Arkansas is an affordable retirement destination for seniors with a lower-than-average cost of living and no state income tax charged on Social Security payments or military retirement income. The mild weather is ideal for active seniors looking forward to exploring the state’s many natural attractions. However, the relatively high crime rates in the state may deter some retirees. This guide covers assisted living in Arkansas, including the associated costs and the regulations these communities need to follow. It also includes options for covering care costs.

Arkansas Assisted Living Facility Requirements

The Office of Long-Term Care within the Division of Medical Services in the Department of Human Services licenses and regulates assisted living facilities in Arkansas. The state licenses two levels of assisted living facilities. Both levels provide services in a home-like setting for older adults and disabled persons. Alzheimer’s special care units are units within long-term care facilities that offer services specifically for individuals with Alzheimer’s or other forms of dementia.

An assisted living facility is a building or a part of a building responsible for providing services for a period exceeding 24 hours to four or more residents.  The services may be provided directly or through third-party contractors. At a minimum, the facility must provide residents with 24-hour assistance in performing all activities of daily living (ADLs), such as eating, bathing, dressing, and ambulating.

Assisted Living Admission Policies

Before or on the day of admission, the ALF and the resident must enter into an occupancy agreement. The agreement outlines the core services, optional services, health care services (available through home health agencies), medication policies, fees, payment and refund information, facility rules, discharge criteria, and provisions for emergency transfers.

The ALF must provide a comprehensive disclosure that outlines the care offered, the treatment, staffing, emergency preparedness plan, special services, and the costs for services provided by the facility.  

In many states, the difference between levels of assisted living facilities is determined by the number of beds they are licensed for. In Arkansas, the two levels of ALFs are determined by the services they are permitted to provide. A Level I facility is not licensed to provide nursing home services. A resident is not permitted to move in if they require 24-hour nursing services, with some exceptions. A person is not permitted under the terms of the Level I license if they are bedridden, require transfer assistance that the facility cannot meet with current staff, present a danger to themself or others, or require medication administration.

A Level II facility is permitted to serve nursing home-eligible residents. Like a Level I facility, a Level II facility cannot serve bedridden residents with certain conditions or needs, a terminal condition, need transfer assistance that cannot be met by the facilities staff, or present a danger to themself or others.

Assisted Living Service Requirements

A Level I ALF provides 24-hour supervision by staff, linen service, and assistance with the following: obtaining 24-hour emergency care, obtaining transportation, ADLs, medication, and social, recreational, and other activities. It is also required that staff must be awake 24 hours a day.

Direct care services for ADLs help residents with mobility and transfers, hands-on assistance with feeding, grooming, bathing, dressing, personal hygiene, bladder and bowel requirements, and assistance with medication to the extent permitted. Health care services are available in maintaining social, physical, spiritual and psychological well-being.

A Level II ALF must provide 24-hour staff to respond to the needs of the residents as identified in the direct care and health care services plans set up in the residents’ occupancy admission agreements.

An individual assessment must be completed for all residents every year. This assessment is used to identify the services needed for each resident so they can receive personalized care.  The resulting care plan is also used to outline what the facility will and will not do to meet the resident’s needs so that they can provide alternatives.

Assisted Living Medication Provisions

Staff in a Level I facility may assist residents with self-administration or oral medications. The assistance consists of taking the container from where it is stored and handing it to the resident in the container. In the presence of the resident, staff members may remove the container cap or loosen the packaging. Facility staff cannot administer the medication.

In a Level II facility, licensed nursing personnel may administer medications to residents who are assessed as being unable to self-administer medication. These facilities must hire a consulting pharmacist.

Assisted Living Food and Housing Requirements

All assisted living facilities must provide three balanced meals per day, snacks, and sufficient fluids for the residents.

All units in ALFs must be adequately sized and configured to provide residents with all the functions necessary to live independently, with or without assistance. The units must allow residents to sleep, sit, dress, perform personal hygiene, store clothing and personal possessions, entertain visitors, and store, prepare, serve and eat food. Each apartment must accommodate wheelchairs or mobility aids.

Each apartment must have a lockable door and separate bathroom and kitchen areas and may not be occupied by more than two individuals. Each apartment must include a small refrigerator and microwave oven (except where not permitted) and must have a call system that is monitored 24 hours a day by staff.

Assisted Living Staffing Requirements

There must be a full-time certified administrator in each ALF. The administrator must be certified as an administrator through a state-approved certification program. The administrator is responsible for the facility’s daily operation and must be on-site during business hours.  Sometimes, a second administrator may be required depending on the number of beds the facility is licensed for.  

Level II facilities must employ at least one registered nurse (RN) and licensed practical nurses (LPNs) to provide residents with nursing or direct care services. The facility must provide certified nursing assistants (CNAs) to provide direct care services to residents. The facility may also provide personal care aides (PCAs) to provide direct care services. The RN is responsible for preparing, coordinating, staffing, and implementing care service plans and overseeing the LPN, CNA, and PCA staff.

