Delaware Assisted Living
Delaware is a famously tax-friendly state for retirees. The state doesn't tax Social Security benefits; if you're 60 years of age or older, you can exclude up to $12,500 of your pension income from your income tax burden. On top of that, Delaware is one of only four states with no sales tax, which helps residents save money on big-ticket purchases and small transactions. This guide provides an overview of assisted living costs in Delaware and the laws and regulations governing assisted living communities or similar long-term care centers in the state.
The typical resident population in Delaware's assisted living communities is 69% female. Overall, 82% of residents are ages 75 and older, with 32% of residents ages 75 to 84 and 50% ages 85 and older.
Assisted living communities in Delaware are for older adults who want to and can maintain their independence but need some help with daily living activities, meals, and household chores. The Delaware Department of Health and Social Services (DHSS) regulates all assisted living facilities in the state. Delaware offers arrangements to medically stable persons who do not require skilled nursing services and supervision. Delaware offers two types of adult foster care, also known as rest homes.
Both options offer room and board and personal care for two to three residents who cannot live independently. Family care homes are permitted to offer higher care than residential care homes. When they move in, all residents must be able to perform all activities of daily living (ADLs) independently and administer their own medications.
Delaware defines assisted living as a combination of housing, support services, supervision, personal assistance and health care to care for those that need help with ADLs.
Residents in Delaware cannot be admitted to an assisted living facility in the following situations:
Assisted living facilities in Delaware must provide a number of services for their residents. The facility must assist with activities of daily living, laundry and housekeeping and must provide appropriate health care and social services as described in the service agreements with their residents. ALFs must provide residents with opportunities for social and leisure activities to promote physical and mental well-being. The ALF must provide transportation in case of emergency.
Within 30 days of admission to an ALF, a registered nurse (RN) must complete an assessment of the resident’s condition. An update of this assessment must accompany any change in condition. The information gathered includes information on their condition, medical status, and psychological needs. In addition to this assessment, the facility must develop a service agreement describing the services that each resident will receive.
There are several staff requirements that each ALF must follow. Overall management requirements of the facility depends on the size of the facility. Each ALF must have a director responsible for managing the facility and ensuring it follows all statutory and regulatory requirements. Facilities that are licensed for 25 or more beds must have a full-time administrator. Facilities licensed for five to 24 beds must have a part-time administrator on-site and on duty at least 20 hours per week. Facilities with four or fewer beds must have a full-time house manager responsible for daily operations and on-site a minimum of eight hours per week.
Every ALF must have a director of nursing that is an RN. For facilities with 25 or more beds, the director must be full-time and on-site/on-duty at least 20 hours per week for facilities with 5-24 beds. Those facilities with four or fewer beds must have a director on-site for at least eight hours per week.
The ALF must have a staffing plan that provides sufficient staffing with employees adequately trained to meet the residents' needs and comply with state laws and regulations. At least one person must be awake on-site 24 hours per day. The staffing plan must also designate a person responsible should the director be absent. Every staff member providing direct care must be familiar with the service agreement for every resident they provide care for. There must be one staff member on-site 24 hours per day who is qualified to administer medications or to assist with the self-administration of medication. That staff member must also know emergency procedures, basic first aid, CPR, and the Heimlich maneuver.
Before hiring an employee, facilities must obtain a criminal history report from the Delaware Bureau of Identification and a report from DHSS for a person’s federal criminal history record.
Delaware housing units may be single or double occupancy with no more than two residents sharing a room. There must be one bathroom for every four residents, and it must be in their living unit or an area accessible to each resident. Residents must be able to access a microwave or a stove/convection oven, refrigerator and sink either in their living unit or in an easily accessible central kitchen. All bathrooms and bedrooms must be equipped with an intercom or other communication system in case of an emergency.
