Are Nurses Required in Assisted Living?

NurseA frequent concern for someone considering assisted living is whether there is adequate nursing or medical monitoring and assistance. In order to promote a healthy independence for its residents, assisted living communities often provide residents with numerous coordinated services including health services. Many residents choose assisted living because they can no longer manage tasks like properly taking their blood pressure readings, diabetic testing or medications. Consumers in need of medical assistance like medication management need to be aware of the fact that health services offered in assisted living environments vary by state.

Because the acute needs of assisted living residents have increased over the last decade most advocacy groups feel that a facility should indeed have a nurse on staff, however, this is not a requirement in many regions.

Currently, assisted living is state-regulated and has no single uniform set of regulations. However, all states and communities do recognize and follow certain specific designations. These designations or service provisions include a 24-hour awake staff member, meals, personal and supportive services, social services, housekeeping including laundry, transportation and recreation.

Assisted living communities also provide health services such as medication management but that does not necessarily mean they provide a 24-hour nurse on duty. Some states require a round-the-clock nurse be available while some states still do not require a nursing staff at all.

When evaluating a community, always ask specific questions pertaining to the available nursing supervision offered and how qualified the staff is that will be administering medications. Certain states simply require that pharmacists or licensed nurses manage medications.  This means they can delegate the task of dispensing medications to unlicensed staff who have completed a minimal eight-hour state approved course. There are many concerns that each manipulation of a medication, especially by a non-nurse, doctor or pharmacist, creates an opportunity for potentially dangerous errors to occur even when setup is done with the best intentions.

Because of this and other health concerns the national nonprofit consumer-based organization the Consumer Consortium on Assisted Living or CCAL, recommends that all communities, regardless of size, have at least a nurse on call 24-hours a day, whether the state requires it or not.

Knowing your state’s nursing requirements for assisted living homes is imperative. A little education can help to ensure your loved one’s health and safety. The National Center for Assisted Living has posted “Assisted Living State Regulatory Review for 2008″ on its web site at This invaluable review supplies information on how each state regulates assisted living facilities and lists important phone numbers and contact information for each state.

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