Pennsylvania Assisted Living

Pennsylvania is a wonderful retirement destination due to its amazing outdoor activities, cultural events, low crime rate, and high-quality health care. While property taxes in Pennsylvania are higher than average, the sales tax rate is among the lowest in the country. Social Security benefits and all retirement income for people aged 60 and over are exempt from state income taxes, making it a tax-friendly state for retirees. Read on to learn more about available assisted living options, how much they cost, and how Pennsylvania regulates long-term care centers.

The typical resident population in Pennsylvania's assisted living communities is 66% female. Overall, 75% of residents are ages 75 and older, with 27% of residents ages 75 to 84 and 48% ages 85 and older.

Assisted Living in Pennsylvania


The Division of Licensing within the Office of Long-Term Living, a unit in the Department of Aging, issues licenses for Assisted Living Residences (ALRs). The Adult Residential Licensing Unit in the Department of Public Welfare issues licenses for Personal Care Homes (PCH). These two licenses differ in the level of care and the types of units the facilities provide. Personal care homes are not permitted to retain residents who require nursing home levels of care, whereas assisted living residences are allowed to provide these services.

Assisted living residences have several requirements that they must follow. ALRs must support aging in place, provide private living units that include kitchen capacity, and provide a higher level of care compared to personal care homes. It is permitted for a building to operate under both ALR as well as PCH licenses. These units include provisions for special care units (SCUs). An SCU provides for residents with Alzheimer’s disease and other forms of dementia.

A third type of care is Adult Foster Care. This type of facility is licensed to provide care for up to three residents in a home-like setting. Area Agencies on Aging (AAAs) place the residents in these facilities. AAAs ensure that the homes pass safety and background checks of those providing care. The majority of providers serve one resident but are permitted to serve up to three.

ALRs provide food, shelter, services and supplemental health care services for four or more adults unrelated to the operator. The residents require assistance or supervision to support their activities of daily living (ADLs), instrumental activities of daily living (IADLs), or medication administration.

A personal care home provides food, shelter and personal assistance or supervision to four or more adults unrelated to the operator. The residents cannot require nursing home levels of care. The residents typically require supervision and assistance with ADLs as well as IADLs.

Resident Agreements and Admission


The agreement between the resident or their representative and the ALR has to provide information on several topics. These topics include a fee schedule, any optional amenities and services, assessment and service planning policies, payment and refund policies, arrangements for financial management, the rules of the residence, contract terms, a complete list of the services provided based on the support plan for the resident, complaint procedures, and a list of the rights of the residents.

Residents are permitted to opt out of assisting living services, but the agreement states that the services are not being provided and that there is an adjustment in charges reflecting this change.

PCH agreements must provide similar information in their resident agreement. Both PCHs and ALRs must include the services provided in a dementia care unit, criteria for admission and discharge, change in condition policies, special programming, and costs and fees.

In addition to the information outlined above that appears in the resident agreement, the facility must provide a written disclosure statement that includes the following:

     
  • Services and core services provided by the facility, including costs.

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  • Conditions where a resident may require the services offered in a different package.

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  • The most recent inspection report.

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  • The number of units that comply with the provisions of the Americans with Disabilities Act.


If a resident resides in a dementia care unit, the following information must also be disclosed:

     
  • The mission and philosophy for individuals with Alzheimer’s or dementia.

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  • A description of the environment and design features to support the residents with dementia.

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  • A description of the frequency of individual and group activities specifically for residents with Alzheimer’s or dementia.

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  • Security measures to ensure the safety of all residents. 

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  • An outline of training for staff who provide care to residents with Alzheimer’s or dementia.

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  • The assessment process and the development of a service plan for the individual, including the changes to the resident's service plan, should their condition change.


Assisted Living Admission and Retention


Several conditions can prevent a potential resident from being admitted or retained. The following conditions or health care needs can prevent admission or retention without approval from the licensing agency:

     
  • Dependency on a ventilator.

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  • Stage 3 or 4 vascular ulcers or decubiti that are not healing.

