Illinois Assisted Living
Despite its hot, humid summers and cold winters, Illinois is a great Midwestern retirement destination because of its low cost of living, cultural opportunities, scenic byways, outdoor adventures, and many transportation options. Although the Prairie State has some of the country's highest sales and property taxes, almost all retirement income is exempt from state income taxes — making Illinois an affordable state for older adults. The following information can help you understand what assisted living options are available, the average costs of residential care, and how Illinois regulates long-term care communities.
The typical resident population in Illinois's assisted living communities is 72% female. Overall, 82% of residents are ages 75 and older, with 31% of residents ages 75 to 84 and 51% ages 85 and older.
The Illinois Department of Public Health regulates assisted living and shared housing establishments based on occupancy. Assisted living facilities require single-occupancy apartment units, while shared housing does not. Sheltered care facilities are licensed under the Nursing Home Care Act. These facilities provide personal care services and are typically located with a nursing facility.
An assisted living facility (ALF) is a residence for three or more unrelated adults. These facilities must provide a single-occupancy living space with a private bathroom and space for small kitchen appliances. Eighty percent of the residents must be aged 55 or older.
A shared housing facility is a freestanding residence for three to 16 adults unrelated to the owner or manager. Eighty percent of the residents must be aged 55 or older. These facilities provide the same services as an ALF.
Supporting living facilities are certified by the Department of Healthcare and Family Services. These facilities provide residential care and supportive services to low-income older or younger adults with disabilities who are eligible for Medicaid. These facilities are residential settings that provide or coordinate personal care services, provide 24-hour supervision and assistance, activities, and health-related services.
The agreements between residents or their representatives and assistive living and shared housing facilities represent the contract between the parties. This agreement must include the duration of the contract, the base rate and services included in that rate, additional services available and their cost, the complaint resolution process, residents’ rights and responsibilities, billing and payment procedures, refund policies, notice requirements for fee changes, risk management, termination policies, and policies for notifying relatives regarding changes in the resident’s condition.
Resident agreements for shelter care facilities must include information about the services provided and their cost, the termination process, and whether the facility accepts Medicaid.
Supporting living facility agreements must describe the services provided under Medicaid, payment arrangements, grievance procedures, termination provisions, and resident’s rights. The agreement must also provide a list of services available for an additional fee and arrangements for sharing units.
All four of the facilities that have a special care unit that provides care for residents with Alzheimer’s or another form of dementia must provide disclosure regarding the state agency responsible for licensing or certifying the following:
Each type of facility has its own admission and retention requirements. Assisted living and shared housing facilities have the same policies. These facilities cannot admit or retain individuals who are a danger to themself or others, cannot communicate their needs, require total assistance with two or more activities of daily living (ADLs), require the assistance of more than one paid caregiver with ADLs, or require more than minimal assistance in case of an emergency.
These facilities cannot admit or retain residents who need certain health services unless they are self-administered or administered by a licensed health professional that the facility does not employ. These conditions include IV therapy or feeding, gastrostomy feedings, catheters, sterile wound care, sliding scale insulin, routine insulin injections, and Stage 3 or 4 decubitus ulcers. Facilities cannot service residents with dementia or whose mental or physical condition is detrimental to other residents in any way.
Sheltered care facilities cannot admit or retain residents needing nursing care, have a communicable disease, are mentally ill, need treatment for mental illness, are likely to harm themself or others, or have needs that the facility cannot meet.
Assisted living and shared housing facilities must provide several services to their residents. These services include housekeeping, laundry, security, emergency response systems, and ADL assistance. Additional services they may provide include medication reminders, supervision of self-administered medications, medication administration, and non-medical services. The facility must provide a home-like environment that promotes the resident's independence.
A comprehensive assessment must be completed by a physician and must be updated annually. The assessment includes an evaluation of the resident’s physical, cognitive, and psychosocial condition. Part of the assessment process includes some negotiated risks where the facility indicates what level of risk they are unwilling to provide for residents.
Home health agencies that are unrelated to the facility may be contracted to provide services to residents.
A sheltered care facility may provide personal care, individual or group activities, medical services, therapeutic activities, and assistance with the self-administration of medications or administration by a physician or a nurse.
