Small-scale assisted living programs have meaning. Some may have the designation adult foster care and others 
community residential group homes. Traditionally since around 1968 many of these have served the de-institutionalized mentally ill and developmentally disabled. Today we have tons of them serving the medically fragile elderly including those with dementia and the younger catastrophically injured.
The advantages of these programs are many. For one they are smaller, often 6-12 beds and as a result are less overwhelming. For two, (2) many subscribe to a consistent system of staff development that allows them to render a more focused level of care. Click here for an example of quality training available for smaller assisted living programs.
Of even greater importance for many these programs are less expensive. Compare the now under development Green Oaks Assisted Living Care Center being developed in Jacksonville, Florida which will serve residents from $2950.00 to $4500.00 per month to nursing home care at an average of $300.00 per day and larger assisted living not far under that.
What these smaller programs must be sure and accomplish is the development of systems that help to monitor chronic conditions. This does not mean that the bedridden or those using ventilators should be in these small programs. However, those using nebulizers are as well as fragile diabetics and quadriplegics. At time of discharge hospitals often know these programs are the preference of many, including disabled veterans, for reasons of cost and the likelihood of more person-centered care.
Staff development has to include in-service training on managing these situations in an effort to keep a resident as medically stable as possible within their own community. Of course this has to be done without trampling on regulatory statutes that govern the operation of the home. Bottom-line is you need to show the more institutional providers of care that you can partner with them in a meaningful way to keep patients stable and well cared for in community settings. This demonstrates real clinical competence.
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