Medicare Rules for Assisted Living in Michigan

"Assisted living" is not defined by Michigan law or administrative regulations, but it is a term generally applied to living arrangements other than traditional nursing homes. In Michigan, the term "assisted living" applies to retirement communities, senior housing, group homes and assisted independent living arrangements. Health and Human Services (HHS) promulgates admission policy, facility standards and medical services. The day-to-day regulation of assisted living facilities is left to the states, as long as their guidelines and laws conform to the federal regulations.

Admission Policy

• The Michigan Department of Human Services states that persons who cannot walk or who require tracheotomy suctioning, gastric feedings, catheters, sterile wound care, and those who require physical restraints or pose a threat to themselves or other residents may not be admitted to an assisted living facility in Michigan. Admissions policy for Medicare-funded facilities must include a statement of the assisted living home's purpose; eligibility requirements for admission; and a statement of the services and accommodations available. Resident applications must include a written assessment and an assessment plan. There must be a resident care agreement and a health care evaluation.

Facility Standards

• There are two types of licensed facilities in Michigan: adult foster care (AFC) homes and homes for the aged (HFA). The Office of Children and Adult Licensing under the Michigan Department of Human Services regulates AFC and HFA facilities. Independent senior living facilities that do not provide board are not regulated.

  Numerous safety and health requirements apply to licensed facilities in Michigan. The U.S. Department of Health and Human Services establishes the minimum standards for facilities. Inspections are conducted without notice to the AFC and HFA facilities. Health and safety inspections are conducted according to Michigan Health Department policy that applies current sanitary and safety regulations. Local fire departments conduct inspections to ensure that the facilities comply with all local ordinances regarding fire safety, extinguishers, sprinkler systems and escape routes. Facilities must observe basic infectious disease control measures and maintain a clean and safe environment.

Medical and Other Services

• Assisted living facilities for disabled and special needs adults and the elderly do not provide medical care. The residents have the right to the services of a medical doctor, dentist or psychiatrist. The residents also have the right to refuse treatment, which includes refusing to take medications. If residents refuse to take prescribed medications, they have the right to be made aware of the possible effects of refusing medicines. Residents who require psychiatric medications may be discharged from a facility if their failure to take medications as prescribed causes them to behave in a manner that could endanger themselves, other residents or staff.

  No minimum requirements exist for services to residents of assisted living facilities in Michigan, according to the Michigan Assisted Living Association, and most facilities provide a wide range of services designed to assist the residents with their daily lives while maintaining a measure of independence. These services include, but are not limited to: supervision of and security for medications; group meals; bathing and toilet assistance; grooming; housekeeping for their rooms or apartments; transportation; laundry; and on-call nurses.