Wisconsin Assisted Living
With a low cost of living and abundant open spaces, lakes, rivers, and streams, Wisconsin can be an ideal retirement destination for cost-conscious people who enjoy the outdoors. In addition, Social Security benefits and public pensions are exempt from state income taxes, making it more affordable for older adults to live in the Badger State. Those looking for assisted living communities in Wisconsin can use the information below to learn about options, residential care costs, and state regulations on long-term care facilities.
The typical resident population in Wisconsin's assisted living communities is 70% female. Overall, 82% of residents are ages 75 and older, with 29% of residents ages 75 to 84 and 53% ages 85 and older.
The state licenses four types of assisted living settings, including adult day care. The Bureau of Assisted Living regulates community-based residential facilities (CBRFs), residential care apartment complexes (RCACs), and adult family homes.
CBRFs are licensed based on their size and the class of residents they house. Small licenses are for five to eight beds, the medium is for nine to twenty beds, and large facilities have 21 or more beds. The resident classes are for either ambulatory, semi-ambulatory, or non-ambulatory, and whether they are mentally and physically able to respond to a fire alarm and exit the facility without assistance. These facilities provide care, treatment, and other services to residents who need supporting services or supervision because they cannot live independently. Residents are limited to no more than three hours of nursing care per week.
RCACs provide residents with home-like independent apartments. These facilities are not licensed or monitored and must only register with the state. Medicaid may reimburse RCACs if they are certified and in compliance with all applicable requirements at the federal, state, and local levels.
RCACs provide apartments with a lockable entrance and exit, a kitchen with a stove, an individual bathroom, and sleeping and living areas. The community provides residents with up to 28 hours of weekly personal, supportive, and nursing services.
Adult foster care homes provide care and maintenance beyond room and board for three to four adults in the licensee's residence.
The resident agreement for CBRCs must be provided before move-in or within five days of an emergency admission. The agreement specifies the services provided, the daily or monthly rate, payment and refund policies, security deposits, and discharge policies. The facility must disclose the type of facility (size and class), the services it provides, the main contact of the facility, and 24-hour staffing patterns, including the availability of a licensed nurse.
The RCAC agreement must include the services provided, the fees, and any optional services available, along with its cost.
CBRFs are able to admit and provide services for older individuals, individuals with dementia, physical or mental disabilities, individuals with substance abuse issues, or the terminally ill. The facility must ensure that all residents are compatible. Facilities cannot admit or retain individuals who are confined to their bed, are destructive of property or themself, are physically or mentally abusive to others, have physical, psychiatric, mental, or social needs that are not compatible with the facility or those who present a risk of serious harm to residents or employees of the facility.
CBRFs are limited to no more than 10% of their licensed capacity (or four residents, whichever number is greater) who need more than three hours of nursing care per week or intermediate nursing care for more than 30 days.
RCACs can admit residents to share an apartment with a competent spouse or another person with legal responsibility for the resident. A facility may retain a resident who is deemed incompetent or incapable of recognizing danger, summoning assistance, or making care decisions if the following conditions are met:
Facilities can discharge residents if the facility is unable to meet the needs of the resident if they need more than 28 hours of service per week, their condition requires nurse availability for 24 hours per day, their behavior poses a threat to others, they refuse to cooperate in a physical exam, are incapable of making care decisions, or recognizing danger, summoning assistance, expressing a need.
CBRFs must provide supervision, information and referral services, leisure activities, transportation, and health monitoring. Additional resident-specific services include personal care, activity programming for residents with dementia, independent living skills, behavior management, and up to 3three hours of nursing care per week.
Prior to admission, the needs, abilities, and physical and mental condition must be assessed and reassessed annually. Upon admission, the facility must develop a temporary service plan to meet immediate needs and develop a full care plan within the first 30 days. The service plan includes all of the services provided to meet the needs of the resident.
RCACs must provide a package of services that includes housekeeping, access to medical services, personal services, assistance with activities of daily living (ADLs), and nursing services. The total amount of assistance provided to a resident cannot exceed 28 hours per week. Social and recreational activities are not included in the 28-hour maximum.
Before admission, a comprehensive assessment must be completed that will be used to develop a service plan for each resident. The assessment covers their physical health, functional limitations, medication, ability to self-administer, nutritional status and needs, mental health, behavioral problems, and capacity for self-care.
Both RCACs and CBRFs can provide or contract with third parties to meet the care needs of their residents. Residents are also permitted to contract directly with third parties.
CBRFs must provide at least three nutritious meals per day and a nutritious snack. They must provide special dietary needs and therapeutic diets if ordered by a physician. RCACs must provide meals and snacks for their residents.
