Tips for Selecting the Right Senior Housing
Senior residences in Michigan offer different levels of services, support, policies, programs, and practices. Use checklists to compare differences.
- Make a first visit for a tour; make return visits for a meal and to observe activities.
- Consider: atmosphere, physical features, medication and health care insurance, unit features, social and recreational activities, food service and satisfaction surveys
- Analyze the terms and conditions of contacts and understand resident rights and responsibilities.
- Involuntary discharge is possible with notice for non-payment of rent, medical reasons, danger to self or others, and danger to the property.
- The Michigan Long-Term Care Ombudsman provides advocacyservices to help address the quality of care and quality of life in licensedresidences (i.e. nursing homes, homes for the aged, and adult foster care facilities).
- Medicare and private health careinsurance do not cover costs for independent living, assisted living, or long-term care in a nursing home. Private pay is primary (e.g., savings, investments and income).
- For those who qualify, check Medicaid for assistance.
- If a veteran, veteran spouse, or widow, ask about the Veteran Aid and Attendance benefit to help pay for in-home care, assisted living, or nursinghome
Types of Senior Housing
There are five distinct types of Senior Housing:
- Independent Living
- Homes for the Aged / Adult Foster Care
- Assisted Living
- Nursing Homes / Skilled Nursing
- Continuum of Care
Independent Living
Housing communities designed for independent seniors. Typically apartments, condominiums, or free-standing homes.
- Housing / apartments for retirees / senior adults
- Independent Living facilities do not have to be licensed.
- May be referred to a "Housing with Services."
- If residents need or want help with personal care, they can hire a non-medical agency to provide the services.
- May offer meals and other support services
- Must meet local health, safety, and zoning codes
- No licensing oversight
- Payment is private, some may offer options for those with a limited income
Homes for the Aged / Adult Foster Care
Adult Foster Care (AFC)—care for up to 20 adults. Homes for the Aged (HFA)—care for 21 adults who are 55 years and older.
AFCs and HFAs are inspected for rule compliance. LARA offers a statewide resource to check for rule violations. When there are violations, Special Investigation Reports are prepared with a corrective action plan.
To locate a home, go to the Michigan Department of Licensing and Regulatory Affairs (LARA) website Adult Foster Care and Homes for the Aged page. Under General Public, click on Search for Adult Foster Care and Homes for the Aged to search for a location.
Assisted Living Facilities (ALC)
In ALCs, one is a resident and not a patient and may receive help for a range of daily activities such as personal care meals and medication management. Some ALCs are licensed by the state.
- An admission contract must specifythe services to be provided; monthly fees and rate increase policies; refund policies; admission and discharge policies; and resident rights and responsibilities.
- In Michigan, each community mayhave different prices, policies, programs, practices, services, andlevels of support.
- The ALC may ask the resident to leave or arrange for additional services for care if a resident's mental and physical faculties deteriorate and require more care than the ALC can provide.
- Here is a link to a helpful checklist when considering a residence that offers assisted living:
- Larger facilities that provide 24-hour protective oversight and supportive services (services offered can vary from facility to facility)
- Not licensed except must meet local health, safety, and zoning codes
- Payment is private, some funds may be available for support services
Nursing Home and Skilled Nursing Homes
- Facilities that provide 24-hour nursing care and medical supervision
- Beware the many terms that get used!
- Nursing homes may be an option for either short-term or long-term care.
- Not all Nursing Homes provide "skilled nursing care," which must becertified by Medicare or Medicaid. Skilled nursing care can include intravenous injection and physical, occupational, and speech therapy
- Care that can be provided by para-professional staff, like longterm custodial care and assistance with daily activities, is not considered "skilled care," though it may be provided in a residence called a "nursing home"
- Medicare does not cover long-term car
- Depending on the type of care you need and your insurance, rules and regulations may further limit your choices
- Services also include short term admission for someone who is recovering from an acute illness or injury
- Levels of care include skilled ( requires the skill and judgment of a licensed professional) and basic ( provides necessities of daily living)
- Licensed by the Michigan Department of Licensing & Regulatory Affairs
- Payment is private, Medicare (Skilled care), Medicaid (basic care)
Continuum of Care Facilities
- Facilities offering two or more levels of care at the same location
- May require a long-term contract be signed prior to admission guaranteeing housing and services as long as resident lives
- May involve an entrance fee in addition to monthly fees