Assisted Living in California

California is consistently touted as one of the best place in the world weather-wise. It is consistently sunny in much of the state. Additionally, there is no tax on groceries nor prescription medications – two of the largest expenditures seniors typically have. For this and other reasons, it’s no surprise that many seniors have this state at the top of their list of places for retirement and senior living. California’s elderly population is set to grow substantially, and many of these seniors lived on fixed, limited incomes and need advice in qualifying for and locating affordable housing.

Directory of Assisted Living Facilities in California

Choosing the right assisted living facility for yourself or a loved one is one of the most important decisions you will need to make as a senior, and so thorough and detailed research of potential facilities is critical. We have compiled a comprehensive directory of assisted living facilities in California, and reviewing this directory is a great way to jumpstart the research process. Use the tool below to review information about amenities, size of the facility, pricing, health insurance, and more.

Paying For Assisted Living in California

The Cost of Assisted Living in California

The monthly median cost of assisted living in California is $4,500, which is above the national average of $4,000. According to Genworth’s 2018 Cost of Care Survey, assisted living in California is more expensive than two out of its three neighboring states:

 

California is the third largest state in the US and has a large number of different metropolitan areas. Average costs significantly across the different regions of the state. The average monthly cost in the Napa region, otherwise known as “Wine Country,” is on the high end, while Bakersfield averages the cheapest. Below is a breakdown of all the median costs in other areas of the state:

 

In California, the state median cost of assisted living is less expensive than most other types of long-term care except adult day health care and independent living. It’s considerably cheaper than nursing home care, in particular, and a few hundred dollars cheaper than in-home care:

Financial Assistance for Assisted Living in California

The Assisted Living Waiver

Medi-Cal is California’s combined federal and state program designed to help pay for medical care for public assistance recipients and other low-income persons. Medi-Cal does not cover the full cost of assisted living directly, but the program does offer a waiver to cover long-term care services for seniors who are nursing-home eligible, but could have their health and personal needs met in an assisted living facility. Seniors must also meet certain financial requirements in order to be eligible for the Assisted Living Waiver.

A Medi-Cal social worker can draft a personalized care plan for you or your loved one to outline the appropriate services your or they will need. Below is a list of all the available services and supports included in the scope of the waiver:

• Assistance with activities of daily living, including bathing, grooming and toileting
• Assistance with logistical activities of daily living, including medication administration and transportation
• Health-related services, including skilled nursing care, if needed
• Recreational and social activities
• Prepared meals
• Laundry and housekeeping
• Nursing home transition care, if needed

Who is Eligible?

Seniors older than 65 years of age with an income 138% of the poverty level ($16,395 for an individual and $22,108 for a couple) can receive Medi-Cal benefits. To qualify for the Assisted Living Waiver under Medi-Cal, California residents must meet the following eligibility criteria:

• Have Medi-Cal eligibility with zero share of cost;
• Have health and personal care needs that are the equivalent of the needs of Medi-Cal-funded residents living and receiving care in nursing facilities;
• Willing and able to safely live in an assisted living setting as an alternative to a nursing facility.

Share of cost is essentially an arrangement for seniors whose income is too high to qualify for Medi-Cal benefits, but too low to afford their health care expenses. Share of cost requires people to spend a certain amount of their income on health care before Medi-Cal provides coverage. As noted, Californians approved for Medi-Cal through the share of cost arrangement are not eligible for the Assisted Living Waiver.

Of note, not all counties in California have assisted living settings covered under the waiver. To receive covered services under the waiver, seniors must be willing to live in one of the following counties:

• Alameda
• Contra Costa
• Fresno
• Kern
• Los Angeles
• Orange
• Riverside
• Sacramento
• San Bernardino
• San Diego
• San Francisco
• San Joaquin
• San Mateo
• Santa Clara
• Sonoma

How to Apply

To apply for Medi-Cal coverage and to discuss the Assisted Living Waiver, you will need to contact your local county office. Additionally, Area Agencies on Aging are a good place to start the application process. Your local Agency may be able to help you craft a more comprehensive and detailed picture of your retirement.

