Nestled in the Great Lakes region of the upper Midwest, Michigan is a favorite retirement destination because of its low cost of living, breathtaking shorelines, easy access to cultural events, and abundant indoor/outdoor recreational activities. In addition, there is no sales tax on Social Security benefits, U.S. military pensions, Michigan National Guard pensions, or Railroad Retirement pensions, making it a more affordable place for retirees. The following information explores what senior living options are available, average care costs, and an overview of what some of the state regulations for assisted living cover.

Assisted Living Facility (ALF) Definitions

In Michigan, assisted living facilities are called homes for the aged and adult foster care (AFC) homes. They are licensed and regulated by the Department of Human Services. The key difference between the two is that the homes for the aged provide care to persons over the age of 60, and an AFC provides care to any adult in need of care. The term “assisted living” may be used on this page in place of “home for the aged,” or as a general term but is not used as part of the state guidelines.

Adult foster care homes are defined in different categories:

• Family homes that serve up to six residents with the licensee residing in the home.
• Small group homes serving up to 12 residents; the licensee is not required to reside there.
• Large group homes serving between 13-20 residents; the licensee is not required to reside there.

Homes for the aged are personal care facilities that provide supervised personal care to 21 or more residents aged 60 or older. If the home is associated with a nursing home facility, it can serve fewer than 21 residents.

Resident Agreements and Disclosures

The admission contract for each resident must include the services that are being provided, the monthly rate along with any fees, the refund policy, admission and discharge policies, and the rights and responsibilities of each resident.

All assisted living facilities that represent to the public that they provide services and care for people with dementia, including Alzheimer’s, must provide the following information, in writing, to prospective residents:

• The overall mission and philosophy of the facility for the needs of residents with Alzheimer’s or some other form of dementia.
• Services provided for these residents.
• Frequency and type of activities for these residents.
• Admission and discharge criteria.
• Any fees associated for dementia care services.
• The process for assessment and care planning.
• Training and continuing education of the staff.

Assisted Living Admission and Retention

An assisted living facility is not permitted to admit a resident whose needs cannot be met by the facility. There are several situations where the resident cannot be retained in the home, such as if the facility can no longer support the resident’s needs or if the resident requires continuous nursing care unless the resident receives hospice or home health agency care. A resident may also be discharged if their behavior puts themself, other residents, or staff at risk.

If an applicant for admission is under the care of a health care professional, a written care statement that describes treatments and medications must be provided to the facility before admission. The home must develop a service plan for the resident that specifies the needs for care, services, and activities of the resident. The service plan must be updated annually or when a significant change in the resident’s health occurs.

Assisted Living Food and Dietary Provisions

Facilities must provide three nutritious meals per day and snacks. If a licensed medical professional prescribes a therapeutic diet, that must be provided to the resident. All meals must be provided in accordance with the daily dietary allowances outlined by the Food and Nutrition Board of the National Academy of Sciences.

Assisted Living Staffing Requirements

All homes must have an administrator to operate and manage the home.  Each shift must have a designated resident care supervisor responsible for ensuring that the residents are protected from accidents and injuries, maintaining their safety in an emergency, and being treated well.  The direct care staff provides the residents with care, supervision, and protection.

No minimum staff ratios are required, but the home must have adequate staffing to provide for the needs and care of the residents according to their service plans. When on duty, the resident care supervisor must be on the premises and awake. 

Assisted Living Staff Training Requirements

The administrator is responsible for establishing and implementing training programs that support the home’s program statement, fulfill the requirements of the resident’s service plans, and meet the employees’ needs. Training must include reporting requirements, first aid, medication administration, personal care, residents’ rights, safety and fire prevention, infectious disease containment, resident supervision, and standard safety precautions.

Assisted Living Housing Requirements

Apartment style units are not required in Michigan. Rooms may be single or multiple-occupancy, with up to four beds permitted in a room. Homes that were constructed before 1969 are allowed to have more than four beds in a room. One toilet and sink are required for every eight resident beds per floor, and one bath or shower is required for every 15 residents.

What Is Included With Assisted Living Care In Michigan?

There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident’s health condition and ability to function. The facility must assist residents with all activities of daily living (ADLs), and medication services. and assess the need for medication attention or nursing services.

Assisted Living Medication Provisions

Homes are required to supervise and administer medications for residents. Supervision means giving reminders to the resident to maintain their medication schedule. The home must train any direct care workers who assist residents or administer medications. This training includes the proper handling of medications and their administration. Residents may self-medicate if they are capable.

Health Care Services

Assisted living facilities must provide supervised care, including overall guidance, assistance with ADLs, medication management, assisting a resident with appointments, and supporting their personal and social needs.

In Michigan, 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 66% of communities providing skilled nursing. Many have health care specialists and on-site services, with 58% of communities offering dental care. In addition, 59% of ALFs have hospice services.

Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Michigan, 81% of communities conduct depression screenings, and 64% offer mental health counseling. Social work programs are also found in 57% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents have access to all the resources they need.

Mental Health Resources

The Michigan Department of Health and Human Services manages several mental health programs and services to help individuals improve their mental health. The State of Michigan maintains a Mental Health Resources Directory with information on available mental health programs and services and several crisis hotlines. The Veterans Administration offers a variety of mental health resources, information on mental health conditions, and treatment options to all veterans and the general public.

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 Michigan’s assisted living facilities often receive help with their ADLs. In Michigan, 31% of residents need help eating. Other commonly used services include bed transfer (44%), toileting (56%), and walking (66%). Caregivers in ALFs help 57% of residents dress and 77% of residents bathe.

Cost Of Assisted Living Care In Michigan

The average cost of assisted living care in Michigan is $4,250. This cost is $250 lower than the monthly national average of $4,500 per month. The cost of living in Michigan is less than the national average by 8.7%, with health care costs less than the national average by 3.7% and housing costs less than the national average by 19.3%.

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 $3,400 in the Battle Creek area to a high of $6,093 per month in the Ann Arbor area of Michigan.

How Costs Compare In Nearby States

Every state bordering Michigan has a lower average cost for assisted living, so you might also consider assisted living facilities in these states as options. Indiana has the closest average monthly cost at $4,283—Wisconsin and Ohio average $4,600 and $4,635 per month, respectively.

How to Pay for Assisted Living

Michigan Assisted Living Oversight

The Michigan Department of Health and Human Services oversees the state’s homes for the aged. The Aging and Adult Services Agency offers resources and advocacy to help older adults maintain their health and independence. In addition, the Michigan Long-Term Care Ombudsman Program is an excellent resource for seniors living in long-term care facilities who need help with a dispute or complaint against the facility. The ombudsman also works to improve the quality of care for seniors in residential care communities.

Michigan Department of Health and Human Services

Aging and Adult Services Agency

Michigan Long-Term Care Ombudsman

Legal Resources

The term “elder law” is often associated with estate planning, trusts, and help obtaining benefits through Medicare or Medicaid. Unfortunately, the field has grown to include cases involving elder abuse, elder neglect, and exploitation. Skilled attorneys can help older adults affected by these issues.

Elder Law of Michigan is a nonprofit charitable organization that provides information, counseling, advocacy, and legal services to promote and protect the rights, health, and well-being of seniors and disabled people. The Michigan Legislature maintains a reference guide that provides information on various laws and programs that affect services designed to help older adults. Lakeshore Legal Aid is a nonprofit law firm for low-income residents. Attorneys at this firm offer free professional legal advice, civil legal counseling, and court representation to improve their clients’ legal statuses.