Louisiana Assisted Living
Louisiana offers several tax benefits for older adults, such as the ability to exclude all Social Security and federal retirement benefits from their taxable income. It also has low property tax rates and lower-than-average costs of living, making it suitable for retirees with modest incomes.
The following guide introduces the housing options available to older adults in Louisiana and details how assisted living works, how much it costs, and how it compares to other types of senior care. It also gives an overview of the many resources available to seniors in the Bayou State, including healthcare communities, mental health services, and legal assistance.
The typical resident population in Louisiana's assisted living communities is 74% female. Overall, 88% of residents are ages 75 and older, with 29% of residents ages 75 to 84 and 59% ages 85 and older.
The Department of Health and Hospitals licenses four different levels of adult care collectively known as adult residential care facilities (RCFs). These are also known as board and care facilities, assisted living facilities (ALFs), personal care homes, shelter care homes, foster homes, and RCFs. RCFs were created in December 2008 to launch a Medicaid-funded assisted living service.
Adult RCFs are facilities, agencies, residences, and persons that provide residential care, for compensation, to two or more adults unrelated to the facility's operators. RCFs provide the following services for its residents: lodging, meals, housekeeping, laundry, medication administration, intermittent nursing services, assistance with personal hygiene, assistance with transfers and ambulation, and assistance with dressing.
Personal care homes (Level 1), or PCHs, provide care and services to two to eight residents in a group living and dining setting. The PCH is located in a home that is designed as a private dwelling in a neighborhood.
Shelter care homes (Level 2) are RCFs that provide room, board, and personal services to nine or more residents in a group living and dining setting.
Assisted living homes/facilities (Level 3) are RCFs that provide room, board, and personal services to two or more residents who live in individual living units containing one room with a kitchenette and a private bathroom.
Adult residential care facilities (Level 4) furnish lodging, meals, housekeeping, laundry, medication administration, intermittent nursing services, and assistance with personal hygiene, transfers, ambulation, and dressing.
An Alzheimer’s special care unit (ASCU) is a residential care provider that segregates or provides a special program for residents who have been diagnosed with Alzheimer’s disease or some other form of dementia.
All levels of RCF enter into a written agreement with residents or their representatives. The agreement must specify the rights and responsibilities of both the resident and the facility, the cost of basic and optional services, payment provisions, and the terms and conditions of continued occupancy.
Residents with advanced or higher care needs beyond routine care can be admitted or retained if they are able to arrange for additional care from private duty services; they do not need continuous nursing care for more than 90 days, and if the facility is able to provide for their needs.
There are a number of situations where the RCF is able to discharge residents. These situations include:
RCFs must provide adequate services and supervision 24 hours a day as needed for each resident. Providers in Levels 1, 2, and 3 provide assisted living services that coordinate various supportive personal services, 24-hour supervision and assistance, activities, and health-related services. The basic services include assistance with activities of daily activities (ADLs), instrumental activities of daily living (IADLs), personal laundry services, group social activities, housekeeping, transportation, recreational activities, and assistance with self-administration of medications.
Providers must plan and arrange for health assessments, health care monitoring, and assistance with health tasks as needed. The facility must be able to provide transportation for medical and personal services, personal errands, and social or recreational activities.
Facilities must perform a pre-admission assessment on each applicant to determine their needs and whether it is appropriate to admit them. After admission, the facility conducts an assessment of their needs and preferences to develop an individualized service plan. The plan must include the scope, frequency, and duration of services and monitoring necessary to meet the needs of the resident. The plan includes the staff or provider that is responsible for providing the services.
RCFs must provide three meals a day to residents. The facility must have a nutritionist or dietitian review the menu to ensure that it provides the necessary nutrients. Medically prescribed special diets must be accommodated as stipulated in the residents' service plan.
Each RCF must have a director, a designated recreation and activity staff, and direct care staff. The direct care staff provides direct care services to the facility residents and can include care assistants, social workers, and activities personnel.
There are no minimum staff ratios required in Louisiana. The facility must provide sufficient staffing levels to ensure its residents' health, safety, and welfare. The facility must ensure that there is adequate staffing 24 hours per day.
Shelter care facilities and personal care homes do not need to provide an apartment-style living environment. Rooms are not to be shared by more than two residents, and in shelter care facilities, individuals who room together must agree in writing to share the room. The residents must have adequate toilets, hand-washing, and bathing facilities.
Assisted living facilities must offer apartment-style units with lockable doors. Each unit must have a food preparation area with a sink with hot and cold running water, electric outlets, a mini-refrigerator, a cooking appliance, food storage cabinets, and counter space. The living area must include an ADA-compliant bathroom with a toilet, sink, shower, tub, dining/sitting/bedroom area, storage space, emergency call system, and an individually controlled thermostat to regulate the temperature of the unit.
