Rhode Island Assisted Living
Although Rhode Island is the smallest state by area, it has plenty for older adults, making it an attractive retirement destination. The cost of living is above the national average, but it's lower than in many other areas of New England. Rhode Island also offers easy access to Boston and other major cities.
The following guide covers the senior care options available to Rhode Island residents and provides more information about state costs for senior care, assisted living regulations, and resources.
The typical resident population in Rhode Island's assisted living communities is 71% female. Overall, 82% of residents are ages 75 and older, with 29% of residents ages 75 to 84 and 53% ages 85 and older.
Assisted Living Facility/Residence (ALR) Definitions
The Department of Health of Rhode Island licenses assisted living residences (ALRs). Residences are classified according to medication classifications, dementia care, and based on fire code. The fire code designation is based on whether the residents are capable of self-preservation in an emergency. Level 1 is for residents who are not capable, and Level 2 is for residents who are capable.
Medication Level 1 licenses are for residences where one or more resident requires centralized storage of their medications or medication administration. Level 2 residences are for residents who are fully capable of self-medication. A dementia care license is required when one or more residents’ symptoms affect their ability to function based on several criteria.
An ALR is either a publicly or privately owned and operated residence that provides meals, lodging, and personal assistance to two or more residents who are unrelated to the licensee. The care provided in residence is either provided directly by the licensee or indirectly through a third-party contract.
An Alzheimer’s dementia special care unit is a distinct living environment within a residence that has been adapted to provide safety for residents based on their particular needs and behaviors. Staffing levels are higher than in an ALR, including higher levels of training and therapeutic activities.
Resident Agreements and Disclosures
All resident agreements must include information about the rights of the residents, admission and discharge policies and procedures, the unit to be rented, shared space, the services that will be provided or arranged, special care provisions, house rules, assessments, and service plans. The financial relationship between the resident and the residence is also disclosed in this agreement, including the basic rates, additional charges for extra services, deposits, and the rate increase policy.
The following information must be disclosed to a potential resident early in the decision-making process and definitely prior to admission:
- The residence owner and operator.
- An explanation of the license level.
- Services available in residence.
- Financial terms.
- Admission and discharge criteria.
Assisted Living Admission and Retention
Residents in ALRs must be mentally and physically able to take appropriate action in case of emergency. Residences cannot admit or retain individuals who need skilled nursing care, medical care that includes daily observation and evaluation, or persons who are bedbound or need the assistance of more than one person for ambulation. Should an existing resident require skilled nursing care or therapy from a licensed health care provider for up to 21 days, that resident can be retained.
Residents may be discharged if they are a danger to themself or to others in the residence after reasonable accommodations have been made to manage the behavior. A resident may also be discharged if they no longer meet the criteria set forth in the resident agreement or state and local laws.
Assisted Living Services and Service Planning
ALRs provide assistance with activities of daily living (ADLs), medication management, arrange for support services, and monitor their recreational, social, and personal activities.
Before admission, each resident must complete a comprehensive assessment of their health and physical, social, and functional abilities. The assessment is used to determine cognitive needs and preferences. This assessment is also used to determine if the prospective residents' needs can be provided for in residence. This assessment is performed at least annually, but also as the conditions of the resident undergo a significant change.
Residents may contract with outside agencies for skilled nursing care or therapy from a licensed practitioner or from a licensed hospice agency.
Assisted Living Food and Dietary Provisions
ALRs must provide three nutritious, balanced, and varied meals daily. If a resident requires a therapeutic diet, that should be provided as indicated in their care plan.
Assisted Living Staffing Requirements
A certified administrator is responsible for the safe and proper operation of the residence and is responsible for maintaining the appropriate staff to provide the direct care services of the residents. At least one resident must be awake and on-premises at all times, and that employee must be trained in CPR.
There are no stated staffing ratio minimums. The staffing levels must be appropriate in order to provide the necessary care and services required by the residents and their care plans.
Assisted Living Housing RequirementsApartment-style units are not required in Rhode Island. Resident rooms or apartments, if provided, may be either single or double occupancy. Residents must have access to a locked area to store personal items. Residences must have at least one bath for every ten beds and one toilet for every eight beds on each floor where residents reside if bathing facilities are not located within residents' rooms.
