facility in Michigan be any different than anywhere
Well, no, assisted living is not the same everywhere. Rules
and regulations for assisted living facilities vary from state to state. There
actually isn’t any federal regulation, so paying extra special attention to
your state’s laws is paramount.
Just because you have experience opening a successful assisted
living facility in California doesn’t mean that experience will necessarily
transfer to opening a successful assisted living facility in Michigan. The
laws, regulations, and quality control might be completely different, and so
one of those elements might radically change your business plan. In fact,
depending on your organization’s goals and quality of care, you might not even
be opening just an “assisted living facility.” It might actually be called
something completely different, as you’ll see.
Furthermore, the residential care business, as well as real
estate in general, is all about location. If you’re not willing to do some
research on what’s different about assisted living in Michigan, you’re not off
to a good start.
Luckily, we’re here for you. We’ll break down everything you
need to know.
Cost of Care
Cost of Care Survey 2018 breaks down the cost of assisted living nationally
and by state. Now, we know you’re looking to purchase an assisted living
facility – not just assisted living services for a loved one – but this data
might help you determine your competition’s rates. That could provide you with
some valuable information on how you can outperform them, whether it’s in
service, quality, or price. It’s a good place to begin.
Nationally, the cost for assisted living is pretty high: it
works out to about $133 per day for most, and $278 per day for a private room.
Full-time home health aide services aren’t that much better, either, with an
average of roughly $127 per day.
The costs for assisted living in Michigan are both higher
and lower than the national average, so that indicates, for certain services,
the market is ripe for arbitrage. The median cost for assisted living in
Michigan is $126 per day for most, and $300 for a private room. Full-time home
health aide services work out to roughly $137 per day.
The cost of assisted living in Michigan isn’t all that
competitive, then. As we talked about in a previous article, the proportion of
older Americans is growing every day – and so, then, is the demand for assisted
What else about assisted living in Michigan do you need to
Difference Between “Assisted Living Facilities,” “Adult Foster Care
Facilities,” and “Homes for the Aged.”
For one, regulatory agencies in Michigan don’t use the term
“assisted living facilities.” Instead, they prefer the terms, “adult foster
care facilities” (also known as an AFC or AFC home) and “homes for the aged.” Among
other things, this means that assisted living facilities in Michigan don’t
necessarily have to be licensed. The
Department of Licensing and Regulatory Affairs only licenses adult foster
care facilities and homes for the aged, and the licensing requirement is
different for both.
This all might sound semantic, but it’s actually incredibly important. In order to qualify for an SBA 7(a), the primary method of financing for most assisted living facilities, you’re very likely going to need to be licensed.
And, before you apply for licensing in Michigan to start
your organization, you’re going to want to know if you want to make it an AFC
or a home for the aged. Each of them are designed, of course, to provide care to
individuals who need some sort of assistance, but there are important
Living Facilities in Michigan
Since Assisted Living Facility doesn’t technically refer to
any sort of licensing, it’s possible that some room and board facilities and certain
types of senior housing don’t need to be licensed, as we mentioned before, so
it’s important to understand the rules and regulations to avoid any legal
issues. Unlicensed facilities may not qualify for an SBA 7(a). There are other
financing options available for your venture, but the SBA 7(a) is by far the
most popular when starting or buying an assisted living facility.
For consumers, this means that the term “assisted living
facility” only exists in Michigan to borrow some brand name recognition from
other assisted living facilities that exist across the nation. Assisted living
facilities in Michigan, then, may refer to any type of residential facility
that provides some sort of personal or medical care.
What is an adult foster care facility and how does it differ
from other types of assisted living facilities?
As stated by The
Department of Licensing and Regulatory Affairs,
“Adult foster care is a specific type of assisted living, as
outlined in Public
Health Code Act 218 of the Michigan legislature.”
It goes on to outline the exact provisions of supervision,
personal care, and protection for every AFC resident, as well as the
requirements for room and board – all of which are fairly straightforward and
easy to understand.
In order to develop a more comprehensive idea of the differences
between adult foster care and every other type of facility, it might be easier
to focus on what adult foster care isn’t. As they list in the article,
adult foster care isn’t:
- A nursing home, because the residents don’t
require continuous care.
- “It is not a room and board situation, because
24-hour supervision is provided.” Now, this is a little confusing and
contradictory. The “Adult Foster Care Tutorial” says just a few sentences above
that, “Foster care means the provision of supervision, personal care, and
protection in addition to room and board.” When they wrote this, I’m
sure they meant it isn’t strictly a room-and-board situation, because of
the necessity for high-quality care. (Aren’t you glad we’re going through all
this data for you?)
