Oklahoma Assisted Living
Oklahoma offers a beautiful and affordable location for retirement. A mild climate with four distinct seasons also makes this state comfortable for older adults. Crime is slightly higher here than in the average American city, but its low cost of living can help residents stretch their dollars. The state fully exempts Social Security retirement benefits from taxes and offers a $10,000 deduction toward retirement and pension income. Here you can learn about options for assisted living in Oklahoma, their costs, and how the state regulates this and other types of senior care.
The typical resident population in Oklahoma's assisted living communities is 71% female. Overall, 85% of residents are ages 75 and older, with 29% of residents ages 75 to 84 and 56% ages 85 and older.
The Department of Health in Oklahoma licenses assisted living centers (ALFs) and residential care homes (RCH).
An ALF is a home or establishment that coordinates or provides services to two or more residents who need personal care or nursing supervision, including unscheduled nursing care, medication assistance, and assistance with transfer or ambulation.
And RCH is a facility that provides accommodations and supportive services. In order to reside in an RCH, the resident must be ambulatory and capable of managing their own affairs and does not need skilled nursing care or intermediate care.
The resident agreement between assisted living facilities and their residents is a complete and understandable contract that outlines information regarding admission and discharge, the services provided by the ALF, dispute resolution and grievance procedures, the term of the contract, and renewal and cancellation provisions.
Any ALF with only one awake direct care staff member on duty during the night shift must disclose this to residents or their representatives. ALFs that have a special care unit for residents with Alzheimer’s or some other form of dementia must disclose information on the types of services they provide as well as their cost, admission, transfer, and discharge policies, service planning, and implementation of this care.
The resident agreement between residents and RCHs must be signed within 120 days of admission or when the source of funds for the resident changes from private to public funds or public to private. The contract specifies the term, the services that may be provided to supplement those in the contract, and the charges for those services.
There are a number of conditions that prevent a potential resident from being admitted or retained. If an individual requires more care or services than the facility is able to provide, that individual cannot be admitted or retained. Those who require physical or chemical restraints and those who pose a threat to themself or others also cannot be admitted or retained.
Suppose a resident develops a condition that coincides with the discharge criteria of the ALF. In that case, a determination must be made among the resident (or their representative) and the facility staff as to whether the resident can be accommodated and what additional services would be required.
Residential care homes cannot admit or retain individuals that require services that would be provided in a nursing facility or who are not ambulatory and capable of managing their own affairs.
The services provided in an assisted living facility include assistance with personal care, nursing supervision, intermittent and unscheduled nursing care, medication administration, assistance with cognitive orientation, and care or services for residents with dementia. ALFs also provide assistance with ambulation, social activities, and housekeeping and laundry services.
ALFs must have a health professional assess each applicant. The professional must be specially trained in the state assessment process. The assessment is used to determine if placement is appropriate for the resident and facility, and it is also used to develop a care plan for the individual.
ALF residents may receive home health care, hospice care, and intermittent or recurrent nursing care by contracting with licensed third-party home health agencies. Facilities must monitor and ensure the delivery of these services.
RCHs, assist with personal care, housekeeping, storage, distribution, and medication assistance. Facilities may provide supportive assistance to residents receiving rehabilitation or habilitation services. This service is not required.
ALFs must use a licensed dietician or a qualified nutritionist to develop the center’s diet plan and to address the needs of residents that need special or therapeutic diets. ALFs provide three meals per day.
RCHs must provide three nutritious meals per day. Any home that has residents who require a special diet as prescribed by a physician must contract with a consulting dietitian who is licensed or registered to approve all special diet menus.
ALFs must have an administrator responsible for the facility's daily operations. Nursing services must be provided either by a nursing staff hired by the facility or contracted through a third party to provide skilled interventions or other nursing services. If there are no nurses on staff, the facility must contract with a dietary consultant, a pharmacy consultant, and a nurse consultant. The facility must have adequate staffing in the direct care staff to provide for the needs of the residents.
There are no staff ratio requirements other than to be able to support the needs of the residents. There must be two staff members on duty and awake on all shifts if the facility has a unit or program requiring limited access to areas outside designated areas. This special unit must always have one staff member on duty in the designated area.
RCHs must have an administrator responsible for operations and a signed contract with a registered nurse consultant. Staff must be hired to provide residents with personal care services. All staff members must be certified in first aid and CPR. The home must have sufficient staff to provide the essential services of the home. The home must provide .75 of an hour of personnel per day per resident based on the average number of residents in the home. Whenever residents are present, one staff person must be on duty.
