- Entering and Exiting from Assisted Living
- Complaint Investigation
- Health and Safety Standards
- Developing an Assisted Living Residence
- Registering an Assisted Living Residence
Entering and Exiting from Assisted Living
What happens if a resident who is cognitively well gets sick?
Residents may encounter episodes of decreased physical or mental functioning — e.g., while recovering from an injury, an acute illness or an exacerbation of a chronic illness. Operators may provide professional care to such residents on a short-term basis.
How do I get my mother assessed for eligibility for publicly subsidized assisted living?
Contact your local health unit in the regional health authority, and you will be referred to a case manager.
Does a person need to be assessed by a health authority case manager to be eligible for private-pay assisted living?
No. However, the assisted living operator, with professional input from a clinician (e.g., the resident’s family physician) does need to ensure that the person is able to function safely in the supportive semi-independent environment of the assisted living residence.
Complaint Investigation
Can I make a complaint anonymously?
Yes. If requested, the OALR will not reveal your identity to the assisted living operator. The OALR needs to know your name and contact information in order to get further information, if necessary, and to report on the outcome of the complaint.
Can an operator take action against a resident if a complaint is made to the OALR?
No. However, some people are concerned that if they make a complaint, this will happen. When investigating a complaint, the operator must ensure the resident’s health and safety and continue to provide services to the resident as outlined in the resident’s personal services plan.
What risks to resident health and safety might prompt the OALR to do a site inspection?
Some risks the OALR might identify include the operator having an overly medicalized model of service delivery; not understanding the service delivery model, philosophy or regulatory model for assisted living in B.C.; or housing people who are unable to make decisions on their own behalf. Risks can be identified when processing an application for registration or when investigating a complaint.
Who conducts the site inspection?
A peer reviewer accompanies OALR staff on the inspection.
Are inspections always announced?
The Community Care and Assisted Living Act permits the OALR to conduct an unannounced inspection. However, the OALR generally notifies the operator about the inspection in advance, in order to schedule a mutually convenient time. The OALR also advises the operator of the name of the peer reviewer to ensure no conflict of interest exists.
Health and Safety Standards
Are the Health and Safety Standards optional?
No. All operators of assisted living residences must meet the Health and Safety Standards [PDF 272 Kb]. However, there are various ways to meet each of the outcomes identified in the standards.
What type of 24-hour emergency response system must be in place?
Operators must establish an emergency response system that addresses the unique features of their building and location, and meets the needs of the resident population. An operator can adopt a combination of staffing, procedural and/or mechanical or electronic emergency call devices. The system must enable a resident to summon emergency assistance 24 hours a day. (See the Health and Safety Standards [PDF 272 Kb], Outcome 2.4.)
Must site managers have specific background or training?
No. However, site management must be effective and appropriate to the resident population. (See the Health and Safety Standards [PDF 272 Kb], Outcome 3.1.)
Are there staffing requirements in assisted living residences?
No. There are no specific staffing ratios in assisted living. However, operators must ensure that staffing levels are adequate for the setting, number and type of residents and personal assistance services offered. Operators must also ensure that all staff (employed or contracted) and volunteers have the necessary knowledge, skills, abilities and training to perform their designated tasks and meet the health and safety needs of the residents. (See the Health and Safety Standards [PDF 272 Kb], Outcomes 3.2 and 3.3.)
Are the staff who provide personal assistance services nurses?
No. Assisted living residences operate mainly with non-professional staff. This is in keeping with the assisted living philosophy, which is to deliver housing with supports rather than medical care. Staff who provide personal assistance services must have either a college-level home support/resident care aide certificate or an equivalent combination of education and experience. Operators must provide professional oversight of home support workers — i.e., by a registered nurse, registered psychiatric nurse or licensed practical nurse.(See Health and Safety Standards [PDF 272 Kb], Outcome 3.3.)
How do assisted living residents get professional care (nurse, doctor, physiotherapist, etc.)?
Assisted living residents have access to professional care just as they would if they lived independently in the community.
What constitutes a serious incident that must be reported to the OALR?
