Rochester Senior AdvisorWho helps residents with medications in a New York adult home?
In an adult home or enriched housing program, trained staff may assist residents with self-administration of medications, which means reminding, opening containers and observing, but administering medications outright requires a licensed nurse or a licensed home care agency.
That distinction explains why so many Rochester-area residences have a home care agency on site or an affiliated one: the agency supplies the nurses and aides who can do what adult home staff may not. Several residences in our directory appear on the state roster twice, once as the residence and once as a licensed home care services agency.
Can a nurse give insulin or other injections in assisted living?
Yes, a registered or licensed practical nurse from the residence's licensed home care agency or an outside agency may give injections and other skilled treatments, but adult home aides may not.
Ask who would give a parent's insulin on weekends and overnight, and whether that nurse is employed by the residence or by an agency that bills separately. Skilled care ordered by a doctor may be billed to Medicare as home health; routine daily injections usually are not.
Can Medicare home health and hospice serve assisted living residents?
Yes; Medicare's home health benefit can send nurses and therapists to an assisted living apartment after an illness or hospital stay, and Medicare's hospice benefit can serve a resident at the end of life, both from Medicare-certified agencies.
The Department of Health's roster shows 3 certified home health agencies, 44 licensed home care services agencies and 5 hospice licenses with office addresses in the five counties; agencies based elsewhere also serve the area, so ask each one about its service area. The residence still provides the room, meals and personal care; Medicare covers only the skilled or hospice services.
How do enhanced assisted living residences handle heavier care?
An EALR must arrange the nursing oversight and aide time its enhanced residents need, usually through an affiliated licensed home care services agency, and must update each resident's individualized service plan as needs change.
The test is not the building's marketing but whether the service plan, written after a nursing assessment, says what will be done and by whom. Ask to see a sample service plan with personal details removed before you sign anything.
What happens at a New York residence when a resident goes to the hospital?
The residence must hold the resident's room under the terms of the residency agreement and readmit the resident on return if their needs still fall within its license and certification; if they do not, the residence must give written notice and help plan a transfer.
Hospital discharge planners at Strong, Highland, Rochester General and Unity see this often. Ask the residence before admission what its bed-hold policy costs and how it decides whether a returning resident can come back.
At a glance
| Adult home staff may | Adult home staff may not | |
|---|---|---|
| Medications | Assist with self-administration | Administer injections or IV drugs |
| Nursing | Arrange a licensed agency or nurse | Act as nurses without a license |
| Medicare | Host Medicare home health and hospice | Bill Medicare for room and board |
| Plans | Keep an individualized service plan | Change care without updating it |
Sources include the N.Y. Social Services Law and Public Health Law, 18 NYCRR Parts 487-494, 10 NYCRR Parts 415 and 1001, Department of Health GIS messages, CMS, the VA and CareScout, as cited above; see our editorial standards.