What Is Included With Assisted Living Care In Rhode Island?
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 Rhode Island, 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 64% of communities providing skilled nursing. Many have health care specialists and on-site services, with 67% of communities offering dental care. In addition, 75% 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 Rhode Island, 0% of communities conduct depression screenings, and 63% offer mental health counseling. Social work programs are also found in 49% 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 Rhode Island, 37% have Alzheimer's disease or another form of dementia. In addition, 48% have high blood pressure, 29% have heart disease, 28% have depression, and 16% have diabetes.
State Mental Health Resources
The Executive Office of Health and Human Services connects Rhode Island residents with the resources they need to access mental health care, including Medicaid and other benefit programs. The Samaritans of Rhode Island operate a free hotline for those who don't have access to professional mental health services or support from family and friends. The Department of Behavioral Healthcare, Developmental Disabilities & Hospitals can also refer people to local mental health treatment providers.
Medication Provisions
One of the criteria for ALR licensure is the type of medication services provided. A Level M1 residence is for residents who require central storage of medications or require medication administration. Licensed or trained, unlicensed employees may administer oral or topical drugs and monitor health indicators. Unlicensed employees must be under the supervision of a nurse or physician. Licensed professionals may only administer Schedule II medications. Schedule II medications include injectable medications, including insulin, which the resident cannot administer.
A Level M2 residence is for residents who can self-administer or need assistance with the self-administration of medications. Unlicensed staff may assist residents with self-administration by reminding them to take their medications. A resident who is capable of self-administering medications can request a one-week medi-set, which is a pre-poured distribution system. A licensed nurse, pharmacist or a trained unlicensed staff member can organize the medi-set.
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 Rhode Island’s assisted living facilities often receive help with their ADLs. In Rhode Island, 13% of residents need help eating. Other commonly used services include bed transfer (22%), toileting (34%), and walking (48%). Caregivers in ALFs help 47% of residents dress, and 62% need help bathing.
Cost Of Assisted Living Care In Rhode Island
The average cost of assisted living care in Rhode Island is $6,826. This is $2,326 higher than the monthly national average of $4,500. The cost of living in Rhode Island is more than the national average by 17.2%, with health care costs more than the national average by 5.8% and housing costs more than the national average by 21.7%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living will vary across the state. The average cost of assisted living in Providence is $6,063.
How Costs Compare In Nearby States
If you live close to one of Rhode Island’s borders, you may find assisted living in a neighboring state is an affordable option. Both of Rhode Island’s neighbors have lower average monthly costs for assisted living. Massachusetts has an average cost of $6,500, and Connecticut has an average cost of $5,129.
How to Pay for Assisted Living
Rhode Island Assisted Living Oversight
The Center for Health Facility Regulations oversees the licensing of all assisted living communities within the state. An assisted living community must obtain a special license to provide dementia care if it has at least one resident whose dementia symptoms affect their ability to function. It bases impairment of functional ability on inappropriate social behaviors, inability to get out on their own if an emergency occurs, or safety concerns associated with wandering and other behaviors.
Every assisted living community must have a quality assurance program to ensure that residents receive high-quality care. ALFs must also maintain quality improvement plans outlining how they'll monitor resident services, identify quality problems, and correct quality problems.
Quality and Safety of Assisted Living Facilities in Rhode Island
Rhode Island has an ombudsman program to monitor the quality of care in assisted living communities and residential care facilities. The ombudsman investigates complaints and advocates on behalf of assisted living residents and their family members. The Department of Health also protects people by issuing licenses to Rhode Island assisted living facilities, conducting inspections, and following up on any deficiencies.
Every assisted living community in Rhode Island must have a license, regardless of the number of residents. These communities aren't allowed to operate unless they can provide all the services needed for each resident. Assisted living communities are also required to maintain personalized plans of care for residents, ensuring that each person receives appropriate services based on their physical and emotional health. Each ALF license specifies a maximum number of residents in a community; no ALF is allowed to exceed the limit.
Legal Resources
Rhode Island Legal Services offers free legal assistance to low-income residents who need help accessing public assistance. Legal help is also available from the Rhode Island Bar Association, which uses a sliding scale to determine the fees charged to residents 60 and older.
