"Excellence in Wisconsin Assisted Living
Through Internal Quality Improvement"
 

Assisted Living in Wisconsin

The past 20 years have seen a dramatic shift in residential long term care, as medically frail older adults with complex health conditions who previously received care in nursing homes and hospitals are now residing in Assisted Living Communities (ALCs). In 2003, Wisconsin had 43,052 nursing home resident beds compared to 30,411 Assisted Living resident beds. By 2015, nursing home resident beds decreased by approximately 8,600 (total = 34,463 beds) versus an increase in Assisted Living resident beds of 23,972 (total=54,383 beds) (Johnson, 2016). As the number of individuals living in ALCs increases so does the need to provide, ensure, and improve quality in these communities.

Unlike nursing homes, ALCs do not have federal regulations and oversight. The Wisconsin Bureau of Assisted Living (BAL) encourages ALCs regulated by BAL to formalize an internal Quality Assurance (QA) and Quality Improvement (QI) program.

Similar to nursing home facilities, ALCs offer a range of services, from home-like settings with minimal care to multiple skilled services. The minimum age requirement for residing in an ALC is 18 years. The state of Wisconsin has 3 types of residential ALCs that are licensed by the Wisconsin Department of Health Services Department of Quality Assurance:

  1. Adult Family Home (AFH): 3-4 bed residential home, where adults who are not related to the operator reside and receive care, they provide treatment or services above the level of room and board and may include up to seven hours per week of nursing care per resident.
  2. Community Based Residential Facility (CBRF): 5-257 bed residential home, where five or more unrelated people live together in a community setting. CBRFs provide services to people of advanced age, persons with dementia, developmental disabilities, mental health problems, physical disabilities, traumatic brain injury, AIDS, Alcohol and Other Drug Abuse, correctional clients, pregnant women needing counseling and/or the terminally ill.
  3. Residential Care Apartment Complex (RCAC): 5-109 individual apartments, where five or more adults reside in an independent apartment complex (sometimes referred to as independent living). Apartments must each have a lockable entrance and exit; a kitchen, including a stove (or microwave oven); and individual bathroom, sleeping and living areas.

For further information and consumer assistance about Assisted Living in Wisconsin please contact The State of Wisconsin Board on Aging and Long Term Care. The state of Wisconsin Department of Health Services has a great deal of information about ALCs and Finding and Choosing an Assisted Living Facility.

Background

  • Wisconsin has a rich history of community based programs, including licensure of the first Community Based Residential Facility (CBRF) in 1979. As a public funding agency, the Department of Health Services (DHS) has honored consumer choice providing supports for people to live in the least restrictive, most integrated setting possible. Beginning with the enactment of the Community Option Program (COP) in 1981 and through the creation of Family Care in 1999, Wisconsin has been a national leader in relocation efforts from institutions to community settings.
  • In 1980 Wisconsin ranked 2nd nationally in the number of nursing homes beds per capita with 87 nursing home beds per 1,000 residents 65 years of age and over. Thirty years later that ranking moved to 20th nationally with 46 nursing home beds per 1,000 residents 65 years of age and over, an increase of 47%. In 2008 Wisconsin Assisted Living beds surpassed nursing home beds with the gap widening each year since.
  • Since 1979 Assisted Living licensed beds have increased 34 consecutive years while the regulatory agency resources has not kept up with the increasing workload.
  • Wisconsin’s innovative regulatory approaches have improved overall quality in Assisted Living while also receiving national recognition.
  • Wisconsin has four strong Assisted Living provider associations supporting their members to improve the care and services they provide to the residents/tenants in their communities.
  • Wisconsin’s ombudsman program is a national leader with committed resources to the advocacy of residents in Assisted Living Communities (ALCs).