How Assisted Living Is Licensed

Assisted living communities are designed for seniors who need help with Activities of Daily Living (ADLs), like bathing, dressing, meals, and medication reminders, and general oversight. They are not licensed as hospitals or skilled nursing facilities. That difference matters: certain medical interventions and levels of supervision fall outside assisted living regulations and staffing models.

Clinical Needs Beyond Assisted Living’s Scope

While each community’s capabilities vary, the following needs commonly require a higher-acuity setting (e.g., nursing facility) or dedicated home health/hospice oversight that an assisted living alone can’t provide….

• 24/7 skilled nursing or continuous monitoring (e.g., ventilator dependence, complex IV therapies without home-health support).
• Unstable or advanced medical conditions requiring frequent interventions or rapid response (e.g., recurrent uncontrolled seizures, acute infections needing isolation precautions).
• Complex wound care beyond routine dressing changes (e.g., advanced pressure injuries needing daily skilled treatment).
• Feeding tubes, central lines, or complex ostomy care when policies require skilled personnel on site beyond what the community can provide.
• Two-person transfers at all times or total mechanical lift dependence when staffing or policies cannot meet safe transfer requirements.
• Active detox or unmanaged substance use disorders that require medical stabilization.

Note: Some services can be delivered in assisted living if licensed home health or hospice agencies are involved and the community permits it. Always confirm the specific provider’s policy.

Behavioral and Safety Exclusions

Assisted living must maintain a safe environment for all residents. Situations that may disqualify someone include….

• Uncontrolled exit-seeking or elopement risk that exceeds the community’s ability to secure and supervise safely.
• Physical aggression or severe behavioral disturbances that endanger self or others.
• Severe cognitive impairment without appropriate memory care supports available on site.
• Refusal of essential care (e.g., consistently refusing meds or hygiene to a degree that creates health/safety hazards).
• High fall risk without safe mitigation when the needed staffing/equipment exceeds policy.

Short-Term vs. Long-Term Changes

Not every temporary setback leads to a move. Many residents experience short-term changes (e.g., after surgery) that can be managed with home health, rehab, or hospice while remaining in assisted living. A transition to nursing care is considered when the baseline level of need becomes permanently higher than assisted living can legally or safely support.

Assessment & Move-In Criteria

Before move-in, communities complete a clinical and functional assessment to determine fit. Expect questions about ADLs, medications, mobility, cognition, continence, recent hospitalizations, and behavioral history. Families should also disclose any home-health, hospice, or specialty services involved.

If the assessment indicates higher-acuity needs, reputable providers will recommend a safer level of care rather than accepting an unsafe admission.

Safer Alternatives in Wichita

• Skilled Nursing Facilities (Nursing Homes) – 24/7 nursing for complex or unstable medical conditions, intensive wound care, or frequent clinical interventions.
• Memory Care – For moderate to advanced dementia with exit-seeking, wandering, or behavioral symptoms, often with enhanced security and dementia-trained staff.
• Assisted Living + Home Health/Hospice – For residents who remain appropriate for assisted living but require intermittent skilled services or end-of-life support.
• Short-Term Rehab – Post-hospital recovery and therapy with the goal of returning to assisted living when stable.

Questions to Ask Providers

• Which clinical services are you licensed and staffed to provide on site?
• Can you safely support transfers/mobility needs (one-person vs. two-person assist, gait belt, lifts)?
• How do you manage cognitive or behavioral symptoms (exit-seeking, aggression, sundowning)?
• Do you coordinate with home health, hospice, or therapy? What does that look like day-to-day?
• What are your move-out triggers if needs escalate?
• What are the pricing implications when care needs increase?

How Keepsake Kottage Helps Families Decide

Keepsake Kottage Home Plus offers licensed, small-scale assisted living in a warm, residential setting. We help families:

• Complete a clear, honest fit assessment before move-in.
• Build individualized care plans and coordinate with outside providers when appropriate.
• Recognize early signs when a higher level of care may be safer, and assist with a smooth transition.

Start a conversation – 8428 W 13th St N, Ste 130, Wichita, KS  |  (316) 650-4526

Disclaimer: This article is for general information, not medical or legal advice. Policies vary by provider and change over time. Always consult your clinician and the specific community.

FAQs: Who Cannot Live in Assisted Living?