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  • The continuous need for intravenous fluids.

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  • A communicable infectious disease requiring isolation or precautions unless the agency directs the isolation to be in residence.

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  • Nasogastric tubes.

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  • Physical restraints.

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  • 24-hour skilled nursing care.


Assisted Living Services


Assisted living residents provide a core package of services for individuals that do not require assistance with ADLs. This package includes 24-hour supervision, laundry, social activities, and cognitive support. Individuals who require assistance with ADLs or IADLs for an unspecified period are offered an enhanced core package. This package includes transportation and assistance with self-administration of medication or medication administration.

ALRs must also provide financial management, monitoring, and emergency response and must make accommodations for aging in place, including supplemental services provided by the resident’s family.  

Dementia-specific services include intermittent cuing, redirecting, environmental cues, measures to address wandering, a dementia-specific activity program, and communication techniques.

Personal care homes provide the same services as ALRs.

The dementia care units of both facility types must offer: gross motor activities and exercise, support with self-care activities like hygiene, group and individual activities, sensory and memory enhancement activities, and outdoor activities.  Resident participation is voluntary.

Service Planning


Within 60 days before admission, a physical examination must be performed by a physician, physician's assistant, or nurse practitioner. This medical evaluation is used to inform the development of the resident service plan, including resident health status, medical information that is key to diagnosis and treatment in case of emergency, special health or dietary needs, allergies, immunization history, medication regimen and side effects, a mobility assessment, tuberculin skin test results, and ADL service needs.

Within the first 30 days after admission to an ALR, the administrator, an RN, or an LPN must complete an assessment. This assessment is used to develop a preliminary support plan which must be reviewed and approved by an RN or LPN. At a minimum, the assessment must evaluate ADLs and IADLs, mobility, ability to self-administer medications, medical history and conditions that can impact service needs, dietary needs, the ability of the individual to operate key-locking devices, and the ability of the individual to evacuate from the residence in case of emergency. The resident or their representative must sign the final support plan, which must be implemented within 30 days. These plans must be reassessed annually.

PCHs must complete a pre-admission screening to determine if the home can meet the applicant's needs. A medical evaluation must be completed 60 days before admission or 30 days after moving into the home. Within 15 days of admission, the facility must conduct an assessment of mobility needs, medication administration needs, cognitive function, communication abilities, ADLs, IADLs, and personal interests and preferences. A support plan must be developed and implemented within 30 days of admission to meet the needs identified in this assessment.

Within 72 hours before an individual is admitted to a secured dementia unit in a PCH or ALR, the facility must conduct a written cognitive pre-admission screening in collaboration with a physician or a geriatric assessment team. Each resident must be reassessed annually to determine if residency in the secured unit is still required.

ALRs must provide or arrange for several health care services. These services include hospice, occupational therapy, skilled nursing, physical therapy, home health, beharioral health, specialized cognitive support services, and escort to and from medical appointments if required in the support plan or if requested by the resident.

PCHs may permit residents to use hospice services and must encourage residents to use services available in the community, including mental health services, drug and alcohol counseling, senior centers, home health agencies, or services provided by an AAA.

Assisted Living Food and Dietary Provisions


Assisted living residents must be permitted to prepare food in their apartments unless otherwise stated in their service plan. PCHs and ALRs must offer three daily meals that meet the U.S. Department of Agriculture's dietary needs guidelines. The facility must always provide between-meal snacks and beverages to every resident unless medical conditions forbid them. The facility must meet each resident’s prescribed dietary needs.

As outlined in their support plans, facilities must provide physical assistance to residents with eating. The facility must have a dietician on staff or must contract with one to provide for any special dietary needs indicated in residents' support plans.

Assisted Living Staffing Requirements


Due to the differences in care provided by ALRs and PCHs, there are some differences in their staffing requirements.

