What is the difference between Personal Care and Assisted Living in Pennsylvania?
Until a few years ago the term personal care home (PCH) and assisted living residence (ALR) was interchangeable. Seniors and families looking for communities that provided assistance with personal care (bathing, dressing, toileting, transferring and medication management) as well as meals, housekeeping and transportation stated they were looking for assisted living. In actuality these communities are licensed by the state of Pennsylvania as Personal Care Homes. Prior to the rise of personal care communities, if a senior was unable to care for themselves at home they went to the dreaded “nursing home”. Under PCH license, care is limited to general health maintenance and assistance with personal care. The cost, which averages between $3,500.00 and $4,500.00 per month is private pay by the resident. When the level of care required is outside the scope of PCH license, the individual often must transfer to a nursing home as a permanent resident. The average cost of a nursing home is between $10,000.00 and $12,000.00 per month. Once the resident exhausts their financial resources they may qualify for state funded medical assistance ( Medicaid) to pay for a permanent nursing home stay. Not all nursing homes in Pennsylvania will accept residents with Medicaid as the payer.
To bridge the gap between PCH and nursing homes, Pennsylvania Department of Long Term Living proposed a license for Assisted Living Residences (ALR’S) in 2011 to allow seniors with increased care needs to “age in place” in a community based setting. The plan was to shift Medicaid funding to assisted living communities when residents exhausted personal financial assets. This would result in a significant cost savings to the state vs. nursing home cost paid by Medicaid.
So what is the difference in an Assisted Living License and a Personal Care Home? License?
- Construction- ALR’S must provide each resident with a private room and a door that locks. A private bathroom and a kitchen capacity to prepare a meal.
- Concept- ALR’S will allow residents to “age in place” for as long as possible.
- Level of Care- ALR’S aligned with the “aging in place” concept will provide residents with more care as their need to increase without a move.
Many PCH’S, like Sacred Heart Senior Living, already meet or exceed the requirements for an ALR license. Currently only 33 communities have obtained an ALR license to date. Over 1300 communities still maintain a PCH license. Why??? There are additional administrative and staffing cost for a PCH to obtain an ALR license and the state of Pennsylvania has yet to put in place provisions for payment to providers through Medicaid funding when residents have exhausted private pay resources. As long as the state drags it feet on funding for ALR’S, Personal Care Homes will keep their current licensing. The real losers are the seniors of Pennsylvania!