Adult Residential Care Homes (ARCH)
The State of Hawaii Department of Health, Office of Health Care Assurance, licenses two residential care settings: assisted living facilities (ALFs) and adult residential care homes (ARCHs). Type I ARCHs are licensed for five or fewer residents and Type II for six or more residents. In addition, the state has provisions for licensure of expanded adult residential care homes (E-ARCHs) that provide professional health services similar to those provided by nursing facilities.
Adult Residential Care Home Definition
a facility providing 24-hour living accommodations to adults, unrelated to the provider, who require at least minimal assistance in activities of daily living (ADLs). E-ARCH are licensed to serve a limited number of residents who need an intermediate level of nursing facility care.
es must have a written agreement that explains the resident’s rights, the provider’s responsibilities, and services to be provided based on the resident’s care plan.
Admission and Retention Policy
Adult residential care homes are for individuals who need assistance with personal care below an intermediate level of nursing facility care. Homes must develop admission and discharge policies and procedures. E-ARCHs may admit individuals who meet nursing facility level of care criteria as determined and certified by a physician or an advanced practice registered nurse (RN). No more than 20 percent of residents in Type II E-ARCHs may need a nursing facility level of care, though exceptions are possible.
Adult residential care homes provide personal care services, medication services, assistance with self-administration of medications, laundry and housekeeping, transportation to health care appointments, supervision, and social activities. E-ARCHs provide additional health-related services needed by residents who meet nursing facility level of care criteria; the facility must make arrangements for such residents to visit a medical doctor every 4 months for a medical evaluation.
Adult residential care homes must conduct a comprehensive assessment of each resident’s needs and develop a schedule of activities that describes the services to be provided. For E-ARCHs, a care plan is developed by the resident’s case management agency and–at a minimum.
Third Party Providers
Residents who require therapeutic services prescribed by a physician may receive these services provided by an outside agency at the facility.
Adult residential care homes may make medications available unless the resident is capable of and prefers to self-administer. E-ARCHs require licensed nurses to administer medications by injection unless the resident is capable of self-administration. In addition, this task may be delegated to unlicensed assistive personnel according to state administrative rules and the state’s Nursing Model Act.
Food Service and Dietary Provisions
Adult residential care homes provide three meals a day, snacks, and may offer meals recommended or prescribed by a physician.
Provisions for Apartments and Private Units
Inspection and Monitoring
How Much Does Residential Care Cost?
Between $3,000 to $7,000 per month.
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