Assisted Living in Mississippi

Agency: Department of Health, Bureau of Health Facilities Licensure and Certification
Phone: (601) 364-1110
Website: www.msdh.state.ms.us

Personal care homes are licensed facilities that provide assistance to residents in performing one or more of the activities of daily living (ADLs), including, but not limited to, bathing, walking, excretory functions, feeding, personal grooming, and dressing. Personal care homes/residential living provide services to individuals who require personal care services or individuals, who due to functional impairments, may require mental health services. Personal care homes/assisted living provide personal care and the addition of supplemental services to include the provision of medical services (i.e., medication procedures and medication administration), and emergency response services.

Facility Scope of Care:
Facilities may provide assistance with ADLs that may extend beyond providing shelter, food, and laundry. Assistance may include, but is not limited to, bathing, walking, toileting, feeding, personal grooming, dressing, and financial management.

Move-In/Move-Out Requirements:
Personal care homes/assisted living facilities may only admit residents whose needs can be met by the facility. An appropriate resident is primarily an aged ambulatory person who requires domiciliary care and who may require non-medical services, medical services such as medication assistance, emergency response services, and home health services as prescribed by a physician's order and as allowed by law. For both personal care residential and personal care assisted living, a person may neither move in nor continue to reside in a licensed facility if the person: (1) Is not ambulatory; (2) Requires physical restraints; (3) Poses a serious threat to self or others; (4) Requires nasopharyngeal and/or tracheotomy suctioning; (5) Requires gastric feedings; (6) Requires intravenous fluids, medications, or feedings; (7) Requires an indwelling urinary catheter; (8) Requires sterile wound care; or (9) Requires treatment of decubitus ulcer or exfoliative dermatitis. A resident may continue to live in a personal care home when a resident or the resident's responsible party (if applicable) consents in writing for the resident to continue to reside in the home and approved in writing by a licensed physician, unless the licensing agency determines that skilled nursing services would be appropriate. No home may allow more than two residents, or 10 percent of the total number of residents, whichever is greater, to remain under these circumstances.

Resident Assessment:
A medical evaluation is required annually for each resident but there is no required form

Medication Management:
Facilities may monitor the self-administration of medication. Only licensed personnel are allowed to administer medication.

Physical Plant Requirements:
Private and shared resident units must provide a minimum of 80 square feet per resident.

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

Life Safety:
Automatic Fire Sprinklers: All new personal care homes must be protected with automatic fire sprinklers. If the facility has a capacity of 16 or fewer beds, a 13D-styled automatic sprinkler system compliant with the National Fire Protection Association (NFPA) Standard 13D, "Standard for the Protection of One- and Two-Family Dwellings and Manufactured Homes," is sufficient. For facilities with capacity greater than 16 beds, a sprinkler consistent with NFPA 13 is required. Smoke Detectors: Smoke detectors must be installed in each hallway no more than 30 feet apart, in all bedrooms, and in all storage rooms. Smoke detectors must be electrically powered by the building's electrical system and have battery back-up. Building Construction: Facilities licensed after Aug. 14, 2005 must be constructed to have a one-hour fire resistance rating as prescribed by the current edition of the NFPA Standard 220, "Types of Building Construction."

Alzheimer's Unit Requirements:
Regulations for Alzheimer's disease/dementia care units were adopted in 2001 and apply to licensed nursing homes or licensed personal care homes and are in addition to other rules and regulations applicable to these licensed facilities. A registered nurse or licensed practical nurse must be present on all shifts and a minimum of two staff members must be on the unit at all times. Minimum requirements for nursing staff are based on the ratio of three hours of nursing care per resident per 24 hours. Licensed nursing staff and nurse aides can be included in the ratio. If the Alzheimer's/dementia care unit is not freestanding, licensed nursing staff may be shared with the rest of the facility. Facilities are only permitted to house persons with up to stage II Alzheimer's disease. A licensed social worker, licensed professional counselor, or licensed marriage and family therapist must provide social services to residents and support to family members. The social service consultation must be on site and be a minimum of eight hours per month.

Staff Training for Alzheimer's Care:
An orientation program including specific topics must be provided to all new employees assigned to the Alzheimer's/dementia unit. Ongoing in-service training must be provided to all staff who are in direct contact with residents on a quarterly basis and must include training on at least three of eight specific topics.

Staffing Requirements:
A full-time operator must be designated to manage the facility. Detailed staffing ratios apply.

Staff Education Training:
Direct care staff must be at least 18 years of age and must verify that they are not listed on the Mississippi Nurse Aide Abuse Registry. Personnel must receive training on a quarterly basis on topics and issues related to the population being served by the facility. All direct care staff must successfully complete a criminal history record check. When on duty, staff must be awake and fully dressed to provide personal care to the residents. The following staffing ratio applies: (1) One direct care staff person per 15 or fewer residents between 7:00 a.m. and 7:00 p.m. (2) One direct care staff person per 25 or fewer residents between the hours of 7:00 p.m. and 7:00 a.m. Additionally, personal care homes assisted living must: (1) Post a list of on-call personnel in the event of an emergency during the 7:00 p.m. to 7:00 a.m. shift. (2) Have a licensed nurse on the premises for eight hours per day. Licensed nurses are not to be included in the residentattendant ratio. (3) If a resident is unable to self-administer prescription medication, a licensed nurse must be present to administer the medication

Medicaid Policy and Reimbursements:
A Medicaid home and community-based services waiver with a limited number of slots covers services in assisted living facilities for residents that are Medicaid eligible. Facilities are reimbursed on a flat rate, per diem basis.