Who can live in assisted living in Louisiana

Who cannot live in an assisted living community in Louisiana?

Louisiana bars ARCPs from entering residency agreements with people whose care needs exceed what an ARCP can safely deliver, and the rule names six prohibited conditions: coma, ventilator dependency, continuous IV or TPN therapy, wound vac therapy, active communicable tuberculosis, and any condition requiring chemical or physical restraints (LAC 48:I.6833.C).

• Coma
• Ventilator dependency
• Continuous IV or TPN therapy
• Wound vac therapy
• Active communicable tuberculosis
• Any condition requiring chemical or physical restraints

The list is short on purpose. Many conditions families worry about, such as diabetes managed with insulin, oxygen use, a wheelchair, incontinence or mild to moderate memory loss, are not on it. Whether a given ARCP will accept them depends on its level, its staffing and its written admission policies, which it must give prospective residents in writing.

What does a Louisiana ARCP have to check before move-in?

Before the residency agreement is signed, the ARCP must complete and date a pre-residency screening covering the applicant's physical and mental status including fall risk, need for personal assistance, help needed with daily and instrumental activities of daily living, and ability to evacuate in an emergency (LAC 48:I.6833.B).

The evacuation item is distinctly Louisianan in practice. A resident who cannot get out of the building with the help the ARCP provides is a safety problem in a fire and a logistical one in a hurricane evacuation. Ask to see the completed screening, and ask how the provider will reassess as needs change. The screening also feeds the person-centered service plan that sets out what the ARCP will do for your parent.

Can a resident stay in an ARCP after developing a prohibited condition?

Yes, for a limited time: a resident with a prohibited condition may stay up to 90 days if the resident or representative, the physician and the provider all agree, the physician certifies the condition is time-limited, and the ARCP coordinates the outside providers who meet the need (LAC 48:I.6833.D).

The classic example is a wound that needs vacuum therapy after surgery. Instead of a nursing home stay, a resident may return to the ARCP with a home health agency managing the wound for a few weeks. Level 4 ARCPs may deliver or contract for those added services themselves. The residency agreement makes the resident or family responsible for arranging third-party services beyond the ARCP's scope, but the ARCP stays responsible for noticing if they are not delivered.

What written information must an ARCP give a prospective resident?

Louisiana requires each ARCP to give prospective residents written information on conditions for residency, services offered and allowed, resident responsibilities, smoking and pet policies, the fee structure including any extra charges during natural disasters, and the criteria for ending the residency agreement (LAC 48:I.6833.A).

The disaster-fee item is worth reading closely in the New Orleans area. The rule requires a formula with cost parameters for additional charges incurred because of tropical storms, hurricanes and floods, such as the cost of evacuating and housing residents at a host site. Compare those formulas between providers the same way you compare monthly rates.

Can someone in a wheelchair or with memory loss live in an ARCP?

Often yes: neither a wheelchair nor memory loss is a prohibited condition under Louisiana's rule, and many ARCPs serve both, but each provider decides within its level and staffing, and the resident must be able to evacuate with the help the ARCP provides.

Level 1 and 2 homes are often single-story houses with fewer steps, while Level 3 and 4 buildings have elevators and wider halls. For memory loss, the question is whether the person is safe in an open building or needs a specialized dementia care program; see Louisiana's dementia program rules.