Did you know? Arkansas is different than most states in that there are two designated "levels" of assisted living, each with its own regulations. Basically, Level I communities are for more independent residents and Level II communities are for residents who need intermediate nursing care. Let's take a look at what assisted living looks like in Arkansas and the differences between the two levels of care.
Level I and Level II: Similarities and Differences
Both Level I and Level II assisted living provide meals, housekeeping, transportation, laundry, and activities.
The biggest difference between the two levels is that Level II communities offer nursing services and a registered nurse is on staff or contract. Therefore, only Level II communities are eligible for residents to apply for the Medicaid waiver program.
Level I communities are almost always private pay. There are strict requirements for eligibility for the federal/state Medicaid waiver program, including financial eligibility requirements. The resident must require intermediate nursing care which is defined as:
- The individual is unable to perform either of the following:
A. At least one of the three activities of daily living (ADL) of transferring/locomotion, eating or toileting without extensive assistance from or total dependence upon another person; or
B. At least two of the three activities of daily living (ADL) of transferring/locomotion, eating or toileting without limited assistance from another person; or,
- The individual has a primary or secondary diagnosis of Alzheimer’s disease or related dementia and is cognitively impaired so as to require substantial supervision from another individual because he or she engages in inappropriate behaviors which pose serious health or safety hazards to himself or others.
On the other hand, Level I residents are mentally and physically more independent. They must be able to feed and use the restroom themselves. Perhaps they have some arthritis or a condition that makes dressing or bathing challenging, so Level I includes staff that can help with these activities.
Or perhaps the resident is becoming forgetful about medications, such as not taking them at the right time. Staff working in a Level I community are able provide assistance that enables residents to self-administer medications. However, in Level II facilities, licensed nursing personnel may actually administer medication.
Some Level I residents still have their own car and can drive themselves places, however, most prefer staff drive them to their appointments in the community van or car. Some of our residents prefer to do their own laundry as well. It’s all up to their preferences and abilities.
A Home—Not a Nursing Home
Assisted living is a relatively new concept, starting back in the late 1980s. Before that, a family member would take care of their parents as long as they could, and then it was pretty much “off to the nursing home.” Today, it is more common for both spouses to be working, and there is seldom the family structure in place for an aging parent to live with their adult children. When we speak at senior events or just out in the community using the term "assisted living," we still run into people quite often who say, “Oh, I don’t need a nursing home.”
Rest assured. Assisted Living Level I is definitely not a nursing home. Assisted Living residents are much more mobile, independent, and engaged in community activities and events, and they enjoy the comforts of apartment-style living with their own furniture and pets!
We would love the privilege of answering any questions you may have regarding your or your loved one’s needs, and we will help you find choices that work for you—choices everyone can feel great about and look forward to.