Apartment-style units are not required in ALFs in Oklahoma. There can be no more than two residents sharing a bedroom. There must be one toilet and bathing facility for every four residents.
RCHs have no specified limit on the number of residents sharing a bedroom. Toilet facilities must be provided for every six residents, and shower/bathing facilities for every ten residents.
Medicaid requires apartment-style units for waiver program participants, but that is by choice of the resident.
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 Oklahoma, 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 63% of communities providing skilled nursing. Many have health care specialists and on-site services, with 44% of communities offering dental care. In addition, 62% of ALFs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. 76% of communities in Oklahoma conduct depression screenings, and 49% offer mental health counseling. Social work programs are also found in 43% 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 Oklahoma, 37% have Alzheimer's disease or another form of dementia. In addition, 60% have high blood pressure, 42% have heart disease, 36% have depression, and 16% have diabetes.
The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) strives to provide the highest quality care possible to support its residents' dignity, well-being, and safety. ODMHSAS oversees prevention, treatment, and recovery services for mental illness and related disorders. Due to limited resources, programs are geared toward the needs of the most seriously ill and those in crisis.
The National Alliance for Mental Health of Oklahoma (NAMI Oklahoma) offers education, support, and advocacy for people affected by mental illness. Oklahoma's veterans and their families can connect with a free, 24/7 Veterans Crisis Line and find resources through the Oklahoma Veterans Assistance Locator (OKVALOR).
ALFs must provide administration of medications that can only be administered on a physician's order. The employee responsible for administering medications prepares the dose, observes the swallowing or oral medications, and records the medication. Unlicensed personnel are allowed to administer medications but must first complete a state training program. Medications must be reviewed monthly by an RN or pharmacist and quarterly by a pharmacist.
RCHs may administer medications, and they may assist with the self-administration of medications. Self-administration of medications is permitted after a resident is determined to be capable of self-administration.
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 Oklahoma’s assisted living facilities often receive help with their ADLs. In Oklahoma, 14% of residents need help eating. Other commonly used services include bed transfer (26%), toileting (33%), and walking (50%). Caregivers in ALFs help 37% of residents dress, and 55% need help bathing.
The average cost of assisted living care in Oklahoma is $3,855. This cost is $645 lower than the monthly national average of $4,500 per month. The cost of living in Oklahoma is less than the national average by 12.1%, with health care costs less than the national average by 5.5% and housing costs less than the national average by 25.3%.
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 $3,561 in the Lawton area to a high of $4,800 per month in the Oklahoma City area of Oklahoma.
If you live close to one of Oklahoma’s borders, you may find assisted living in a neighboring state is an affordable option. Arkansas, to the east of Oklahoma, has an average monthly cost for assisted living of $3,760 per month, which is lower than the average cost in Oklahoma. Missouri also has a lower average monthly cost of $3,000. The other four neighboring states' average monthly costs are higher. The average monthly cost in Texas is slightly higher than in Oklahoma, at $3,998 per month. New Mexico, Kansas, and Colorado also have a higher average monthly cost of $4,498, $4,580, and $4,750, respectively.
How to Pay for Assisted Living
The Health Facility Systems Office of Oklahoma’s Department of Health oversees the state’s assisted living communities. Oklahoma’s long-term care ombudsman fields grievances regarding assisted living communities, nursing homes, and other senior living communities. For help accessing medical or social services, you can reach out to the Oklahoma Department of Human Services – Aging Services Division.
The Continuum of Care and Assisted Living Act, Title 63 of the Oklahoma Statutes, outlines the state’s standards regarding licensing, staffing, care quality, and inspection requirements for its assisted living communities. For example, residents have the freedom to choose their personal attending care providers without a fee or financial penalty. The Oklahoma Department of Health investigates and mediates complaints and oversees on-site inspections.
To help ensure resident safety and care quality, the Department of Health also requires assisted living communities to conduct background checks on prospective administrators. Every administrator must complete a 15-hour Medication Administration Training (MAT training) or show proof of Certified Medical Assistant (CMA) certification as a nurse.
The field of elder law has grown. As a result, to help protect seniors and their families from abuse, scams, and fraud. Here, Legal Aid Services of Oklahoma, Inc. provides legal services through the state’s Area Agencies on Aging to older adults with economic or social needs. Assistance covers:
The typical resident population in Oklahoma's assisted living communities is 71% female. Overall, 85% of residents are ages 75 and older, with 29% of residents ages 75 to 84 and 56% ages 85 and older.
