Admission and Continued-Stay Criteria for Assisted Living Facilities


  • This article was made possible by a grant from the Rhode Island Health Care Association.

Address correspondence to David R. Gifford, MD, MPH, Rhode Island Quality Partners, 235 Promenade St. Suite 500, Box 18, Providence, RI 02908. E-mail:


As residents in assisted living facilities (ALFs) try to “age in place” but decline in health, the facilities, families, and residents must find a balance between protecting the health and safety of residents in ALFs and maintaining their desire to live independently. The assisted living industry incorporates resident autonomy into its goals, but with regard to resident health and safety, recent reports have found that ALF staff are struggling to provide adequate care for residents with increasingly complex needs. Moreover, state regulations are not consistent in obligating ALFs to prioritize adequate health care and protection for residents over resident autonomy, or vice versa. A set of admission and continued stay criteria for individuals residing in assisted living that could serve as a guideline for state regulations in addressing the balance between safety and autonomy in ALFs is recommended.