There are several requirements that each assisted living community must provide for its 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 Louisiana, 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 26% of communities providing skilled nursing. Many have health care specialists and on-site services, with 33% of communities offering dental care. In addition, 27% 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 Louisiana, 68% of communities conduct depression screenings, and 29% offer mental health counseling. Social work programs are also found in 24% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all the resources they need.
Some assisted living residents live with various medical conditions. In Louisiana, 35% have Alzheimer's disease or another form of dementia. In addition, 54% have high blood pressure, 36% have heart disease, 27% have depression, and 15% have diabetes.
The Office of Behavioral Health’s local governing entities throughout Louisiana provides access to mental health and addiction treatment services. These entities are organized into human services districts to ensure that residents in each region can get the care they need. The Governor's Office of Elderly Affairs also makes mental health services available through the state aging network. NAMI Louisiana even offers support groups, educational events, and other tools to help residents of the Bayou State get help with a wide range of mental health concerns.
Staff in RCFs are permitted to help residents self-administer both over-the-counter and prescription medications. The assistance provided is limited to the following:
Any staff member who provides assistance with medication self-administration must have documented training on medication assistance policies and procedures. This training must be completed annually.
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 neglect of household chores.
Residents in Louisiana’s assisted living facilities often receive help with their ADLs. In Louisiana, 19% of residents need help eating. Other commonly used services include bed transfer (29%), toileting (32%), and walking (47%). Caregivers in ALFs help 40% of residents dress, and 49% need help bathing.
The average cost of assisted living care in Louisiana is $3,748. This cost is $752 lower than the monthly national average of $4,500 per month. The cost of living in Louisiana is less than the national average by 7.0%, with health care costs less than the national average by 0.6% and housing costs less than the national average by 14.0%.
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 $2,650 in the Monroe area to a high of $4,800 per month in the Houma area of Louisiana.
If you live close to Louisiana’s borders, you may find assisted living in a neighboring state is an affordable option. All three neighboring states have comparable average monthly costs for assisted living. Though the average cost of Texas is higher than Louisiana’s at $3,998 per month, you may find an affordable option. Average assisted living costs in Arkansas are also slightly higher at $3760 per month, and Mississippi’s average is lower than Louisiana’s at $3,500 per month.
How to Pay for Assisted Living
At the state level, the Department of Health and Hospitals (DoHH) oversees assisted living communities in Louisiana. Every ALF must follow the regulations outlined in Chapter 68 of the Louisiana Administrative Code, which the DoHH is also responsible for enforcing. As of June 2022, Louisiana has 163 active assisted living communities, according to the Health Standards division. Louisiana doesn't publish its ALF inspection reports online. Still, older adults and their loved ones may be able to obtain these reports by filing a request with the Department of Health under the Freedom of Information Act
The Department of Health and Hospitals has the authority to inspect an ALF each time it applies for license renewal. Inspection reports are a matter of public record, making it easier for older adults and their loved ones to make informed decisions about their care. If the Department of Health identifies any serious violations during an inspection, it may suspend, revoke, or terminate the ALF's license. The Louisiana Long-Term Care Ombudsman also advocates for the rights of assisted living residents and investigates complaints regarding specific assisted living communities.
Louisiana has stringent licensing requirements for every assisted living community. Before issuing a license, the Department of Health and Hospitals sends an inspector to ensure the applicant complies with all state regulations. To qualify for a license, an ALF must offer studio apartments with at least 200 net square feet of floor space. Apartments with separate bedrooms must have a minimum of 100 square feet of bedroom space and 190 square feet of living space. The size requirements don't include the square footage used for bathrooms. All residents must also have access to common areas, at least one outside window, a call system, and a kitchenette.
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.
The Louisiana Attorney General accepts complaints regarding unfair housing practices and consumer disputes, giving older adults help when a landlord or business owner is taking advantage of them. People who need help securing public benefits should contact the Governor's Office of Elderly Affairs, which offers assistance provided by an attorney or paralegal. In some cases, seniors may be matched with law students working under the supervision of licensed attorneys. The Louisiana Bar Association operates the Legal Education and Assistance Program, which makes referrals to attorneys in each parish.
The following guide introduces the housing options available to older adults in Louisiana and details how assisted living works, how much it costs, and how it compares to other types of senior care. It also gives an overview of the many resources available to seniors in the Bayou State, including healthcare communities, mental health services, and legal assistance.
The typical resident population in Louisiana's assisted living communities is 74% female. Overall, 88% of residents are ages 75 and older, with 29% of residents ages 75 to 84 and 59% ages 85 and older.
