Assisted Living and Personal Care in PA: There is a Difference

In Pennsylvania, Assisted Living and Personal Care were essentially synonymous, interchangeable terms for many years. However, most facilities referred to themselves as “assisted living” rather than a “personal care home” because it sounded more pleasant and inviting. But if pressed to see their provider license, every single site would have donned a Personal Care Home certificate.

That all changed in January 2011 when the Intra-Governmental Council on Long-Term Care enacted PA Senate Bill 704 which established and began to license Assisted Living Residences (ALR) as a separate form of long-term care statewide. Despite this major change, which occurred over four years ago, most consumers and many healthcare professionals still don’t realize or understand there’s a difference.

So why the change? 

First, the state felt it needed to do better job of balancing public funding of institutional care with home and community programs for PA’s seniors. Secondly, they wanted to provide more alternatives to nursing homes for those unable to live independently at home, but not requiring round-the-clock nursing care. Preliminary findings also stated that ALR would cost between one-half and two-thirds of the cost of daily nursing care. Lastly, the bill was “supposed” to be a starting point to help shift Medicaid (Medical Assistance) dollars towards assisted living and away from nursing homes, and therefore reduce the reliance on the much more expensive alternative.

Essentially, assisted living was created to bridge the gap in care between personal care homes and nursing homes, but in a lower cost setting that could allow residents to “age in place” for a longer period of time.

Though Assisted Living Residences provide similar care to Personal Care Homes, they have the capability to care for people who require heavier and/or medical care. Personal care home regulations maintain certain limits on care and revolve primarily around custodial needs. According to the Office of Long-Term Living, Assisted Living Residences are different from a Personal Care Home in 3 ways: concept, construction and level of care. Click here for details.

The Current Outlook

The introduction of ALR in PA as a cheaper alternative to nursing homes that will allow seniors to delay or avoid a move to nursing facility in essence is great. However, the reality is a bit disappointing, at least presently. As of January 2015, there were only 33 licensed Assisted Living Residences spanning just 19 counties as compared to 1,200+ Personal Care Homes in just about every county.

Time will tell whether the growth and viability of assisted living will work in congruence with personal care homes and nursing homes in Pennsylvania. The jury is still out on ALR, but ultimately (in theory) it’s a better option for seniors, and I think it needs to replace its predecessor to become sustainable on a long-term basis. However, there are just too many what-ifs presently, especially due to zero reimbursement through Medicaid, despite the initial legislation.

For more information visit the Pennsylvania Department of Aging website. 

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