ALRs must have an Administrator who is responsible for the facility's daily operations. They must provide assisted living services and must supervise the daily care workers. Someone must be designated to function as the administrator when the administrator is absent. The Administrator must be present an average of at least 36 hours per week. The direct care staff is responsible for providing personal care assistance to residents. When on duty, direct care staff must always be awake and provide at least one hour of services per day to each mobile resident and at least two hours per day to each resident with mobility assistance needs. An RN must be available in the building or on call at all times. 

No set staffing ratios are required, but sufficient staffing must be in place to provide for all residents' support plans. For every 35 residents, there must be at least one staff member on-site at all times who is trained in first-aid and certified in obstructed airway techniques and CPR.

Assisted Living Staff Training Requirements


All ALR staff, including ancillary staff, substitute staff, and volunteers must receive orientation in fire safety and emergency preparedness either before or on their first day. All staff, including administrative staff, must also receive a minimum of four hours of dementia-specific training within 30 days of hire and at least two hours every year after.

Within their first 40 hours of scheduled work hours, direct care staff, ancillary staff, substitute workers, and volunteers must have training that includes topics relating to their job responsibilities, resident’s rights, mandatory reporting of abuse and neglect, behavior management techniques, person-centred care, communication, problem-solving and relationship skills, assisting with ADLs/IADLs, care for residents with mental illness, neurological impairments, nutrition, and food handling and sanitation.

All administrators must complete an orientation program administered and approved by the licensing agency for the facility type, including a 100-hour training course and passing a competency-based training test. Administrators must also complete 24 hours of annual training related to their job duties.

ALR direct care staff members are not permitted to provide unsupervised services until they have completed 18 hours of training, demonstrating proficiency in performing their job duties. They must also complete and pass the licensing agency direct care training course, including a competency test. This staff must also complete 16 hours of annual training on topics related to their job duties. This training can only include care for residents with mental illness or intellectual disabilities if the facility serves residents with these conditions.

Administrators of PCHs must complete 24 hours of annual training, and direct care staff must complete 12 hours of annual training.

Assisted Living Housing Requirements


The requirements for housing residents in PCHs differ from those for ALRs. ALRs must provide residents with their own living units unless two residents agree, in writing, to share one living unit. A maximum of two residents may live in one unit. The bathrooms in each unit must include a toilet, sink, and bathtub or shower. If two residents share a unit, the unit must be larger than a single-occupancy unit, and the bathrooms must be lockable. Each unit must include storage space, a telephone jack, and individually controlled heating and cooling thermostats. Each unit must have a lock unless it poses a risk to the resident, and the unit must be equipped with an emergency notification system. Doors must provide access for wheelchair use.

While units are not required to have a fully equipped kitchen, the facility must equip units with electrical outlets suitable for microwaves or small refrigerators should the resident request them.  Residents must meet the facility's safety standards if they provide their own appliances. The unit must also provide access to a sink for dishes, a stovetop to prepare hot foods and a food preparation area in a common area, but not in an area used by staff to prepare staff or resident meals.

Any new construction of a facility after January 18, 2011, must include the following for the kitchen space in each unit:  a cabinet for food storage, a small bar-type sink with hot and cold running water, and the aforementioned electrical outlets.

PCHs must have single and multiple occupancy bedrooms with toilets and sinks that up to six residents can share and bathtub or shower rooms for up to ten residents.

What Is Included With Assisted Living Care In Pennsylvania?


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 Medical Provisions


Both PCHs and ALRs must assist with resident self-administration of prescribed medications as needed. Assistance includes helping the resident remember their medication schedule, storing it in a secure place, and offering it to the resident at prescribed times.  The facility must administer medication to residents who have been determined to need such or have chosen not to self-administer. A licensed professional or trained staff must administer all prescription medications if the medication is not self-administered.

Health Care Services


In Pennsylvania, ALRs 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 60% of communities providing skilled nursing. Many have health care specialists and on-site services, with 70% of communities offering dental care. In addition, 73% 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 Pennsylvania, 77% of communities conduct depression screenings, and some offer mental health counselling. Social work programs are also found in 58% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all the necessary resources.