Assisted Living Facility (ALF) Definitions
The Department of Health in Oklahoma licenses assisted living centers (ALFs) and residential care homes (RCH).
An ALF is a home or establishment that coordinates or provides services to two or more residents who need personal care or nursing supervision, including unscheduled nursing care, medication assistance, and assistance with transfer or ambulation.
And RCH is a facility that provides accommodations and supportive services. In order to reside in an RCH, the resident must be ambulatory and capable of managing their own affairs and does not need skilled nursing care or intermediate care.
Resident Agreements and Disclosures
The resident agreement between assisted living facilities and their residents is a complete and understandable contract that outlines information regarding admission and discharge, the services provided by the ALF, dispute resolution and grievance procedures, the term of the contract, and renewal and cancellation provisions.
Any ALF with only one awake direct care staff member on duty during the night shift must disclose this to residents or their representatives. ALFs that have a special care unit for residents with Alzheimer’s or some other form of dementia must disclose information on the types of services they provide as well as their cost, admission, transfer, and discharge policies, service planning, and implementation of this care.
The resident agreement between residents and RCHs must be signed within 120 days of admission or when the source of funds for the resident changes from private to public funds or public to private. The contract specifies the term, the services that may be provided to supplement those in the contract, and the charges for those services.
Assisted Living Admission and Retention
There are a number of conditions that prevent a potential resident from being admitted or retained. If an individual requires more care or services than the facility is able to provide, that individual cannot be admitted or retained. Those who require physical or chemical restraints and those who pose a threat to themself or others also cannot be admitted or retained.
Suppose a resident develops a condition that coincides with the discharge criteria of the ALF. In that case, a determination must be made among the resident (or their representative) and the facility staff as to whether the resident can be accommodated and what additional services would be required.
Residential care homes cannot admit or retain individuals that require services that would be provided in a nursing facility or who are not ambulatory and capable of managing their own affairs.
Assisted Living Services and Service Planning
The services provided in an assisted living facility include assistance with personal care, nursing supervision, intermittent and unscheduled nursing care, medication administration, assistance with cognitive orientation, and care or services for residents with dementia. ALFs also provide assistance with ambulation, social activities, and housekeeping and laundry services.
ALFs must have a health professional assess each applicant. The professional must be specially trained in the state assessment process. The assessment is used to determine if placement is appropriate for the resident and facility, and it is also used to develop a care plan for the individual.
ALF residents may receive home health care, hospice care, and intermittent or recurrent nursing care by contracting with licensed third-party home health agencies. Facilities must monitor and ensure the delivery of these services.
RCHs, assist with personal care, housekeeping, storage, distribution, and medication assistance. Facilities may provide supportive assistance to residents receiving rehabilitation or habilitation services. This service is not required.
Assisted Living Food and Dietary Provisions
ALFs must use a licensed dietician or a qualified nutritionist to develop the center’s diet plan and to address the needs of residents that need special or therapeutic diets. ALFs provide three meals per day.
RCHs must provide three nutritious meals per day. Any home that has residents who require a special diet as prescribed by a physician must contract with a consulting dietitian who is licensed or registered to approve all special diet menus.
Assisted Living Staffing Requirements
ALFs must have an administrator responsible for the facility's daily operations. Nursing services must be provided either by a nursing staff hired by the facility or contracted through a third party to provide skilled interventions or other nursing services. If there are no nurses on staff, the facility must contract with a dietary consultant, a pharmacy consultant, and a nurse consultant. The facility must have adequate staffing in the direct care staff to provide for the needs of the residents.
There are no staff ratio requirements other than to be able to support the needs of the residents. There must be two staff members on duty and awake on all shifts if the facility has a unit or program requiring limited access to areas outside designated areas. This special unit must always have one staff member on duty in the designated area.
RCHs must have an administrator responsible for operations and a signed contract with a registered nurse consultant. Staff must be hired to provide residents with personal care services. All staff members must be certified in first aid and CPR. The home must have sufficient staff to provide the essential services of the home. The home must provide .75 of an hour of personnel per day per resident based on the average number of residents in the home. Whenever residents are present, one staff person must be on duty.
Assisted Living Housing Requirements
Apartment-style units are not required in ALFs in Oklahoma. There can be no more than two residents sharing a bedroom. There must be one toilet and bathing facility for every four residents.
RCHs have no specified limit on the number of residents sharing a bedroom. Toilet facilities must be provided for every six residents, and shower/bathing facilities for every ten residents.
