You asked if an assisted living facility must have a nurse on duty 24 hours a day.

SUMMARY

State law does not require the presence of a registered nurse (RN) 24 hours a day at an assisted living facility. But an RN must be on-call 24 hours a day.

BACKGROUND

"Assisted living" generally refers to a facility for seniors who need some help with activities of daily living but do not need or want to go to a nursing home. The facility usually provides the seniors with a private apartment; access to common spaces; meals in common; housekeeping and chore services; transportation; recreation; some nursing or medical care; and assistance with activities of daily living such as dressing, bathing, eating, walking, or transferring from a bed to a chair.

Connecticut does not actually license "assisted living facilities. " It instead licenses "assisted living services agencies"(ALSA). Such agencies can only provide assisted living services at "managed residential communities" (MRCs). Connecticut law does not require MRCs to be licensed, but they must meet certain requirements and provide certain

"core" services to their residents before they can engage an assisted living service agency to provide services to their residents (see Department of Public Health (DPH) Regulations, § 19-13-D105).

NURSE STAFFING REQUIREMENTS FOR ASSISTED LIVING IN CONNECTICUT

An ALSA must designate an RN to be on call 24 hours a day. The ALSA must have a supervisor of assisted living services who must also be an RN. The supervisor must be on site (1) at least 20 hours per week for every 10 or less full-time or full-time equivalent licensed nurses (RNs, LPNs) or assisted living aides or (2) at least 40 hours per week for every 20 or less full-time or full-time equivalent licensed nurses or assisted living aides. In addition, there must be at least 10 hours per week of licensed nurse staffing for each additional 10 or less full time or full time equivalent assisted living aides (Department of Public Health Regs. § 19-13-D105(j)).

The on-call RN must have two years of full-time or full-time equivalent clinical experience in nursing, at least one year of which must be in a home health care agency or community health program that included care of the sick at home. The on-call RN can be the supervisor of assisted living services or another RN. An ALSA can contract for on-call RNs with a licensed home health care agency. The on-call nurse must be reachable by telephone and be available to make an on-site visit, if necessary, to (1) respond to assisted living aides while giving care to clients and (2) respond to client emergencies (Regs. § 19-13-D105(j)).

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