Supporting living facilities must provide personal and health-related services, including nursing services, personal care, social and recreational programs, exercise, transportation, security, and medication oversight and assistance with self-administration. Security includes a 24-hour response and security staff, emergency call systems, daily checks, and maintenance services. Provided nursing services include resident assessment and care planning, quarterly health evaluations, medication setup, health counseling, disease prevention, and temporary administration of medications.
Within 24 hours of admission, residents must receive an initial assessment of their condition and a comprehensive assessment within 14 days. Service planning must include the participation of family members.
All four types of facilities must provide meals to their residents, although the requirements differ. Assisted living and shared housing facilities must provide their residents with three meals daily. Sheltered care facilities must provide either three meals daily or two meals and a breakfast bar. When ordered by a physician, therapeutic meals must be provided. Supportive living facilities must provide three meals daily or a breakfast bar with noon and evening meals.
Assisted living and shared housing facilities must employ a full-time manager responsible for the facility's daily operations as well as the direct care staff who provide services to the residents. A licensed health care professional must be available if the facility offers medication administration or other specialized treatment services. At least one staff member who is certified in CPR must be awake and on duty at all times.
There are no minimum staff ratios other than the facility must have adequate staff to provide for the needs of the residents according to their care plans.
A supporting living facility requires a manager to oversee daily operations. Personal care services and assistance with the self-administration of medication must be provided by certified nursing assistants (CNAs). Licensed nurses are required to administer medications and provide other nursing services. An emergency response staff member who is certified in emergency resuscitation is required to respond to emergency calls from residents.
One CNA must be on duty during all shifts with at least one emergency response staff member for facilities with 1-75 residents, a second required for facilities with 76-150 residents, and a third for facilities with 151 or more residents.
All staff in all facility types must receive orientation or training according to the level of care provided by the facility. Assisted living and shared housing staff must receive an orientation covering the facility's service philosophy and goals, resident rights, confidentiality, hygiene and infection control, disaster procedures, and abuse and neglect prevention and reporting. An additional orientation is required to cover the needs and service plans of the residents, job responsibilities and limitations, and ADL assistance. Ongoing training includes 20 hours every two years for managers and eight hours of annual training for the rest of the staff.
Supervisory personnel in sheltered care facilities must attend annual education programs on supervision, nutrition, and other related subjects.
Supporting living facility staff must receive training on their areas of responsibility, infection control, crisis intervention, prevention and notification of abuse or neglect, behavior intervention, and techniques for working with the elderly and residents with disabilities.
As indicated above, assisted living facilities must provide single-occupancy housing units that may be shared by choice. All units must accommodate small kitchen appliances with a sink, toilet, and private bathing or washing facilities.
A shared housing facility may have shared bathrooms, one for every four residents, and shared tubs or showers, one for every six residents.
Sheltered care facilities can have no more than four residents in a room. There must be one sink and toilet for every 10 residents, and one shower or bathtub is required for every 15 residents. A sink and toilet, as well as a shower or tub, are required on every floor.
Supportive living facilities licensed after October 2004 must have a full bathroom, lockable doors, an emergency call system, a sink, a microwave, oven, or stove, a refrigerator, and a separate bedroom for each unrelated occupant.
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.
Assisted living and shared housing facilities may provide residents with medication reminders, supervised self-medication, and medication administration. A licensed health care professional employed by the facility may administer medications, including injections, oral medications, topical treatments, eye and ear drops, and nitroglycerin patches.
Supervision of medication self-administration means any of the following: reminding residents to take medications, reading the label on medications to the resident, checking the dosage against the label, and confirming that the resident has obtained and is taking the medication as prescribed.
In Illinois, facilities 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 58% of communities providing skilled nursing. Many have health care specialists and on-site services, with 49% of 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 Illinois, 82% of communities conduct depression screenings, and 54% offer mental health counseling. Social work programs are also found in 59% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all necessary resources.
Some assisted living residents live with various medical conditions. In Illinois, 31% have Alzheimer's disease or another form of dementia. In addition, 44% have high blood pressure, 26% have heart disease, 23% have depression, and 19% have diabetes.
The Illinois Department of Human Services Division of Mental Health offers a continuum of services to help people improve their mental health. The Chicago Behavioral Hospital in Des Plaines is a mental health facility that offers a geriatric psychiatry program known as the Monarch Program to help older adults’ mental health. Comprehensive Connections maintains a list of available mental health resources.