There are several requirements that each assisted living community must provide for their residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
In Delaware, ALFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 56% of communities providing skilled nursing. Many have health care specialists and on-site services, with some communities offering dental care. In addition, 67% of ALFs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Delaware, 72% of communities offer mental health counseling. Social work programs are also found in 40% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents access all the resources they need.
Some assisted living residents live with various medical conditions. In Delaware, 47% have Alzheimer's disease or another form of dementia. In addition, 51% have high blood pressure, 35% have heart disease, 40% have depression, and 16% have diabetes.
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglecting household chores.
Residents in Deleware assisted living facilities often receive help with their ADLs. In Delaware, 15% of residents need help eating. Other commonly used services include bed transfer (33%), toileting (44%), and walking (66%). Caregivers in ALFs help 47% of residents dress, and 60% need help bathing.
All ALFs must establish written medication policies and procedures that specify the processes for obtaining, documenting, storing and administering medications. Residents who can self-administer medications may do so. They can also receive assistance with self-administration or may have medications administered to them.
Within thirty days of admission, an RN must review medications for residents who self-administer medications. This assessment evaluates residents' cognitive and physical ability, ensures they have received the medications, that the medications are labeled and properly stored and determines the presence of adverse side effects.
Only staff who has completed a Board of Nursing-approved training program may assist in the self-administration of medication. Assistance includes opening and holding the container, assisting the resident in taking the medication ( not including injections), following the directions on the original container, and documenting that each medication has been taken.
The average cost of assisted living care in Delaware is $5,995. This is $1,495 higher than the monthly national average of $4,500. The cost of living in Delaware is more than the national average by 7.9%, with health care costs more than the national average by 6.5% and housing costs more than the national average by 3.1%.
The exact price of care differs depending on where in the state you’re located. Costs in Dover are higher than the state average at $6,073 per month.
Living close to one of Delaware’s borders may make assisted living in a neighboring state affordable. New Jersey, which has a small border with Delaware, has a higher average cost of assisted living. The average in New Jersey is $6,495 per month, about $500 per month more than in Delaware. The cost of assisted living in Maryland is very similar to the cost in Delaware at $5,865, while Pennsylvania’s average cost is considerably lower at $4,100 per month.
How to Pay for Assisted Living
Delaware's Health Care Quality Division has oversight of the state's assisted living communities. Its Long-Term Care Ombudsman Program investigates complaints from residents in long-term residential care and can help seniors defend their rights and address concerns regarding their quality of care.
The term "elder law" is often associated with estate planning, trusts, and help to obtain benefits through Medicare or Medicaid. Unfortunately, the field has grown to include cases involving elder abuse, elder neglect, and exploitation. Skilled attorneys can help older adults affected by these issues.
Several legal aid services in Delaware offer pro bono help for older adults with elder law issues, including housing problems, power of attorney transfers, guardianship questions, and more. The state's Legal Help Link can assist people in finding private representation for these and other civil cases.
Delaware's Division of Health Care Quality is responsible for issuing the regulations governing assisted living communities in the state. These standards help ensure resident safety and quality of life by requiring that all such communities have a minimum number of staff members on hand at all times, strong tracking policies surrounding medication, and respect for residents' rights, among other conditions.
Title 16 of the Delaware Code of Regulations defines the requirements for assisted living communities in the state and specifies how they differ from those concerning nursing homes. For example, an assisted living facility may not admit or continue to provide services to a resident who needs skilled monitoring of acute health issues, has been bedridden for over two weeks, or presents a threat to the safety of other residents.
Delaware regulations also require assisted living communities to establish resident contracts that clearly explain and define services offered, occupancy guidelines, discharge procedures, and rate structures, among other policies.
The typical resident population in Delaware's assisted living communities is 69% female. Overall, 82% of residents are ages 75 and older, with 32% of residents ages 75 to 84 and 50% ages 85 and older.