CBR facilities must employ an administrator to be responsible for all day-to-day operations and are responsible for training and retaining a staff that includes residential care staff that provides direct care to its residents. There are no minimum staff ratios, but the facility must provide sufficient employees on a 24-hour basis to meet all resident needs outlined in their care plans.
RCACs must employ a service manager who is responsible for day-to-day operations, including ensuring that all services and care are provided to residents according to their care plans. There are no minimum staffing requirements, but there needs to be enough appropriate staff to provide for the needs of their residents.
CBR facilities provide both private and double-occupancy bedrooms with shared bathrooms. Small and medium facilities must offer one bathroom and shower facility for every eight residents. Large facilities must have one toilet, bath, and shower for every eight male and eight female residents. Each facility must have a least one toilet, sink, and tub or shower for every ten residents.
All units in RCACs are independent, with a lockable entrance. Multiple occupancies are permitted for a spouse or a roommate of the residents choosing. The kitchen must be a distinct area in the unit. Sleeping and living areas must be functionally different but not necessarily in different rooms. Each apartment must have floor-to-ceiling walls, a door, a toilet, a sink, and a bathtub or shower.
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 Wisconsin, 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 66% of communities providing skilled nursing. Many have health care specialists and on-site services, with 71% of communities offering dental care. In addition, 68% 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 Wisconsin, 90% of communities conduct depression screenings, and 67% offer mental health counseling. Social work programs are also found in 61% 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 Wisconsin, 46% have Alzheimer's disease or another form of dementia. In addition, 49% have high blood pressure, 40% have heart disease, 30% have depression, and 19% have diabetes.
The Wisconsin Department of Health Services supervises the state's mental health system. The department partners with several community-based agencies and organizations to provide programs and services to help individuals improve their mental health. Mental Health America of Wisconsin also offers support and resources by county for people living with mental health conditions. The U.S. Department of Veterans Affairs has various mental health resources, information, and treatment options available to veterans.
Residents of CBRFs may self-administer medications if they are deemed competent to do so. Medication administration is permitted if a registered nurse, practitioner, or pharmacist supervises it. If an RN or other practitioner does not supervise medication administration, the facility must arrange for a pharmacist to package and label all medications into unit doses. Injectables, nebulizers, stomal and enteral medications, and treatments must be administered by an RN or LPN or by a non-licensed employee if delegated by a licensed nurse.
RCAC facilities can offer medication administration and medication management. Medications can be administered by an RN or as a delegated talk to unlicensed staff under the supervision of the RN.
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 Wisconsin’s assisted living facilities often receive help with their ADLs. In Wisconsin, 28% of residents need help eating. Other commonly used services include bed transfer (41%), toileting (45%), and walking (49%). Caregivers in ALFs help 51% of residents dress, and 71% need help bathing.
The average cost of assisted living care in Wisconsin is $4,600. This is $100 higher than the monthly national average of $4,500. The cost of living in Wisconsin is less than the national average by 3.6%, with health care costs more than the national average by 11.9% and housing costs less than the national average by 11.6%.
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 $4,125 in the Wausau area to a high of $5,450 per month in the Racine area of Wisconsin.
If you live close to one of Wisconsin’s borders, you may find assisted living in a neighboring state is an affordable option. Seniors in Minnesota pay around $4,508 per month, while costs in Illinois average $4,488. Iowa’s prices are even lower, at $4,365. All of these states do have lower average prices than in Wisconsin, but the prices are similar.
How to Pay for Assisted Living
The Division of Quality Assurance oversees Wisconsin's assisted living communities. The Long-Term Care Ombudsman program is a service from the Wisconsin Board on Aging and Long-Term Care. Specially trained volunteers advocate for older adults residing in long-term care facilities, investigating and attempting to resolve neglect and abuse complaints.
Under the Wisconsin Statute Chapter DHS 50 and DHS 83 of the Emergency Preparedness Regulations for Assisted Living, all CBRFs must meet specific safety and quality standards. For example, every CBRF must have a written emergency and disaster plan in place and follow local fire safety protocols. The Division of Quality Assurance at the Wisconsin Department of Health Services ensures residents are safe by conducting unannounced inspections and responding to complaints.
The state requires all CBRF employees to receive basic first aid and other safety training within 90 days of the first date of employment. Employees must also take fire prevention and control training along with evacuation techniques within the same time frame.
People aged 60 and above living in Wisconsin needing legal assistance can receive it through the Elder Benefit Specialist program. Professionals are available to provide free and confidential counseling, information, and advice on Medicaid, Medicare, SSI, senior care, and financial assistance programs.
