Assisted Living Facility
Dear Management Doctor:
I need a good definition of an assisted living facility. My County Commissioners want a definition that includes services but excludes individual kitchen facilities. I am trying to develop a definition of what it is instead of what it is not. If you have a good definition, I would love to see it!
Vicki S. Taylor Lee, AICP
I'm no longer a zoning specialist, but hopefully some of my readers are and can help you. Your question makes my management point — in a contemporary organization the employees know more than the manager.
The Management Doctor
I’ve always wanted to play the zoning geek, so I’ll take this one.
A really great resource for standardized definitions was the former SICS (Standard Industrial Classification System). NAFTA effected a change in this system to the NAICS (North American Industry Classification System). This resource tries to standardize land use classifications across the US, Canada and Mexico. Even if the exact land use you seek isn’t listed here, the standardized approach to defining uses will prove helpful.
The link is: www.census.gov/epcd/www/naics.html
From the front page, click the “NAICS 2002” link; on this page, select one of the tables and you’ll be able to find your way from there. I selected Table 3, group 62 (Health Care and Social Assistance), then group 623 (Nursing and Residential Care Facilities). You can shop for something that either fits your needs or allows you to cobble a definition for your purpose. I found this to be a tremendous resource.
Kevin G. Buchheit, AICP
As a footnote to Kevin Buchheit's answer, the SICS code (now NAICS) is indeed a good resource, but planners should use it with caution. The system is designed to classify business operations for purposes of economic reporting. It is not designed to classify them according to land-use impacts and generally does not take the scale of the operation into consideration. The City of Lakeland's zoning code uses SICS to classify industrial uses and we run into this problem frequently.
Bruce Kistler, AICP
A definition can be found in almost any community's zoning ordinance. However, I would recommend you actually visit a couple assisted living facilities to get a first-hand sense of what they are like and how they operate. They are quite different than a nursing home. You will want to make sure your definition does not exclude key functions of a typical facility.
Best of luck.
David A. Evancoe, AICP
We crossed this bridge a few years ago, and decided to leave our definition broad. These uses are "conditional" in about 75% of the zones they were added to (mostly higher density residential), and "permitted" by right in the other 25% (mostly commercial).
Let me know if you desire any additional information.
Having good definitions is always a good idea. But don't discount having the definition include "what it's not." In my experience this has often worked better, especially when used in combination with "what it is." It helps eliminate wiggle room or debate — if that's what your Commissioner's are after.
Here’s our definition of “assisted living” that was written by staff with assistance from a minister who worked at one:
Assisted Living — A living arrangement characterized by a residential setting in combination with personal custodial care assistance designed to respond to the individual needs of those who need help with the activities of daily living, but who do not require 24-hour nursing care. Services provided may include personal care assistance, meals, laundry, medication reminders, and similar services. Assisted living facilities do not provide extensive medical care or a program of rehabilitative services to their residents.
Robert Atallo, AICP
We use the term "supervised living facility" to mean the same as assisted living. See if it suits your needs:
A residential facility of three or more dwelling units providing living quarters restricted to individuals who require access to services but not daily nursing or medical intervention. Incidental uses and/or services may include protective supervision, personal care, social and recreational services, assistance with medical requirements, laundry and transportation service, private or common kitchens/dining facilities, as long as such services are provided to residents only.
Michelle Hardin, AICP
An assisted living center by definition includes individual kitchens or kitchenettes. Harvey Moskowitz's Green Book of Definitions (from APA), has some great definitions. Without an definition, Ms. Taylor is essentially trying to define either a type of SRO (single room occupancy) or "residential hotel." This latter use traditionally does not have kitchens in the rooms. They are also defined in Harvey's book.
I would recommend that Ms. Taylor ensure her Commission understands that there is a significant difference between an assisted living center and the use they are asking her to define. ALC's tend to have upscale residents, some may still own or operate vehicles (we've seen parking ratios from 1 space/3 units all the way up to 1.5 spaces/units. Practical experience shows that a 1 space/2 units or 1/3 units, and additional spaces for shift employees, work well. Residential hotels generally do not attract upscale residents, and are used in major metros as a stop gap between homeless shelters and independent living quarters (traditional apartments).
"Assisted Living Center" — means a residential complex with occupancy limited to ambulatory persons over the age of 55 capable of semi-independent living in which individuals or couples reside in an apartment with a kitchen or kitchenette, and are also able to participate in communal dining, organized activities, and other amenities offered as a part of the dwelling unit rent. Accessory uses within the complex may include recreation center, medical facility, swimming pools, tennis courts, spas, massage, craft rooms, and other indoor or outdoor recreation facilities, all of which are exclusively limited to the use of complex residents.
"Residential Hotel" — means a residential building with occupancy limited to persons over the age of 55 in which individuals or couples reside in an dwelling unit of one or more rooms which does not included kitchen facilities, and for whom meals are served in a communal dining setting. Residents may also participate in organized activities and other amenities offered as part of the dwelling unit services. Accessory uses within the complex may include recreation center, medical facility, swimming pools, tennis courts, spas, massage, craft rooms, and other indoor or outdoor recreation facilities, all of which are exclusively limited to the use of complex residents.
Hope this provides some value.
The City of Tacoma has been working on "Special Needs Housing" for the past year. Below is the definition that we have come up with as well as the contact person working on the special needs housing regulations:
Intermediate Care Facility — A facility that provides, on a regular basis, assistance with one or more activities of daily living, such as bathing, toileting, dressing, personal hygiene, mobility, transferring and eating, including persons with functional disabilities, needing health‑related care and services, but who do not require the degree of care and treatment that a hospital or extended care facility provides. Such facility requires a state boarding home license. This use includes assisted living facilities but does not include adult family homes, staffed residential homes, or residential care facilities for youth.
To the person from Georgia who asked about assisted living facilities — most state licensing agencies that deal with group homes and assisted living facilities have definitions to use, and many have to comply with the federal government's definition to get federal funds, or not incur a federal lawsuit. The State of Colorado, in its efforts to respond appropriately to federal mandates and local needs, has a good definition.