Assisted Living in Maine

Agency: Department of Health and Human Services, Division of Licensing and Regulatory Services, Medical Facilities Unit
Phone: (207) 287-9300
Website: www.maine.gov/dhhs/dlrs

An assisted living program may provide assisted living services to residents in private apartments in buildings that include a common dining area. Services are provided either directly by the assisted living program or indirectly through contracts with persons, entities, or agencies. A Residential Care Facility I, II, or III (six or fewer residents) or Residential Care Facility IV (seven or more residents) may provide assisted living services, including housing and assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs.)

Facility Scope of Care:
Assisted housing/living services include but are not limited to personal supervision; protection from environmental hazards; assistance with ADLs and IADLs; administration of medications; and nursing services.

Move-In/Move-Out Requirements:
Residents may be discharged if the services required cannot be met by the facility, the resident's intentional behavior results in substantial physical damage to the property, for non-payment, or if the resident becomes a direct threat to the health or safety of others.

Resident Assessment:
Residents residing in level III and IV residential care facilities are required to be assessed within 30 calendar days of admission. Reassessments must be completed annually or more frequently if there is a significant change in the resident's condition. Residents residing in assisted living programs need to be reassessed at least every six months.

Medication Management:
Administration of medication is permitted and includes reading labels for residents; observing residents taking their medications; checking dosage; removing the prescribed dosage; and the maintenance of a medication record for each resident. Certain injections may be administered by trained medication aides.

Physical Plant Requirements:
Facilities must be designed to meet the special needs of the population served. Private resident bedrooms must be a minimum of 100 square feet and shared resident bedrooms must provide a minimum of 80 square feet per resident. There is no minimum requirement for private apartments in assisted living programs.

Residents Allowed Per Room:
A maximum of two residents is allowed per resident unit.

Life Safety:
Life safety is governed by the state fire marshal's office. The National Fire Protection Association code is used. Life safety standards are applied depending on the type of facility and how/when it was built or bought.

Alzheimer's Unit Requirements:
All facilities with Alzheimer's/dementia care units must offer special weekly activities such as gross motor, self-care, social, outdoor, spiritual, and sensory enhancement activities. The regulations also require specific physical plant design for Alzheimer's units. Facilities with an Alzheimer's unit are required to disclose certain information.

Staff Training for Alzheimer's Care:
Pre-service training is required for staff who work in Alzheimer's or dementia units.

Staffing Requirements:
An on-site administrator must be employed by the facility. Facilities with 10 or fewer beds are required to have, at a minimum, one responsible adult present at all times to perform resident care and provide supervision. Facilities with more than 10 beds are required to have at least two responsible adults at all times. The regulations also have specific staff-to-resident ratios, depending upon time of day. There must also be a Certified Residential Medication Aide on duty at all times.

Staff Education Training:
For Level IV facilities, Maine requires that direct care staff complete a 50-hour standardized training course called Personal Support Specialist. If staff administer medications, they must complete a 40-hour standardized medication course.

Medicaid Policy and Reimbursements:
A Medicaid home and community-based services waiver and a state plan option cover assisted living services. A Minimum Data Set-based case-mix, adjusted pricing system is used for residential care facility residents based on functional abilities and other data collected on residents.