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 Illinois’s assisted living facilities often receive help with their ADLs. In Illinois, 14% of residents need help eating. Other commonly used services include bed transfer (20%), toileting (25%), and walking (44%). Caregivers in ALFs help 28% of residents dress, and 50% need help bathing.
The average cost of assisted living care in Illinois is $4,488. This cost is $12 lower than the monthly national average of $4,500 per month. The cost of living in Illinois is less than the national average by 5.7%, with health care costs less than the national average by 3.5% and housing costs less than the national average by 13.4%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $3,525 in the Carbondale area to a high of $5,250 per month in the Rockford area of Illinois.
If you or your loved one lives near one of the state borders or you have relatives living in a nearby state, you might be considering an assisted living community in one of those states. The median monthly cost of care in Wisconsin is $4,600, in Iowa, the cost is $4,367, in Indiana, it’s $4,283, in Missouri the average monthly cost is $3,000 and in Kentucky, the cost is $3,448.
How to Pay for Assisted Living
The Illinois Department of Public Health Division of Assisted Living oversees the state's assisted living communities and shared housing establishments. The Illinois Department on Aging can connect older adults to services, information, and resources that are available locally. In addition, the Illinois Long-Term Care Ombudsman Program advocates, protects and improves the quality of life for residents in long-term care communities. The program works to resolve complaints regarding residential care facilities.
Unfortunately, Illinois seniors are at high risk for fraud, scams, financial exploitation, and abuse. To protect older adults from these rising crimes, the Illinois Department on Aging provides legal services to Illinoisans aged 60 and above. The state's chief legal officer, the Illinois Attorney General, is responsible for protecting the public interest of the state and its residents. The Illinois Attorney General's office maintains a list of hotlines and helplines to assist consumers on various legal issues.
For older adults with lower incomes, Illinois Legal Aid Online provides legal information and services, free legal forms, and referrals on legal issues related to housing, fraud, abuse, family, safety, health care, and medical benefits.
Division of Assisted Living
Department on Aging
Long-Term Care Ombudsman (by county)
The typical resident population in Illinois's assisted living communities is 72% female. Overall, 82% of residents are ages 75 and older, with 31% of residents ages 75 to 84 and 51% ages 85 and older.
Assisted Living Facility Definitions
The Illinois Department of Public Health regulates assisted living and shared housing establishments based on occupancy. Assisted living facilities require single-occupancy apartment units, while shared housing does not. Sheltered care facilities are licensed under the Nursing Home Care Act. These facilities provide personal care services and are typically located with a nursing facility.
An assisted living facility (ALF) is a residence for three or more unrelated adults. These facilities must provide a single-occupancy living space with a private bathroom and space for small kitchen appliances. Eighty percent of the residents must be aged 55 or older.
A shared housing facility is a freestanding residence for three to 16 adults unrelated to the owner or manager. Eighty percent of the residents must be aged 55 or older. These facilities provide the same services as an ALF.
Supporting living facilities are certified by the Department of Healthcare and Family Services. These facilities provide residential care and supportive services to low-income older or younger adults with disabilities who are eligible for Medicaid. These facilities are residential settings that provide or coordinate personal care services, provide 24-hour supervision and assistance, activities, and health-related services.
Resident Agreements and Disclosures
The agreements between residents or their representatives and assistive living and shared housing facilities represent the contract between the parties. This agreement must include the duration of the contract, the base rate and services included in that rate, additional services available and their cost, the complaint resolution process, residents’ rights and responsibilities, billing and payment procedures, refund policies, notice requirements for fee changes, risk management, termination policies, and policies for notifying relatives regarding changes in the resident’s condition.
Resident agreements for shelter care facilities must include information about the services provided and their cost, the termination process, and whether the facility accepts Medicaid.
Supporting living facility agreements must describe the services provided under Medicaid, payment arrangements, grievance procedures, termination provisions, and resident’s rights. The agreement must also provide a list of services available for an additional fee and arrangements for sharing units.
All four of the facilities that have a special care unit that provides care for residents with Alzheimer’s or another form of dementia must provide disclosure regarding the state agency responsible for licensing or certifying the following:
- Form of care and treatment for persons with dementia.
- Philosophy of the care or treatment for Alzheimer’s or dementia.
- The facility’s pre-admission, admission, and discharge procedures.
- The assessment, care planning, and implementation guidelines for care.
- Activities provided for the residents.
- Cost of care for the program.