Assisted Living Facility (ALF) Definitions
The Department of Health and Hospitals licenses four different levels of adult care collectively known as adult residential care facilities (RCFs). These are also known as board and care facilities, assisted living facilities (ALFs), personal care homes, shelter care homes, foster homes, and RCFs. RCFs were created in December 2008 to launch a Medicaid-funded assisted living service.
Adult RCFs are facilities, agencies, residences, and persons that provide residential care, for compensation, to two or more adults unrelated to the facility's operators. RCFs provide the following services for its residents: lodging, meals, housekeeping, laundry, medication administration, intermittent nursing services, assistance with personal hygiene, assistance with transfers and ambulation, and assistance with dressing.
Personal care homes (Level 1), or PCHs, provide care and services to two to eight residents in a group living and dining setting. The PCH is located in a home that is designed as a private dwelling in a neighborhood.
Shelter care homes (Level 2) are RCFs that provide room, board, and personal services to nine or more residents in a group living and dining setting.
Assisted living homes/facilities (Level 3) are RCFs that provide room, board, and personal services to two or more residents who live in individual living units containing one room with a kitchenette and a private bathroom.
Adult residential care facilities (Level 4) furnish lodging, meals, housekeeping, laundry, medication administration, intermittent nursing services, and assistance with personal hygiene, transfers, ambulation, and dressing.
An Alzheimer’s special care unit (ASCU) is a residential care provider that segregates or provides a special program for residents who have been diagnosed with Alzheimer’s disease or some other form of dementia.
Resident Agreements and Disclosures
All levels of RCF enter into a written agreement with residents or their representatives. The agreement must specify the rights and responsibilities of both the resident and the facility, the cost of basic and optional services, payment provisions, and the terms and conditions of continued occupancy.
Assisted Living Admission and Retention
Residents with advanced or higher care needs beyond routine care can be admitted or retained if they are able to arrange for additional care from private duty services; they do not need continuous nursing care for more than 90 days, and if the facility is able to provide for their needs.
There are a number of situations where the RCF is able to discharge residents. These situations include:
- The resident's physician certifies that the resident needs continuous nursing care that will exceed 90 days.
- The residents' condition poses a danger to themself or to others.
- The resident is in danger due to the failure of the family to contract necessary outside care services.
Assisted Living Services and Service Planning
RCFs must provide adequate services and supervision 24 hours a day as needed for each resident. Providers in Levels 1, 2, and 3 provide assisted living services that coordinate various supportive personal services, 24-hour supervision and assistance, activities, and health-related services. The basic services include assistance with activities of daily activities (ADLs), instrumental activities of daily living (IADLs), personal laundry services, group social activities, housekeeping, transportation, recreational activities, and assistance with self-administration of medications.
Providers must plan and arrange for health assessments, health care monitoring, and assistance with health tasks as needed. The facility must be able to provide transportation for medical and personal services, personal errands, and social or recreational activities.
Facilities must perform a pre-admission assessment on each applicant to determine their needs and whether it is appropriate to admit them. After admission, the facility conducts an assessment of their needs and preferences to develop an individualized service plan. The plan must include the scope, frequency, and duration of services and monitoring necessary to meet the needs of the resident. The plan includes the staff or provider that is responsible for providing the services.
Assisted Living Food and Dietary Provisions
RCFs must provide three meals a day to residents. The facility must have a nutritionist or dietitian review the menu to ensure that it provides the necessary nutrients. Medically prescribed special diets must be accommodated as stipulated in the residents' service plan.
Assisted Living Staffing Requirements
Each RCF must have a director, a designated recreation and activity staff, and direct care staff. The direct care staff provides direct care services to the facility residents and can include care assistants, social workers, and activities personnel.
There are no minimum staff ratios required in Louisiana. The facility must provide sufficient staffing levels to ensure its residents' health, safety, and welfare. The facility must ensure that there is adequate staffing 24 hours per day.
Assisted Living Housing Requirements
Shelter care facilities and personal care homes do not need to provide an apartment-style living environment. Rooms are not to be shared by more than two residents, and in shelter care facilities, individuals who room together must agree in writing to share the room. The residents must have adequate toilets, hand-washing, and bathing facilities.
Assisted living facilities must offer apartment-style units with lockable doors. Each unit must have a food preparation area with a sink with hot and cold running water, electric outlets, a mini-refrigerator, a cooking appliance, food storage cabinets, and counter space. The living area must include an ADA-compliant bathroom with a toilet, sink, shower, tub, dining/sitting/bedroom area, storage space, emergency call system, and an individually controlled thermostat to regulate the temperature of the unit.
What Is Included With Assisted Living Care In Louisiana?
