What is Assisted Living?
Residential Care Apartment Complex
For the purposes of this topic, "assisted
living" means a Residential Care Apartment
Complex or RCAC. It provides a combination of housing,
meals, and support services for people with long term care
needs. RCAC is defined in Ch.
50.034 of the Wisconsin Statutes. Detailed regulatory
requirements for RCACs are contained in the administrative
rule DHS 89.
Key features of RCAC assisted living include:
- A philosophy and procedures designed to
support resident independence and choice:
A written negotiated risk agreement.
Control and responsibility go hand in hand. Because this
model is built on the concept of resident autonomy, it also
includes a mechanism to ensure that residents accept responsibility
for risks inherent in the decisions that they make. That
mechanism is a written risk agreement that clearly identifies
potentially risky situations, spells out how the resident
wants that situation to be handled, and is signed by both
the resident and a provider representative.
- Residents control their personal space, schedule, and
- Residents participate in the needs assessment and service
- Residents control decisions about the services received
and have a right to make what others might consider to
A home-like, non-institutional environment
where the units are recognized as private residences and
have all the features of a studio (or larger) apartment
kitchenette, private bath, living and sleeping area.
The service needs of the residents
are determined through a comprehensive assessment and an
ongoing care management process to monitor, reassess,
and adjust services as necessary, with a goal of providing
an opportunity for residents to age in place.
A broad range of services is available
either directly from or arranged by the RCAC. Typically,
these would include housekeeping, laundry, meals, social
activities, personal care, health assessment and medication
administration. Other types of nursing care may also be
Services are provided on an as needed
basis and are available to meet unscheduled care
The standard to which RCACs are held
is that it meets the needs of the individual residents.
This provides a great deal of flexibility and at the same
time puts a responsibility on the owner to develop policies
and procedures and a staffing plan to ensure that resident
needs are identified and met.
Affordable Assisted Living
Broadly, creating affordable assisted living means reducing housing costs and accessing the Medicaid
program to pay for services. To be affordable in this context,
a Residential Care Apartment Complex (RCAC) in Wisconsin would
need to offer rates as follows:
Service charges that can be
paid with the funding available from the Medicaid
Service charges should reflect the resident's level of
Housing and food charges at
a level that Medicaid Waiver recipients can pay out-of-pocket. Rents for housing must comply with the income
and rent requirements of any housing finance program(s)
used to reduce the cost of shelter in the RCAC.
Many people who are not financially eligible for Medicaid
still cannot afford to pay for care in a typical Wisconsin
RCAC. Moderately priced RCACs, affordable to people
with incomes under $25,000, are much needed. Much of the information
on this site is also useful and applicable to RCACs serving
residents at a variety of income levels.