The typical resident population in Wisconsin's assisted living communities is 70% 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 (ALF) Definitions
The state licenses four types of assisted living settings, including adult day care. The Bureau of Assisted Living regulates community-based residential facilities (CBRFs), residential care apartment complexes (RCACs), and adult family homes.
CBRFs are licensed based on their size and the class of residents they house. Small licenses are for five to eight beds, the medium is for nine to twenty beds, and large facilities have 21 or more beds. The resident classes are for either ambulatory, semi-ambulatory, or non-ambulatory, and whether they are mentally and physically able to respond to a fire alarm and exit the facility without assistance. These facilities provide care, treatment, and other services to residents who need supporting services or supervision because they cannot live independently. Residents are limited to no more than three hours of nursing care per week.
RCACs provide residents with home-like independent apartments. These facilities are not licensed or monitored and must only register with the state. Medicaid may reimburse RCACs if they are certified and in compliance with all applicable requirements at the federal, state, and local levels.
RCACs provide apartments with a lockable entrance and exit, a kitchen with a stove, an individual bathroom, and sleeping and living areas. The community provides residents with up to 28 hours of weekly personal, supportive, and nursing services.
Adult foster care homes provide care and maintenance beyond room and board for three to four adults in the licensee's residence.
Resident Agreements and Disclosures
The resident agreement for CBRCs must be provided before move-in or within five days of an emergency admission. The agreement specifies the services provided, the daily or monthly rate, payment and refund policies, security deposits, and discharge policies. The facility must disclose the type of facility (size and class), the services it provides, the main contact of the facility, and 24-hour staffing patterns, including the availability of a licensed nurse.
The RCAC agreement must include the services provided, the fees, and any optional services available, along with its cost.
Assisted Living Admission and Retention
CBRFs are able to admit and provide services for older individuals, individuals with dementia, physical or mental disabilities, individuals with substance abuse issues, or the terminally ill. The facility must ensure that all residents are compatible. Facilities cannot admit or retain individuals who are confined to their bed, are destructive of property or themself, are physically or mentally abusive to others, have physical, psychiatric, mental, or social needs that are not compatible with the facility or those who present a risk of serious harm to residents or employees of the facility.
CBRFs are limited to no more than 10% of their licensed capacity (or four residents, whichever number is greater) who need more than three hours of nursing care per week or intermediate nursing care for more than 30 days.
RCACs can admit residents to share an apartment with a competent spouse or another person with legal responsibility for the resident. A facility may retain a resident who is deemed incompetent or incapable of recognizing danger, summoning assistance, or making care decisions if the following conditions are met:
- The RCAC can provide adequate oversight, protection, and services.
- The resident has an appointed guardian or a power-of-attorney who can cover the person’s area of incapacity.
- The guardian and the health care agent sign the service agreement and risk agreement.
Facilities can discharge residents if the facility is unable to meet the needs of the resident if they need more than 28 hours of service per week, their condition requires nurse availability for 24 hours per day, their behavior poses a threat to others, they refuse to cooperate in a physical exam, are incapable of making care decisions, or recognizing danger, summoning assistance, expressing a need.
Assisted Living Services and Service Planning
CBRFs must provide supervision, information and referral services, leisure activities, transportation, and health monitoring. Additional resident-specific services include personal care, activity programming for residents with dementia, independent living skills, behavior management, and up to 3three hours of nursing care per week.
Prior to admission, the needs, abilities, and physical and mental condition must be assessed and reassessed annually. Upon admission, the facility must develop a temporary service plan to meet immediate needs and develop a full care plan within the first 30 days. The service plan includes all of the services provided to meet the needs of the resident.
RCACs must provide a package of services that includes housekeeping, access to medical services, personal services, assistance with activities of daily living (ADLs), and nursing services. The total amount of assistance provided to a resident cannot exceed 28 hours per week. Social and recreational activities are not included in the 28-hour maximum.
Before admission, a comprehensive assessment must be completed that will be used to develop a service plan for each resident. The assessment covers their physical health, functional limitations, medication, ability to self-administer, nutritional status and needs, mental health, behavioral problems, and capacity for self-care.
Both RCACs and CBRFs can provide or contract with third parties to meet the care needs of their residents. Residents are also permitted to contract directly with third parties.
Assisted Living Food and Dietary Provisions
CBRFs must provide at least three nutritious meals per day and a nutritious snack. They must provide special dietary needs and therapeutic diets if ordered by a physician. RCACs must provide meals and snacks for their residents.
Assisted Living Staffing Requirements
CBR facilities must employ an administrator to be responsible for all day-to-day operations and are responsible for training and retaining a staff that includes residential care staff that provides direct care to its residents. There are no minimum staff ratios, but the facility must provide sufficient employees on a 24-hour basis to meet all resident needs outlined in their care plans.