More Ways to Finance Assisted Living

Some additional ways to finance assisted living costs include:

• Veterans Benefits: Veterans can take advantage of several different pension programs to help cover the cost of assisted living. For more information, see the article on benefits.va.gov.

• Life Insurance Policies: Even if a spouse or loved one hasn’t died, certain types of life insurance policies can be used to pay for assisted living. More information is available at longtermcare.acl.gov

• Long-Term Care Insurance: Long-term care insurance is a type of insurance policy that pays for long-term care when it becomes necessary, including the cost of assisted living. For more information on the benefits and drawbacks of this financing method, visit longtermcare.acl.gov.

• Reverse Mortgages: Reverse mortgages allow seniors to access the equity from a home that they own, and these funds can be used to pay for assisted living. The U.S. Department of Housing and Urban Development offers a federally insured reverse mortgage program.

Free Assisted Living Resources in California

Nonprofit and governmental organizations found across California may offer free assistance for the seniors and their loved ones in the process of seeking information about long-term care options. These organizations are a great place to start in understanding your rights and options.

Long-Term Care Ombudsman Program

As is the case in many states, California maintains a Long-Term Care Ombudsman program. The Ombudsman is tasked with:

• Providing education for communities, residents and families on the rights of residence and issues of service and care
• Investigating and following up on complaints made by community residents and ensuring all their rights are being upheld
• Advocating for residents and their loved ones while also empowering them to advocate for themselves

Area Agencies on Aging

Area Agencies on Aging (AAA) is a network of hundreds of nonprofit organizations across California and all of America that provide federally funded services to adults over 60 in their respective local areas.

California has many Area Agencies on Aging that offer comprehensive information on various kinds of programs and community supports for seniors.

Veterans Affairs

California, like the majority of states, has VA centers to help veterans and their spouses understand their financing options for various kinds of care. These offices can provide guidance on your eligibility and direct you to the best support options for you. Below is a list of the VA offices in California:

Social Security Offices

California’s Social Security offices offer another great resource for seniors looking for assistance. In reaching out to or visiting a Social Security Office, you and your loved one can get a better picture of your social security benefits and what you may be able to put toward assisted living expenses. Of note, Social Security income is not taxable in this state. Below is a list of Social Security Offices in California.

Assisted Living Laws and Regulations in California

Assisted Living Service Plans

Before developing a service plan, assisted living facilities are required to complete a pre-admission appraisal of the prospective resident. The pre-admission appraisal reviews the following:

• Functional capacity, which is measured by the ability to perform activities of daily living
• Mental condition and social factors
• A physician-conducted medical evaluation that documents medical diagnoses, current health status, any medication and treatments currently used by the resident and any prescribed diet

In California, a written service plan must be developed between the resident, the resident’s representative (if applicable) and the administrator or manager.

The plan must include:

• a description of the resident’s medical conditions, including any physical, cognitive or behavioral impairments.
• the level and scope of services the resident receives.
• the type of services and how often the resident receives them.

Service plans must be updated whenever the resident experiences a significant change in health status to ensure services provided continue to meet his or her needs.

Assisted Living Admission Requirements

Assisted living communities in California cannot accept any resident who requires any of the following services:

• Access to 24-hour skilled nursing care
• Care for Stage III and IV dermal ulcers (open sores)
• Care related to gastrostomies, nasogastric tubes or tracheostomies
• Treatment for a staph infection or any other serious infection
• Assistance with ALL activities of daily living
• Assistance because they are bedridden
• Ongoing care for a communicable disease
• Care for mental disorder that causes ongoing behaviors that could be upsetting or disruptive for other residents

Residents must be able to direct their own care and may be admitted if they have a licensed third party help them with certain health conditions, such as administering oxygen, catheter care, diabetes complications, dementia or incontinence.

Assisted Living Scope of Care

Beyond room and board, there are two types of services provided at assisted living communities in California: basic services and care and supervision services. Basic services encompasses:

• Personal assistance and care
• Observation and supervision
• Planned activities
• Arrangement for obtaining incidental medical and dental care

Meanwhile, care and supervision encompasses the following services:

Assistance with activities of daily living, such as dressing, bathing, other personal hygiene needs, assistance with self-administering medications and monitoring food intake or adherence to a specialized diet.