Assisted Living Facility (ALF) Requirements
Assisted living communities in Delaware are for older adults who want to and can maintain their independence but need some help with daily living activities, meals, and household chores. The Delaware Department of Health and Social Services (DHSS) regulates all assisted living facilities in the state. Delaware offers arrangements to medically stable persons who do not require skilled nursing services and supervision. Delaware offers two types of adult foster care, also known as rest homes.
- Family Care Homes
- Residential Care Homes
Both options offer room and board and personal care for two to three residents who cannot live independently. Family care homes are permitted to offer higher care than residential care homes. When they move in, all residents must be able to perform all activities of daily living (ADLs) independently and administer their own medications.
Delaware defines assisted living as a combination of housing, support services, supervision, personal assistance and health care to care for those that need help with ADLs.
Assisted Living Admission
Residents in Delaware cannot be admitted to an assisted living facility in the following situations:
- The resident requires short-term or intermittent nursing care.
- The resident requires skilled monitoring, testing, and adjustments in medications and treatments.
- The resident has been bedridden for more than 14 days.
- The resident requires monitoring for an unstable medical condition.
- The resident requires a ventilator.
- The resident requires treatment that requires more than isolation.
- The resident requires an intravenous line.
- The resident is prone to wandering to the point where the facility cannot provide supervision and security.
- The resident poses a threat to themself or others.
Assisted Living Services
Assisted living facilities in Delaware must provide a number of services for their residents. The facility must assist with activities of daily living, laundry and housekeeping and must provide appropriate health care and social services as described in the service agreements with their residents. ALFs must provide residents with opportunities for social and leisure activities to promote physical and mental well-being. The ALF must provide transportation in case of emergency.
Within 30 days of admission to an ALF, a registered nurse (RN) must complete an assessment of the resident’s condition. An update of this assessment must accompany any change in condition. The information gathered includes information on their condition, medical status, and psychological needs. In addition to this assessment, the facility must develop a service agreement describing the services that each resident will receive.
Assisted Living Staffing Requirements
There are several staff requirements that each ALF must follow. Overall management requirements of the facility depends on the size of the facility. Each ALF must have a director responsible for managing the facility and ensuring it follows all statutory and regulatory requirements. Facilities that are licensed for 25 or more beds must have a full-time administrator. Facilities licensed for five to 24 beds must have a part-time administrator on-site and on duty at least 20 hours per week. Facilities with four or fewer beds must have a full-time house manager responsible for daily operations and on-site a minimum of eight hours per week.
Every ALF must have a director of nursing that is an RN. For facilities with 25 or more beds, the director must be full-time and on-site/on-duty at least 20 hours per week for facilities with 5-24 beds. Those facilities with four or fewer beds must have a director on-site for at least eight hours per week.
The ALF must have a staffing plan that provides sufficient staffing with employees adequately trained to meet the residents' needs and comply with state laws and regulations. At least one person must be awake on-site 24 hours per day. The staffing plan must also designate a person responsible should the director be absent. Every staff member providing direct care must be familiar with the service agreement for every resident they provide care for. There must be one staff member on-site 24 hours per day who is qualified to administer medications or to assist with the self-administration of medication. That staff member must also know emergency procedures, basic first aid, CPR, and the Heimlich maneuver.
Before hiring an employee, facilities must obtain a criminal history report from the Delaware Bureau of Identification and a report from DHSS for a person’s federal criminal history record.
Assisted Living Housing Requirements
Delaware housing units may be single or double occupancy with no more than two residents sharing a room. There must be one bathroom for every four residents, and it must be in their living unit or an area accessible to each resident. Residents must be able to access a microwave or a stove/convection oven, refrigerator and sink either in their living unit or in an easily accessible central kitchen. All bathrooms and bedrooms must be equipped with an intercom or other communication system in case of an emergency.
What Is Included With Assisted Living Care In Delaware?