Serious incidents include attempted suicide by a resident; unexpected deaths reported to the coroner; disease outbreaks reported to the local medical health officer; abuse or neglect by staff reported to the appropriate local agency or the Office of the Public Guardian and Trustee; medication error by staff that requires emergency intervention or transfer to hospital; and fire that causes personal injury or building damage. (See Health and Safety Standards [PDF 272 Kb], Outcome 1.7.2.)
Must all assisted living residences be wheelchair-accessible?
No. However, if a residence is not wheelchair-accessible, the operator must advise prospective residents accordingly and not house people who need wheelchairs. If a resident begins to need a wheelchair, she or he would have to move to other accommodation where their disability could be safely accommodated.
Are the health and safety standards for publicly subsidized and private-pay assisted living the same?
Yes. The Health and Safety Standards are available here >
Developing an Assisted Living Residence
What is the difference between assisted living and supportive housing?
Assisted living goes beyond supportive housing by also providing personal assistance services such as assistance with bathing and dressing. Assisted living is often considered a substitute for intermediate care, formerly provided in long-term-care facilities. In British Columbia, assisted living residences are subject to a regulatory framework under the Community Care and Assisted Living Act, although they do not have to be licensed. Health and safety is not regulated in supportive housing environments.
Supportive housing offers accommodation and hospitality services such as meals, but the operator does not offer personal assistance (e.g., assistance with bathing or medications). Other terms used to describe supportive housing include congregate housing, retirement living and independent living.
Who can be housed in assisted living?
Assisted living is only for adults (people 19 years of age or older) and is designed to meet a range of needs. Seniors are by far the most common population in assisted living today; they may have mild cognitive impairments and/or some physical disabilities. Seniors’ assisted living residences may also provide services to younger adults with physical disabilities such as MS.
The Province of British Columbia is currently working on extending the assisted living regulatory model to residences for people with mental disorders and/or substance use disorders.
Read more about residences for people with mental disorders and/or substance use disorders >
Can people with significant dementia live in assisted living?
No. In the semi-independent supportive environment of assisted living, residents must be able to make decisions on their own behalf, unless a spouse is living with them and is willing and able to make decisions on their behalf.
Read more about dementia and cognitive impairments in assisted living >
What sorts of decisions do people need to be able to make in order to live safely in an assisted living residence?
Residents must be able to make decisions on their own behalf. This means, for example, that residents must be able to use the emergency response system and follow directions in an emergency. (See also Entering an Assisted Living Residence.) People who are not able to make the range of decisions necessary to live safely on their own pose too great a risk to themselves and potentially to others. Under the Community Care and Assisted Living Act, residences cannot house them unless a spouse lives with them in the residence. When a person can no longer live safely in assisted living, the operator must help them move to another level of care. (See also Exiting from an Assisted Living Residence.)
Registering an Assisted Living Residence
When should an application for registration of an assisted living residence be submitted?
The application should be submitted at least two months before the residence is anticipated to open.
Must a residence be registered before it opens and starts to operate?
Yes. A residence cannot begin to operate until the application to register is approved.
Whose responsibility is it to meet the application requirements?
The applicant’s. Applicants, not the Assisted Living Registrar, are responsible for following up with third parties such as local governments and fire departments to obtain supporting documents or other required information and approvals.
Must an application be complete (i.e., have all the required attachments) before it is submitted?
No. Applicants often have no control over when they receive information needed to complete the application (e.g., the occupancy permit). If something is not available at the time of application (e.g., the occupancy permit), the applicant should make a note on the application form or in a covering letter and forward the information when it becomes available.
NOTE: Applicants must submit all outstanding information, and the application must be approved, before the residence can begin to operate.
What constitutes a unit, for purposes of registration?
In order to determine how many units to register, count each unit regardless of how many people live in it. Even if two people live in one apartment, count it as one unit. This applies regardless of whether one or both people living together in an apartment are receiving assisted living services.
What happens after the application for registration is submitted?
The OALR acknowledges receipt of the application via email, identifies any missing information and asks the applicant to submit the information as soon as it becomes available.
Can one cheque cover both the application and registration fees?
No. Separate cheques must be submitted for the one-time $250 application fee and the registration fee. The application fee must be paid at the time of application. The registration fee can be paid when the application is approved or by separate cheque at the time of application.
What happens if the application fee is not included with the application?
If the application does not include the $250 application fee, the application will not be processed until payment is received.
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