Assisted living communities in California are required to define the scope of services it provides to residents in writing. For any assisted living community your may be considering, it’s important for you to review the scope of care and services you or your loved one requires to make sure they are able to meet your needs.

Assisted Living Medicaid Policy

Residents may find help with cost coverage through an Assisted Living Waiver available California’s Medicaid program, known as Medi-Cal. The Medicaid waiver can cover medical and care related services for California seniors who live in an assisted living community, but it does not cover expenses for room & board.

Assisted Living Facility Requirements

Assisted living communities in California are not required to provide private apartments for seniors. Arizona may provide residences that are apartment-style or bedrooms which offer single- or double-occupancy. Every unit is required to have one toilet for every 6 residents with a shower or tub for every 10 residents. For seniors who have the Assisted Living Facility Waiver, requirements include private occupancy, with shared occupancy only by residents’ choice, and units must have a refrigerator and cooking appliance.

Medication Management Regulations

Residents may administer their own medication as long as a doctor deems them mentally and physically able to do so. Staff that assist with medication self-administration have to complete coursework, pass an examination and complete hours of training depending on how many residents live in the facility. A nurse, pharmacist or physician must oversee the training and examination.

Staffing Requirements

All assisted living facilities in California must have a licensed administrator and a designee to be available when the administrator is not present. Licensed nurses or appropriately skilled professionals can be hired to provide medication administration or incidental medical services.

With respect to ratios, staffing requirements vary based on how many resident reside in a given facility. For 16 residents or less, there must be staff available in the facility. For 16-100 residents, one staff member must be awake. For 101-200 residents, one staff member must be awake with another on call. An additional wake staff is needed for each additional 100 residents.

Staff Training Requirements

Administrators in assisted living facilities must complete 40 hours of continuing education every 2 years – with at least 8 of those hours being for Alzheimer’s and dementia care training. All personnel at the facility must be trained on the job or have experience in housekeeping and sanitation procedures or skills and knowledge needed to provide care and supervision for residents – which includes safely assisting with prescribed medications and recognizing the early signs of illness. All staff that assist residents directly with activities of daily living must receive at least 10 hours of initial training within the first month of employment and at least 4 additional hours each year.

Background Checks for Assisted Living

A criminal background check, including fingerprint clearance, must be performed on all administrative staff, direct care staff and employees that have frequent contact with the residents. This must be completed prior to the first day of work. Privately paid personal assistants hired by residents must also undergo this background check.

Requirements for Reporting Abuse

There is an online complaint form available through California’s Bureau of Medi-Cal Fraud and Elder Abuse to conveniently and anonymously register concerns about a community.

California COVID-19 Rules for Assisted Living Facilities

Note: The following information was compiled and most recently updated on 2/22/22. Since COVID-19 is a rapidly evolving crisis, be sure to contact your assisted living facility or local Area Agency on Aging for the most up-to-date information.

COVID-19 Rules in California
Are loved ones allowed to visit residents in their assisted living community?	Yes (Conditions Apply)
Are residents required to quarantine after their loved ones visit?	No (Conditions Apply
Are loved ones required to wear masks when visiting residents?	Yes
Are Hairdressers and other non-medical contractors allowed in assisted living communities?	Yes (Conditions Apply
Are visitors screened for elevated temperatures before entering the assisted living community?	Yes
Are residents allowed to leave the assisted living community for non-medical reasons?	Yes
Are residents who leave required to quarantine when they get back to the assisted living community?	No (Conditions Apply)
Are assisted living communities required to cancel all group outings?	Not Available*
Are assisted living communities allowed to host group activities within the community?	Yes (Conditions Apply)
Are staff members regularly checked for elevated temperatures?	Yes
Are staff members regularly tested for COVID-19?	Yes
Are residents regularly screened for COVID-19 symptoms?	Yes
Are residents regularly checked for elevated temperatures?	Yes
Are residents regularly tested for COVID-19?	Yes (Conditions Apply)

 

Sources: www.cdph.ca.gov caassistedliving.org

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.