Specifications include, but are not limited to: Component A: Adult Care Facilities Adult Care Facilities (“ACFs”) provide long-term residential care and services to adults who are unable to live independently. Three (3) types of ACFs, operated for the purpose of providing longterm residential care to five (5) or more adults including room, board, housekeeping and personal care, are regulated by the Department: • Adult Homes (“AH”): Provide three (3) congregate meals per day, case management, and supervision. • Enriched Housing Programs (“EHP”): Resemble independent housing units. • Residences for Adults (“RA”): Generally, facilities serving a population of primarily younger adults in need of an array of services including mental health services. The following additional programs may operate in adult homes or enriched housing programs: • Assisted Living Program The Assisted Living Program (“ALPs”) was established to serve Medicaid-eligible individuals who are medically eligible for nursing home placement but not in need of the highly structured medical environment of a nursing facility, and whose needs can be met in a less restrictive and lower cost residential setting. ALPs are responsible for providing residents with long-term residential care, room, board, housekeeping, personal care, supervision, and providing/arranging for home health services. ALPs are required to hold dual licenses/certification as: 1) an Adult Home or Enriched Housing Program, and 2) as a Licensed Home Care Services Agency (“LHCSA”), Long Term Home Health Care Program (“LTHHCP”), or Certified Home Health Care Agency (“CHHA”). If the 6 ALP is licensed as a LHCSA, it must contract with a CHHA for the provision of skilled services (nursing, therapies) to ALP residents. • Assisted Living Residences Assisted Living Residences (“ALRs”) provide or arrange for housing, twenty-four hour on-site monitoring and personal care services, and/or home care services (either directly or indirectly) in a home-like setting to five (5) or more adult residents. ALRs must also provide daily food service, case management services, and an individualized service plan. To operate as an ALR, an operator must also be licensed as an Adult Home or Enriched Housing Program. Additional certifications are available to ALRs: o Enhanced Assisted Living Residence (“EALR”): Authorized to provide for “aging in place”; and o Special Needs Assisted Living Residence (“SNALR”): Allows an operator to advertise/market as serving individuals with special needs (e.g., dementia, cognitive impairments). o Respite: Respite is the provision of temporary residential care for adults in an adult care facility on behalf of or in the absence of the caregiver for up to 120 days in any 12-month period. Component B: Licensed Home Care Services Agencies A Licensed Home Care Services Agency (“LHCSA”) provides home care services, including nursing, home health aide and/or personal care services, and may provide other home care services such as physical therapy, occupational therapy, speech/language pathology, nutrition, social work, respiratory therapy, medical supplies, equipment, and appliances. LHCSAs offer home care services to clients who pay privately or have private insurance coverage. These agencies may also contract to provide services to Medicare/Medicaid beneficiaries whose cases are managed by another provider or entity, including managed care plans, managed long-term care plans, hospices, and certified home health agencies. LHCSAs may also be approved to operate Home Health Aide or Personal Care Aide Training Programs, providing instruction to and certification of these titles. Component C: Nursing Homes Nursing homes provide twenty-four-hour nursing care and supervision outside of an inpatient hospital setting. All nursing homes must provide certain basic services, and some nursing homes provide special care for certain types of patients. Although most nursing home residents are age 65 and over, these facilities are increasingly being used to care for younger individuals who require a nursing home level of care that may not be available elsewhere. Nursing homes now care for individuals with aggressive or threatening behaviors, HIV/AIDS, substance abuse problems, conditions that require the use of a ventilator, traumatic brain injuries (“TBI”), neuro degenerative disorders and other conditions. In addition, most nursing homes provide some level of short-term rehabilitation services for individuals who have recently had surgery in a hospital or have experienced a health episode that requires rehabilitation within a 21-day timeframe. Some facilities have implemented specialized programs and units to address specific populations; and currently seven (7) facilities in New York State provide services to pediatric individuals aged 21 and under.