There are several requirements that each assisted living community must provide for their residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
Health Care Services
In Delaware, ALFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 56% of communities providing skilled nursing. Many have health care specialists and on-site services, with some communities offering dental care. In addition, 67% of ALFs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Delaware, 72% of communities offer mental health counseling. Social work programs are also found in 40% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents access all the resources they need.
Some assisted living residents live with various medical conditions. In Delaware, 47% have Alzheimer's disease or another form of dementia. In addition, 51% have high blood pressure, 35% have heart disease, 40% have depression, and 16% have diabetes.
Activities of Daily Living (ADLs) Assistance Services
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglecting household chores.
Residents in Deleware assisted living facilities often receive help with their ADLs. In Delaware, 15% of residents need help eating. Other commonly used services include bed transfer (33%), toileting (44%), and walking (66%). Caregivers in ALFs help 47% of residents dress, and 60% need help bathing.
Medication Assistance
All ALFs must establish written medication policies and procedures that specify the processes for obtaining, documenting, storing and administering medications. Residents who can self-administer medications may do so. They can also receive assistance with self-administration or may have medications administered to them.
Within thirty days of admission, an RN must review medications for residents who self-administer medications. This assessment evaluates residents' cognitive and physical ability, ensures they have received the medications, that the medications are labeled and properly stored and determines the presence of adverse side effects.
Only staff who has completed a Board of Nursing-approved training program may assist in the self-administration of medication. Assistance includes opening and holding the container, assisting the resident in taking the medication ( not including injections), following the directions on the original container, and documenting that each medication has been taken.
Cost Of Assisted Living Care In Delaware
The average cost of assisted living care in Delaware is $5,995. This is $1,495 higher than the monthly national average of $4,500. The cost of living in Delaware is more than the national average by 7.9%, with health care costs more than the national average by 6.5% and housing costs more than the national average by 3.1%.
The exact price of care differs depending on where in the state you’re located. Costs in Dover are higher than the state average at $6,073 per month.
How Costs Compare In Nearby States
Living close to one of Delaware’s borders may make assisted living in a neighboring state affordable. New Jersey, which has a small border with Delaware, has a higher average cost of assisted living. The average in New Jersey is $6,495 per month, about $500 per month more than in Delaware. The cost of assisted living in Maryland is very similar to the cost in Delaware at $5,865, while Pennsylvania’s average cost is considerably lower at $4,100 per month.
How to Pay for Assisted Living
Delaware Assisted Living Oversight
Delaware's Health Care Quality Division has oversight of the state's assisted living communities. Its Long-Term Care Ombudsman Program investigates complaints from residents in long-term residential care and can help seniors defend their rights and address concerns regarding their quality of care.
Legal Resources for Seniors in Delaware
The term "elder law" is often associated with estate planning, trusts, and help to obtain benefits through Medicare or Medicaid. Unfortunately, the field has grown to include cases involving elder abuse, elder neglect, and exploitation. Skilled attorneys can help older adults affected by these issues.
Several legal aid services in Delaware offer pro bono help for older adults with elder law issues, including housing problems, power of attorney transfers, guardianship questions, and more. The state's Legal Help Link can assist people in finding private representation for these and other civil cases.
Quality and Safety of Assisted Living Facilities in Delaware
Delaware's Division of Health Care Quality is responsible for issuing the regulations governing assisted living communities in the state. These standards help ensure resident safety and quality of life by requiring that all such communities have a minimum number of staff members on hand at all times, strong tracking policies surrounding medication, and respect for residents' rights, among other conditions.
Title 16 of the Delaware Code of Regulations defines the requirements for assisted living communities in the state and specifies how they differ from those concerning nursing homes. For example, an assisted living facility may not admit or continue to provide services to a resident who needs skilled monitoring of acute health issues, has been bedridden for over two weeks, or presents a threat to the safety of other residents.
Delaware regulations also require assisted living communities to establish resident contracts that clearly explain and define services offered, occupancy guidelines, discharge procedures, and rate structures, among other policies.
