Managed Residential Communities (MRC) offering Assisted Living Services (ALS)
These communities, primarily though not exclusively for individuals aged 55 and over who need some assistance with Activities of Daily Living, but not the level of medical care of a nursing home. The goal is to help individuals live as independently as possible, in the community, rather than in an institutional setting.
A Managed Residential Community (MRC) is a facility consisting of private residential units that provides a managed group living environment, including housing and services primarily for persons age fifty-five (55) and older. A managed residential community provides or makes available “core services” for its residents, who may choose to use any or all of the following:
regularly scheduled meal service;
regularly scheduled laundry services for personal laundry and linens;
regularly scheduled transportation for personal shopping, social and recreational events, health care appointments and similar needs when public bus transportation alone is not sufficient;
regularly scheduled housekeeping services;
maintenance service, including chore services for routine domestic tasks;
programs of social and recreational opportunities.
The MRC is not a licensed entity therefore issues related to the core services and tenant agreement (similar to a lease), which the resident signs as a condition of living in the facility, are not regulated by any State Agency. The apartments within the MRC are the tenants’ private homes.
Assisted Living Services provided by an Assisted Living Agency (ALSA) in a Managed Residential Community:
The ALSA may provide assisted living services (ALS) to residents of a MRC, who choose to receive them. These services may include limited nursing services and assistance with activities of daily living in order to maintain a maximum level of independence. Activities of daily living may include assistance with hygiene, feeding, ambulation, dressing or incontinence. Limited nursing services may include assistance with medication administration. Routine household services may also be provided as either assisted living services by the Assisted Living Services Agency (ALSA) or by the MRC. Assisted Living Services (ALS) may be provided to “clients” of the ALSA only after a physician or other healthcare practitioner with applicable authority makes a determination that their conditions are chronic and stable (as opposed to acute or unstable conditions). This determination must be documented annually and upon a change in the “client’s” condition. It is important to remember that ALSA services are intermittent and are never meant to equal the level of care provided by a nursing home.
Should a “client” require skilled nursing services, such as wound care, physical assessment or physical/occupational/speech therapy, and/or medical social services, these services would need to be provided by a Home Health Agency (HHA) or from a licensed health care provider such as a physical therapist. It is important to remember that the “client” may continue to pay for ALSA services and also might assume additional costs for the skilled care should the “client” not be eligible for Medicare reimbursement or private insurance.
An ALSA is not required to have a licensed nurse and/or assisted living aide available on a 24-hour 7-day basis. A registered nurse (RN) is required only to be on duty 20-40 hours per week, but must be on call at all times to address issues that may arise. Sufficient Assisted Living Aides (ALA) must be available to meet the activities of daily living needs of the ALSA “clients.”
Costs range from approximately $2,000 to $5,000 a month, depending on services and accommodations. Generally, the resident pays all fees. Medicare and Medicaid do not pay for assisted living. However, Medicare may cover the costs of some services provided in an assisted living community by a licensed home health agency. Most long-term care insurance policies cover assisted living.
Quality of Standards
Although the assisted living facility itself is not licensed, Connecticut licenses an assisted living services agency to provide assistance with the Activities of Daily Living as well as some limited nursing services, such as medication administration, prevention and wellness services.