- Not strictly a home care service, because you
need physical real estate.
- And, of course, it excludes other facilities
that require different licensing, like “Homes for the Aged,” “Hospitals,”
“Facilities Operated by the Department of Community Health,” and “Children’s
So, in that case, what makes a home for the aged any
different from an adult foster care facility?
Home for the
Also, as stated by the Department of Licensing and
- A home for the aged is a specific type of
assisted living, as outlined in Public
Health Code Act 368 and the administrative
- “Home for the aged means a supervised personal
care facility that provides room, board, and supervised personal care to 21 or
more unrelated, non-transient individuals 55 years of age or older. Home for
the aged includes a supervised personal care facility for 20 or fewer
individuals 55 years of age or older if the facility is operated in
conjunction with and as a distinct part of a licensed nursing home.”
The second rule is by far the most important: adult foster
cares have a specific cap on how many individuals can be members of the
facility. A home for the aged doesn’t necessarily have that same cap.
And here’s what a home for the aged is not, with some
explanatory comments thrown in:
- It is not a nursing home. (The licensing
required for nursing homes is different from the licensing required for homes
for the aged).
- “It is not a room and board situation.” (Here we
go again… They probably mean it isn’t strictly a room and board
situation, but it might be a good question to ask the Department of Licensing
and Regulatory Affairs when you apply).
- The other two rules are the same as the ones
stated above for adult foster care facilities: It’s not strictly a home care
service, because you need physical real estate.
- And, of course, it excludes other facilities
that require different licensing, like “Adult Foster Care (AFC),” “Hospitals,”
“Facilities Operated by the Department of Community Health,” and “Children’s
Ask Yourself Before Applying for a License
Finally, there are some important questions you should ask yourself before determining this route is the one you want to take – whether you want to apply to start or buy an adult foster care facility or home for the aged. Let’s review those questions now.
- Do you believe you have the required business
expertise to successfully run one of these facilities?
- What insurance are you going to buy?
- How are you going to finance? (Hint, hint: We
have an article on that…)
- And, most importantly, are you able and willing
to have the government look through you and your family’s financial history and
criminal records to prove that you’re an upstanding citizen?
In order to run a licensed assisted living facility in Michigan,
you have to make a positive impression on the public. Otherwise, the government
will likely not grant you a license to operate.
Think about it from the consumer’s perspective: No one wants
to invest hard-earned money in someone they can’t trust. With assisted living
prices as high as they are, that’s doubly true.
So, if you’ve had a run-in with the IRS, or if you’ve
declared bankruptcy in the past ten years, or if you’ve had multiple run-ins
with the law, it’s likely going to be that much more difficult to secure a
license for your assisted living facility. That’s simply the reality of what
you’re about to go through.
That doesn’t mean, however, that it’s impossible.
Communication is important, so make sure to talk with whoever’s in charge of
licensing and be ready to explain any moral shortcomings you may or may not
Conclusion: Starting or Buying an Assisted Living Facility in Michigan
As you’ve learned, laws and regulations regarding assisted
living facilities vary from state to state. Starting an assisted living
facility in Michigan is not the same thing as starting an assisted living
facility in California. For that reason, it’s incredibly important to do
The average cost for assisted living in Michigan is a little
bit lower than the national average for most assisted living setups, at $126
per day, and a little bit higher for private assisted living (that is, the
elderly person has his or her own private room in a facility) at a much higher
$300 per day. This information could be central to your business strategy. If
you have experience opening assisted living facilities that specialize in low
costs for private rooms, you might want to consider expanding into the Michigan
The most important thing you’ll need to know about purchasing an assisted living facility in Michigan, or starting one from scratch, is that there’s a difference between “room and board,” which are unlicensed, and “adult foster care facilities,” and “homes for the aged.” The latter two are licensed differently, but the principal difference is that a home for the aged is limited to residents age 55 and older and can’t care for people with some other specific needs. According to the Adult Foster Care Facility Licensing Act, adult foster care facilities can have a maximum number of residents based on certain characteristics of the facility itself, but cannot be licensed for more than 20.
We hope that this guide has pointed you in the right
direction for starting an assisted living facility in Michigan. Once you know
the differences between each type of facility, it becomes that much easier to
fill out the requisite paperwork and apply for your license.
We wish you the best of luck.