The facility must always have enough staff awake and on duty to provide for the residents’ safety, health and welfare. At least one responsible staff person must always be awake and on-premises.  

Level I facilities must follow day, evening, and night direct-care staffing ratios based on the number of residents licensed for the facility. Each on-duty person may be counted for this ratio, even if they are currently involved in other activities like housekeeping, laundry, or dietary activities. If the facility has more than 16 residents, there must be one relief staff to cover should a person need to leave for an emergency.

A Level II facility must have one staff person per 15 residents from 7 AM to 8 PM and one staff person per 25 residents from 8 p.m. to 7 a.m., with no fewer than two staff members on duty.

Assisted Living Staff Training Requirements

All staff and contract employees that provide services to residents must have the following training:

Within seven days of hire, they must receive orientation and training on building safety and emergency procedures, abuse, neglect and financial exploitation and the reporting requirements of such, sanitation, food safety, job-specific requirements, and the residents’ bill of rights for the ALF.

Within 30 days of hire, they must receive orientation and training on medication assistance and monitoring, communicable diseases, and dementia and cognitive impairment.

Within 180 days of hire, they must receive orientation and training on communication skills, review of the aging process, and disability sensitivity training.

All staff must receive six hours of ongoing education and training per year.

What Is Included With Assisted Living Care In Arkansas?

The services provided in assisted living communities generally fall under three broad categories: personal care, medical care, and amenities. 

Most people move to assisted living communities because they’re looking for convenient access to personal care. These services assist with activities of daily living, such as bathing, dressing, walking, and toileting. Communities also provide supervision and can deliver care for unforeseen needs or in cases of emergencies. 

Health Care Services

In Arkansas, ALFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 56% of communities providing skilled nursing. Many have health care specialists and on-site services, with 48% of communities offering dental care. In addition, 56% of ACHs have hospice services.

Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Arkansas, 86% of communities conduct depression screenings, and 49% offer mental health counseling. Social work programs are also found in 41% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all the resources they need.

Activities of Daily Living (ADLs) Assistance Services

A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglecting household chores. 

Residents in Arkansas’ ALFs often receive help with their ADLs. In Arkansas, 12% of residents need help with eating. Other commonly used services include bed transfer (22%), toileting (28%) and walking (67%). Caregivers in ALFss help 43% of residents dress and 59% bathe.

Cost Of Assisted Living Care In Arkansas

The average cost of assisted living care in Arkansas is $3,760. This cost is $740 lower than the monthly national average of $4,500 per month. The cost of living in Arkansas is less than the national average by 9.1%, with health care costs less than the national average by 15.1% and housing costs less than the national average by 20.9%.

The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $3,329 in the Pine Bluff area to a high of $4,500 per month in the Hot Springs area of Arkansas.

How Costs Compare In Nearby States

If you live close to one of Arkansas’s borders, you may find assisted living in a neighboring state is a comparably affordable option. The average monthly cost of assisted living in Mississippi is $3,500, slightly less than in Arkansas. The other two neighboring states have slightly higher average monthly costs than Arkansas: Florida’s assisted living facilities average $4,000 per month, and Tennessee’s average $4,105 per month.

How to Pay For Assisted Living

Arkansas Assisted Living Oversight

The Office of Long Term Care Division of the Arkansas Department of Human Services oversees assisted living communities throughout the state. Seniors can contact the Division of Aging, Adult, and Behavioral Health Services for assistance accessing medical support or social services. Individuals may file complaints against assisted living communities, nursing homes, and other senior residential care communities by contacting Arkansas’s Long-Term Care Ombudsman Program.  

Legal Resources for Seniors in Arkansas

Unfortunately, Arkansas seniors are often targeted by scams and may also be vulnerable to fraud, abuse, and neglect. Since the aging population commonly faces these issues, the area of elder law has grown to offer protection to seniors and their families. Adult Protective Services operates a hotline for people to report adult mistreatment, and Area Agencies on Aging can connect seniors with legal services. Professionals offer free advice on civil law issues, including consumer affairs, public assistance benefits, health insurance, housing, and elder abuse. The Senior Medicare Patrol program educates seniors about Medicare fraud and scams.

Arkansas Legal Aid can assist low-income individuals of all ages with various areas of civil law, such as denied benefits claims, family disputes, debt relief, and consumer fraud. Seniors can also take advantage of estate planning services and can get help with wills, powers of attorney, and guardianship.   

Quality and Safety of Assisted Living Facilities in Arkansas

Per Title 20 of the Arkansas Code, all assisted living communities must obtain a license from the Arkansas Department of Human Services. All communities must also adhere to minimum health, safety, and quality standards. They do this by having procedures for emergencies and disasters, abiding by fire safety regulations, and meeting staffing and physical space requirements.

All prospective employees must pass a background check before commencing employment to enhance resident safety and well-being. A background check must be repeated every five years throughout their employment. Staff members must receive training commensurate with their role, with basic orientation completed within the first week of employment and specialized topics covered within the first month. Minimum staffing ratios are in place to ensure adequate provision of care, and Level II assisted living communities must have a registered nurse on staff.