Some assisted living residents live with various medical conditions. In Pennsylvania, 37% have Alzheimer's disease or another form of dementia. In addition, 55% have high blood pressure, 36% have heart disease, 39% have depression, and 20% 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 neglect of household chores. 

Residents in Pennsylvania’s assisted living facilities often receive help with their ADLs. In Pennsylvania, 14% of residents need help eating. Other commonly used services include bed transfer (22%), toileting (33%), and walking (44%). Caregivers in ALFs help 37% of residents to dress, and 60% of residents need help bathing.

Cost Of Assisted Living Care In Pennsylvania


The average cost of assisted living care in Pennsylvania is $4,100. This cost is $400 lower than the monthly national average of $4,500 per month. The cost of living in Pennsylvania is more than the national average by 2.5%, with health care costs less than the national average by 4.6% and housing costs less than the national average by 2.0%.

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 $2,725 in the Johnstown area to a high of $5,720 per month in the Reading area of Pennsylvania.

Comparing nearby states


Pennsylvania is a large state, and if you live close to another state, you may find assisted living in a neighboring state is an affordable option, although you will have to look for individual facilities that are less expensive. All states bordering Pennsylvania have a higher average monthly cost, with New Jersey and Maryland being the highest at $6,495 and $4,900 per month, respectively.

Pennsylvania long-term care oversight


The Department of Human Services in Pennsylvania keeps an updated list of licensed care providers in the state. You can use it to search for various information on individual facilities. The information available includes inspection reports and infractions. You can use the form on the DHS website; Remember that you might need to search under “assisted living facilities” and “personal care homes” because there is an overlap in services.

Pennsylvania Department of Human Services

Pennsylvania Department on Aging

Pennsylvania Long-term Care Ombudsman

Top Ranked Assisted Living Facilities in Pennsylvania

There are 325 assisted living facilities in PA and the median cost of care is $4,100. The average rating of assisted living facilities in Pennsylvania is 3 out of 5 stars and the top ranked facility is Twin Cedar Senior Living.
Resident Review Score
10
|
Most Loved
Luther Ridge at Seiders Hill
Luther Ridge at Seiders Hill

163 Red Horse Rd, Pottsville PA, 17901


Starting at

$2,775

For this area
$$$

  • assisted living
Resident Review Score
10
|
Most Loved
Clarks Summit Senior Living

Preferred Provider

Clarks Summit Senior Living

950 Morgan Hwy, Clarks Summit PA, 18411


Starting at

$1,590

For this area
$$$

  • assisted living
  • memory care
Resident Review Score
10
|
Most Loved
Brookdale Bloomsburg

Preferred Provider

Brookdale Bloomsburg

420 Shaffer Road, Bloomsburg PA, 17815


Starting at

$2,965

For this area
$$$

  • assisted living
Resident Review Score
10
|
Most Loved
Franciscan Manor

Preferred Provider

Franciscan Manor

71 Darlington Rd, Beaver Falls PA, 15010


Starting at

$1,300

For this area
$$$

  • assisted living
Resident Review Score
9.9
|
Most Loved
The Lakes at Jefferson
The Lakes at Jefferson

7271 W Market St, Mercer PA, 16137


Starting at

$2,800

For this area
$$$

  • assisted living
  • continuing care retirement communities
  • senior living
Resident Review Score
9.8
|
Most Loved
Mifflin Court
Mifflin Court

450 E Philadelphia Avenue, Shillington PA, 19607


Starting at

$4,680

For this area
$$$

  • assisted living
Resident Review Score
9.8
|
Most Loved
Celebration Villa of Altoona

Preferred Provider

Celebration Villa of Altoona

170 Red Fox Dr, Duncansville PA, 16635


Starting at

$3,220

For this area
$$$

  • assisted living
Resident Review Score
9.8
|
Most Loved
Twin Cedar Senior Living
Twin Cedar Senior Living

364 Little Walker Rd, Shohola PA, 18458


Starting at

$3,500

For this area
$$$

  • assisted living

Pennsylvania Assisted Living by City

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