Wide shot of the front of a brick residential facility.

Part 1 of 2: PLACEMENT AND CONTINUED CARE FOR SENIOR RESIDENTS IN LICENSED RESIDENTIAL CARE FACILITIES (Other than Nursing Homes)

By David Jones, Hotline Attorney

A. Scope of Article

At some time, a senior may reach a point where he or she can no longer live in his or her home and must move into a residential care facility. That move can be a difficult and traumatic ordeal. This article is written to assist you in getting through that ordeal.

There are basically three types of licensed residential care facilities in Michigan: Adult Foster Care Facilities (AFCF), Homes for the Aged (HA), and Nursing Homes. This article only covers AFCF and HA. It is not for prospective residents whose high level of care needed requires care in a Nursing Home.

B. Resources on AFCF and HA

Introduction

The most important resource on AFCF and HA is the website of the agency that licenses these facilities: Adult Foster Care and Homes for the Aged Licensing Division, in the Licensing and Regulatory Affairs Department (LARA). This contains most of the information that is important to know about AFCF and HA.

Other useful resources can be found on the website under “Quick Links” on the right side of the screen. Unfortunately, there are no impartial ratings of the facilities.

The Michigan Long Term Care Ombudsman Program may also be able to address questions and concerns about a facility.

C. Legal Authority for AFCF and HA

The legal authority for AFCF and HA is found in the Michigan Compiled Laws (MCL) and the Michigan Administrative Code Rules (MAC R). These are available on the LARA website. Under “Applicants” click on “Licensing Rules and Statutes”.

For AFCF the authority is found at MCL 400.701-737, and much of MAC R400.1401-18702.

For HA, the authority is found mainly at MCL 333.20201, MCL 333.21301-21335 (in the Public Health Code) and at MAC R325-1901-1981.

In addition, there are Rules for fire safety of AFCF. The Rules for fire safety for AFCF with six or fewer residents are found at MAC R400.2201-2376. The fire safety rules for facilities with seven or more residents are found at MAC R400.18101-18702. In addition, some fire safety rules are found in the separate rules for the types of AFCF.

D. Definitions of AFCF and HA

An AFCF is defined by statute as follows: “establishment that provides foster care to adults….Subject to Section 26a(1), adult foster care facility includes facilities and foster care family homes for adults who are aged, mentally ill, developmentally disabled, or physically disabled who require supervision on an ongoing basis but who do not require continuous  nursing care….” MCL 400.703(4)

Continuous nursing care does not include a resident in a licensed hospice program at an AFCF. MCL 400.726a(1).

Foster Care is defined by statute as follows: “…provision of supervision, personal care, and protection in addition to room and board for 24 hours per day, 5 or more days per week, for 2 or more consecutive weeks for compensation.” MCL 400.704(7)

A Home for the Aged is defined by statute as follows: “…supervised personal care facility …that provides room, board, and supervised personal care to 21 or more unrelated, non- transient individuals 60 years of age or older….” MCL 333.20106.

Both AFCF and HA provide supervision, personal care, protection and room and board to adults. AFCF accept adults of any age, but HA only accept adults aged sixty or over. Adult Foster Care Facilities, but not Homes for the Aged, provide care twenty-four hours per day. HA provide care to twenty-one or more residents, but AFCF may provide care to fewer than twenty-one residents. Basically, HA provide a lower level of care than AFCF.

E. Types of AFCF

There is only one type of HA. However, there are five types of AFCF. A Family Home provides care to six or fewer residents. MCL 400.703(5) Also Family Homes are generally in residential areas. A Small Group Home provides care to twelve or fewer residents. MCL 400.703(7).

A Large Group Home provides care to at least thirteen, but not more than twenty residents. MCL 400.703(6). A Congregate Facility provides care to more than twenty adults. MCL 400.703(3).

A Camp provides care to more than four adults in a facility located in a natural or rural environment. MCL 400.703(2)

I do not deal further with AFCF Camps in this article. There are only five in Michigan and they tend to provide care for only short periods of time in the summer.

 

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