Assisted Living Admission and Retention
Each type of facility has its own admission and retention requirements. Assisted living and shared housing facilities have the same policies. These facilities cannot admit or retain individuals who are a danger to themself or others, cannot communicate their needs, require total assistance with two or more activities of daily living (ADLs), require the assistance of more than one paid caregiver with ADLs, or require more than minimal assistance in case of an emergency.
These facilities cannot admit or retain residents who need certain health services unless they are self-administered or administered by a licensed health professional that the facility does not employ. These conditions include IV therapy or feeding, gastrostomy feedings, catheters, sterile wound care, sliding scale insulin, routine insulin injections, and Stage 3 or 4 decubitus ulcers. Facilities cannot service residents with dementia or whose mental or physical condition is detrimental to other residents in any way.
Sheltered care facilities cannot admit or retain residents needing nursing care, have a communicable disease, are mentally ill, need treatment for mental illness, are likely to harm themself or others, or have needs that the facility cannot meet.
Assisted Living Services and Planning
Assisted living and shared housing facilities must provide several services to their residents. These services include housekeeping, laundry, security, emergency response systems, and ADL assistance. Additional services they may provide include medication reminders, supervision of self-administered medications, medication administration, and non-medical services. The facility must provide a home-like environment that promotes the resident's independence.
A comprehensive assessment must be completed by a physician and must be updated annually. The assessment includes an evaluation of the resident’s physical, cognitive, and psychosocial condition. Part of the assessment process includes some negotiated risks where the facility indicates what level of risk they are unwilling to provide for residents.
Home health agencies that are unrelated to the facility may be contracted to provide services to residents.
Sheltered Care Services and Planning
A sheltered care facility may provide personal care, individual or group activities, medical services, therapeutic activities, and assistance with the self-administration of medications or administration by a physician or a nurse.
Supporting Living Services and Planning
Supporting living facilities must provide personal and health-related services, including nursing services, personal care, social and recreational programs, exercise, transportation, security, and medication oversight and assistance with self-administration. Security includes a 24-hour response and security staff, emergency call systems, daily checks, and maintenance services. Provided nursing services include resident assessment and care planning, quarterly health evaluations, medication setup, health counseling, disease prevention, and temporary administration of medications.
Within 24 hours of admission, residents must receive an initial assessment of their condition and a comprehensive assessment within 14 days. Service planning must include the participation of family members.
Assisted Living Food and Dietary Provisions
All four types of facilities must provide meals to their residents, although the requirements differ. Assisted living and shared housing facilities must provide their residents with three meals daily. Sheltered care facilities must provide either three meals daily or two meals and a breakfast bar. When ordered by a physician, therapeutic meals must be provided. Supportive living facilities must provide three meals daily or a breakfast bar with noon and evening meals.
Assisted Living Staffing Requirements
Assisted living and shared housing facilities must employ a full-time manager responsible for the facility's daily operations as well as the direct care staff who provide services to the residents. A licensed health care professional must be available if the facility offers medication administration or other specialized treatment services. At least one staff member who is certified in CPR must be awake and on duty at all times.
There are no minimum staff ratios other than the facility must have adequate staff to provide for the needs of the residents according to their care plans.
A supporting living facility requires a manager to oversee daily operations. Personal care services and assistance with the self-administration of medication must be provided by certified nursing assistants (CNAs). Licensed nurses are required to administer medications and provide other nursing services. An emergency response staff member who is certified in emergency resuscitation is required to respond to emergency calls from residents.
One CNA must be on duty during all shifts with at least one emergency response staff member for facilities with 1-75 residents, a second required for facilities with 76-150 residents, and a third for facilities with 151 or more residents.
Assisted Living Staff Training Requirements
All staff in all facility types must receive orientation or training according to the level of care provided by the facility. Assisted living and shared housing staff must receive an orientation covering the facility's service philosophy and goals, resident rights, confidentiality, hygiene and infection control, disaster procedures, and abuse and neglect prevention and reporting. An additional orientation is required to cover the needs and service plans of the residents, job responsibilities and limitations, and ADL assistance. Ongoing training includes 20 hours every two years for managers and eight hours of annual training for the rest of the staff.
Supervisory personnel in sheltered care facilities must attend annual education programs on supervision, nutrition, and other related subjects.
Supporting living facility staff must receive training on their areas of responsibility, infection control, crisis intervention, prevention and notification of abuse or neglect, behavior intervention, and techniques for working with the elderly and residents with disabilities.