There are several requirements that each assisted living community must provide for its 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 Louisiana, 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 26% of communities providing skilled nursing. Many have health care specialists and on-site services, with 33% of communities offering dental care. In addition, 27% 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 Louisiana, 68% of communities conduct depression screenings, and 29% offer mental health counseling. Social work programs are also found in 24% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all the resources they need.
Some assisted living residents live with various medical conditions. In Louisiana, 35% have Alzheimer's disease or another form of dementia. In addition, 54% have high blood pressure, 36% have heart disease, 27% have depression, and 15% have diabetes.
State Mental Health Resources
The Office of Behavioral Health’s local governing entities throughout Louisiana provides access to mental health and addiction treatment services. These entities are organized into human services districts to ensure that residents in each region can get the care they need. The Governor's Office of Elderly Affairs also makes mental health services available through the state aging network. NAMI Louisiana even offers support groups, educational events, and other tools to help residents of the Bayou State get help with a wide range of mental health concerns.
Medication Provisions
Staff in RCFs are permitted to help residents self-administer both over-the-counter and prescription medications. The assistance provided is limited to the following:
- Reminding the resident to take their medications.
- Medication instructions may be read to the resident.
- The dosage may be checked.
- Staff may open the container if the resident is unable to .
- If the resident understands what the medication is and why they are taking it, the staff may assist the resident in taking the medication.
Any staff member who provides assistance with medication self-administration must have documented training on medication assistance policies and procedures. This training must be completed annually.
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 neglect of household chores.
Residents in Louisiana’s assisted living facilities often receive help with their ADLs. In Louisiana, 19% of residents need help eating. Other commonly used services include bed transfer (29%), toileting (32%), and walking (47%). Caregivers in ALFs help 40% of residents dress, and 49% need help bathing.
Cost Of Assisted Living Care In Louisiana
The average cost of assisted living care in Louisiana is $3,748. This cost is $752 lower than the monthly national average of $4,500 per month. The cost of living in Louisiana is less than the national average by 7.0%, with health care costs less than the national average by 0.6% and housing costs less than the national average by 14.0%.
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 $2,650 in the Monroe area to a high of $4,800 per month in the Houma area of Louisiana.
How Costs Compare In Nearby States
If you live close to Louisiana’s borders, you may find assisted living in a neighboring state is an affordable option. All three neighboring states have comparable average monthly costs for assisted living. Though the average cost of Texas is higher than Louisiana’s at $3,998 per month, you may find an affordable option. Average assisted living costs in Arkansas are also slightly higher at $3760 per month, and Mississippi’s average is lower than Louisiana’s at $3,500 per month.
How to Pay for Assisted Living
Louisiana Assisted Living Oversight
At the state level, the Department of Health and Hospitals (DoHH) oversees assisted living communities in Louisiana. Every ALF must follow the regulations outlined in Chapter 68 of the Louisiana Administrative Code, which the DoHH is also responsible for enforcing. As of June 2022, Louisiana has 163 active assisted living communities, according to the Health Standards division. Louisiana doesn't publish its ALF inspection reports online. Still, older adults and their loved ones may be able to obtain these reports by filing a request with the Department of Health under the Freedom of Information Act
Quality and Safety of Assisted Living Facilities in Louisiana
The Department of Health and Hospitals has the authority to inspect an ALF each time it applies for license renewal. Inspection reports are a matter of public record, making it easier for older adults and their loved ones to make informed decisions about their care. If the Department of Health identifies any serious violations during an inspection, it may suspend, revoke, or terminate the ALF's license. The Louisiana Long-Term Care Ombudsman also advocates for the rights of assisted living residents and investigates complaints regarding specific assisted living communities.
Louisiana has stringent licensing requirements for every assisted living community. Before issuing a license, the Department of Health and Hospitals sends an inspector to ensure the applicant complies with all state regulations. To qualify for a license, an ALF must offer studio apartments with at least 200 net square feet of floor space. Apartments with separate bedrooms must have a minimum of 100 square feet of bedroom space and 190 square feet of living space. The size requirements don't include the square footage used for bathrooms. All residents must also have access to common areas, at least one outside window, a call system, and a kitchenette.
Legal Resources
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.
The Louisiana Attorney General accepts complaints regarding unfair housing practices and consumer disputes, giving older adults help when a landlord or business owner is taking advantage of them. People who need help securing public benefits should contact the Governor's Office of Elderly Affairs, which offers assistance provided by an attorney or paralegal. In some cases, seniors may be matched with law students working under the supervision of licensed attorneys. The Louisiana Bar Association operates the Legal Education and Assistance Program, which makes referrals to attorneys in each parish.