Medicaid requires apartment-style units for waiver program participants, but that is by choice of the resident.
What Is Included With Assisted Living Care In Oklahoma?
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 Oklahoma, 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 63% of communities providing skilled nursing. Many have health care specialists and on-site services, with 44% of communities offering dental care. In addition, 62% of ALFs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. 76% of communities in Oklahoma conduct depression screenings, and 49% offer mental health counseling. Social work programs are also found in 43% 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 Oklahoma, 37% have Alzheimer's disease or another form of dementia. In addition, 60% have high blood pressure, 42% have heart disease, 36% have depression, and 16% have diabetes.
State Mental Health Resources
The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) strives to provide the highest quality care possible to support its residents' dignity, well-being, and safety. ODMHSAS oversees prevention, treatment, and recovery services for mental illness and related disorders. Due to limited resources, programs are geared toward the needs of the most seriously ill and those in crisis.
The National Alliance for Mental Health of Oklahoma (NAMI Oklahoma) offers education, support, and advocacy for people affected by mental illness. Oklahoma's veterans and their families can connect with a free, 24/7 Veterans Crisis Line and find resources through the Oklahoma Veterans Assistance Locator (OKVALOR).
Medication Provisions
ALFs must provide administration of medications that can only be administered on a physician's order. The employee responsible for administering medications prepares the dose, observes the swallowing or oral medications, and records the medication. Unlicensed personnel are allowed to administer medications but must first complete a state training program. Medications must be reviewed monthly by an RN or pharmacist and quarterly by a pharmacist.
RCHs may administer medications, and they may assist with the self-administration of medications. Self-administration of medications is permitted after a resident is determined to be capable of self-administration.
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 Oklahoma’s assisted living facilities often receive help with their ADLs. In Oklahoma, 14% of residents need help eating. Other commonly used services include bed transfer (26%), toileting (33%), and walking (50%). Caregivers in ALFs help 37% of residents dress, and 55% need help bathing.
Cost Of Assisted Living Care In Oklahoma
The average cost of assisted living care in Oklahoma is $3,855. This cost is $645 lower than the monthly national average of $4,500 per month. The cost of living in Oklahoma is less than the national average by 12.1%, with health care costs less than the national average by 5.5% and housing costs less than the national average by 25.3%.
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 $3,561 in the Lawton area to a high of $4,800 per month in the Oklahoma City area of Oklahoma.
How Costs Compare In Nearby States
If you live close to one of Oklahoma’s borders, you may find assisted living in a neighboring state is an affordable option. Arkansas, to the east of Oklahoma, has an average monthly cost for assisted living of $3,760 per month, which is lower than the average cost in Oklahoma. Missouri also has a lower average monthly cost of $3,000. The other four neighboring states' average monthly costs are higher. The average monthly cost in Texas is slightly higher than in Oklahoma, at $3,998 per month. New Mexico, Kansas, and Colorado also have a higher average monthly cost of $4,498, $4,580, and $4,750, respectively.
How to Pay for Assisted Living
Oklahoma Assisted Living Oversight
The Health Facility Systems Office of Oklahoma’s Department of Health oversees the state’s assisted living communities. Oklahoma’s long-term care ombudsman fields grievances regarding assisted living communities, nursing homes, and other senior living communities. For help accessing medical or social services, you can reach out to the Oklahoma Department of Human Services – Aging Services Division.
Quality and Safety of Assisted Living Facilities in Oklahoma
The Continuum of Care and Assisted Living Act, Title 63 of the Oklahoma Statutes, outlines the state’s standards regarding licensing, staffing, care quality, and inspection requirements for its assisted living communities. For example, residents have the freedom to choose their personal attending care providers without a fee or financial penalty. The Oklahoma Department of Health investigates and mediates complaints and oversees on-site inspections.
To help ensure resident safety and care quality, the Department of Health also requires assisted living communities to conduct background checks on prospective administrators. Every administrator must complete a 15-hour Medication Administration Training (MAT training) or show proof of Certified Medical Assistant (CMA) certification as a nurse.
Legal Resources
The field of elder law has grown. As a result, to help protect seniors and their families from abuse, scams, and fraud. Here, Legal Aid Services of Oklahoma, Inc. provides legal services through the state’s Area Agencies on Aging to older adults with economic or social needs. Assistance covers:
- Elder abuse.
- Advance directives.
- Wills and estate issues.
- Guardianship.
- Social Security.
- Disability.
- Fraud/scams.
- Grandparent issues.