Assisted Living Housing Requirements
As indicated above, assisted living facilities must provide single-occupancy housing units that may be shared by choice. All units must accommodate small kitchen appliances with a sink, toilet, and private bathing or washing facilities.
A shared housing facility may have shared bathrooms, one for every four residents, and shared tubs or showers, one for every six residents.
Sheltered care facilities can have no more than four residents in a room. There must be one sink and toilet for every 10 residents, and one shower or bathtub is required for every 15 residents. A sink and toilet, as well as a shower or tub, are required on every floor.
Supportive living facilities licensed after October 2004 must have a full bathroom, lockable doors, an emergency call system, a sink, a microwave, oven, or stove, a refrigerator, and a separate bedroom for each unrelated occupant.
What Is Included With Assisted Living Care In Illinois?
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.
Assisted Living Medication Provisions
Assisted living and shared housing facilities may provide residents with medication reminders, supervised self-medication, and medication administration. A licensed health care professional employed by the facility may administer medications, including injections, oral medications, topical treatments, eye and ear drops, and nitroglycerin patches.
Supervision of medication self-administration means any of the following: reminding residents to take medications, reading the label on medications to the resident, checking the dosage against the label, and confirming that the resident has obtained and is taking the medication as prescribed.
Health Care Services
In Illinois, facilities 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 58% of communities providing skilled nursing. Many have health care specialists and on-site services, with 49% of 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 Illinois, 82% of communities conduct depression screenings, and 54% offer mental health counseling. Social work programs are also found in 59% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all necessary resources.
Some assisted living residents live with various medical conditions. In Illinois, 31% have Alzheimer's disease or another form of dementia. In addition, 44% have high blood pressure, 26% have heart disease, 23% have depression, and 19% have diabetes.
Mental Health Resources
The Illinois Department of Human Services Division of Mental Health offers a continuum of services to help people improve their mental health. The Chicago Behavioral Hospital in Des Plaines is a mental health facility that offers a geriatric psychiatry program known as the Monarch Program to help older adults’ mental health. Comprehensive Connections maintains a list of available mental health resources.
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 Illinois’s assisted living facilities often receive help with their ADLs. In Illinois, 14% of residents need help eating. Other commonly used services include bed transfer (20%), toileting (25%), and walking (44%). Caregivers in ALFs help 28% of residents dress, and 50% need help bathing.
Cost Of Assisted Living Care In Illinois
The average cost of assisted living care in Illinois is $4,488. This cost is $12 lower than the monthly national average of $4,500 per month. The cost of living in Illinois is less than the national average by 5.7%, with health care costs less than the national average by 3.5% and housing costs less than the national average by 13.4%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $3,525 in the Carbondale area to a high of $5,250 per month in the Rockford area of Illinois.
How Costs Compare In Nearby States
If you or your loved one lives near one of the state borders or you have relatives living in a nearby state, you might be considering an assisted living community in one of those states. The median monthly cost of care in Wisconsin is $4,600, in Iowa, the cost is $4,367, in Indiana, it’s $4,283, in Missouri the average monthly cost is $3,000 and in Kentucky, the cost is $3,448.
How to Pay for Assisted Living
Illinois Assisted Living Oversight
The Illinois Department of Public Health Division of Assisted Living oversees the state's assisted living communities and shared housing establishments. The Illinois Department on Aging can connect older adults to services, information, and resources that are available locally. In addition, the Illinois Long-Term Care Ombudsman Program advocates, protects and improves the quality of life for residents in long-term care communities. The program works to resolve complaints regarding residential care facilities.
Legal Resources
Unfortunately, Illinois seniors are at high risk for fraud, scams, financial exploitation, and abuse. To protect older adults from these rising crimes, the Illinois Department on Aging provides legal services to Illinoisans aged 60 and above. The state's chief legal officer, the Illinois Attorney General, is responsible for protecting the public interest of the state and its residents. The Illinois Attorney General's office maintains a list of hotlines and helplines to assist consumers on various legal issues.
For older adults with lower incomes, Illinois Legal Aid Online provides legal information and services, free legal forms, and referrals on legal issues related to housing, fraud, abuse, family, safety, health care, and medical benefits.
Division of Assisted Living
Department on Aging
Long-Term Care Ombudsman (by county)