RCACs must employ a service manager who is responsible for day-to-day operations, including ensuring that all services and care are provided to residents according to their care plans. There are no minimum staffing requirements, but there needs to be enough appropriate staff to provide for the needs of their residents.
Assisted Living Housing Requirements
CBR facilities provide both private and double-occupancy bedrooms with shared bathrooms. Small and medium facilities must offer one bathroom and shower facility for every eight residents. Large facilities must have one toilet, bath, and shower for every eight male and eight female residents. Each facility must have a least one toilet, sink, and tub or shower for every ten residents.
All units in RCACs are independent, with a lockable entrance. Multiple occupancies are permitted for a spouse or a roommate of the residents choosing. The kitchen must be a distinct area in the unit. Sleeping and living areas must be functionally different but not necessarily in different rooms. Each apartment must have floor-to-ceiling walls, a door, a toilet, a sink, and a bathtub or shower.
What Is Included With Assisted Living Care In Wisconsin?
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 Wisconsin, 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 66% of communities providing skilled nursing. Many have health care specialists and on-site services, with 71% of communities offering dental care. In addition, 68% 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 Wisconsin, 90% of communities conduct depression screenings, and 67% offer mental health counseling. Social work programs are also found in 61% 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 Wisconsin, 46% have Alzheimer's disease or another form of dementia. In addition, 49% have high blood pressure, 40% have heart disease, 30% have depression, and 19% have diabetes.
State Mental Health Resources
The Wisconsin Department of Health Services supervises the state's mental health system. The department partners with several community-based agencies and organizations to provide programs and services to help individuals improve their mental health. Mental Health America of Wisconsin also offers support and resources by county for people living with mental health conditions. The U.S. Department of Veterans Affairs has various mental health resources, information, and treatment options available to veterans.
Medication Provisions
Residents of CBRFs may self-administer medications if they are deemed competent to do so. Medication administration is permitted if a registered nurse, practitioner, or pharmacist supervises it. If an RN or other practitioner does not supervise medication administration, the facility must arrange for a pharmacist to package and label all medications into unit doses. Injectables, nebulizers, stomal and enteral medications, and treatments must be administered by an RN or LPN or by a non-licensed employee if delegated by a licensed nurse.
RCAC facilities can offer medication administration and medication management. Medications can be administered by an RN or as a delegated talk to unlicensed staff under the supervision of the RN.
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 Wisconsin’s assisted living facilities often receive help with their ADLs. In Wisconsin, 28% of residents need help eating. Other commonly used services include bed transfer (41%), toileting (45%), and walking (49%). Caregivers in ALFs help 51% of residents dress, and 71% need help bathing.
Cost Of Assisted Living Care In Wisconsin
The average cost of assisted living care in Wisconsin is $4,600. This is $100 higher than the monthly national average of $4,500. The cost of living in Wisconsin is less than the national average by 3.6%, with health care costs more than the national average by 11.9% and housing costs less than the national average by 11.6%.
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 $4,125 in the Wausau area to a high of $5,450 per month in the Racine area of Wisconsin.
How Costs Compare In Nearby States
If you live close to one of Wisconsin’s borders, you may find assisted living in a neighboring state is an affordable option. Seniors in Minnesota pay around $4,508 per month, while costs in Illinois average $4,488. Iowa’s prices are even lower, at $4,365. All of these states do have lower average prices than in Wisconsin, but the prices are similar.
How to Pay for Assisted Living
Wisconsin Assisted Living Oversight
The Division of Quality Assurance oversees Wisconsin's assisted living communities. The Long-Term Care Ombudsman program is a service from the Wisconsin Board on Aging and Long-Term Care. Specially trained volunteers advocate for older adults residing in long-term care facilities, investigating and attempting to resolve neglect and abuse complaints.
Quality and Safety of Assisted Living Facilities in Wisconsin
Under the Wisconsin Statute Chapter DHS 50 and DHS 83 of the Emergency Preparedness Regulations for Assisted Living, all CBRFs must meet specific safety and quality standards. For example, every CBRF must have a written emergency and disaster plan in place and follow local fire safety protocols. The Division of Quality Assurance at the Wisconsin Department of Health Services ensures residents are safe by conducting unannounced inspections and responding to complaints.
The state requires all CBRF employees to receive basic first aid and other safety training within 90 days of the first date of employment. Employees must also take fire prevention and control training along with evacuation techniques within the same time frame.
Legal Resources
People aged 60 and above living in Wisconsin needing legal assistance can receive it through the Elder Benefit Specialist program. Professionals are available to provide free and confidential counseling, information, and advice on Medicaid, Medicare, SSI, senior care, and financial assistance programs.
