{Flower box.}                                     

Housing Options Available in Connecticut for Seniors

    The question of availability for elderly housing is not always a quick answer.  Trying to make it easier for seniors and their families, the Aging Services Division prepares Elderly Housing Directories on a yearly basis.  These directories give the most up-to-date listings of Elderly Housing available in Connecticut.  (Directory is available on the Publications page of this website.)  

    Along with a listing, this page provides definitions for the different types of housing options available for seniors.  There are some distinct differences regarding services that may be required of the living environment and some services that are prohibited.  In addition to providing different types of services, housing communities can offer varying degrees of the same service.  Different housing options can also vary in terms of the following: 1) the residents they serve, 2) whether they are required to be licensed to operate, 3) their conditions for requiring when residents must move to another level of care and 4) costs.  

Assisted Living:

    An assisted living designation in this housing directory is reserved for managed residential communities that provide their residents with support services through an entity that is licensed by the Connecticut Department of Public Health as an Assisted Living Services Agency (ALSA).   Each managed residential community may be the licensee or it may provide services through a contract with a licensed, assisted-living provider.  The ALSA provides residents with assistance with activities of daily living, including nursing services and medication supervision; it does not typically provide skilled-medical services.  Staff members  typically oversee and monitor residents and are available twenty-four hours a day to meet residents’ unscheduled needs.  They develop individualized service plans tailored to the needs of each resident.  A nurse is on call twenty-four hours a day.   

    Residents may be independent upon admission or they may have chronic and stable conditions as determined by a physician or health-care practitioner.  These conditions may be physical or medical;  they may also include chronic and stable mental-health and cognitive conditions.   Residents are usually able to stay in assisted-living facilities until twenty-four hour skilled care becomes necessary.  Residents typically have private, apartment-like living units and pay monthly fees.   

    Along with employing a service coordinator, residential communities must provide core services that include meals, laundry, transportation, housekeeping, maintenance and recreational activities.  Among other services they must provide are twenty-four-hour security, emergency call systems, on-site washers and dryers and sufficient common space to accommodate fifty percent of each community’s resident population.  ALSAs are responsible for providing assisted-living services and ensuring that the required core services are provided by the managed residential communities.  It is important to note that the ALSA license pertains to the provision of services as provided in a managed residential community; it does not pertain to the community itself (Section 19-13-D105 of the Regulation of Connecticut State Agencies).  To be listed as an assisted-living community in this directory, the community must have on-site, assisted-living services provided by a licensed ALSA or expect to have such services in the near future.   

Condominium:

    Residents who live in condominiums generally own specific living units within their condominium complexes.  Unit owners usually jointly own the land on which the housing structures are located and the common areas.  Common areas typically include:  exterior walls, parking areas, walkways, halls and stairways, elevators, outside grounds, basements, and in some cases, recreational areas such as swimming pools and tennis courts.  Living units can be free-standing homes, townhouses, garden apartments or apartments in high-rise buildings.  Residents are responsible for paying the mortgages and property taxes on their units.  Each condominium community governs itself by a unit owner’s association.  The main function of the association is to pay for repairs, maintenance and taxes of common areas.  The association elects a governing body, typically a board of directors,  to manage the community’s property.  Residents usually pay monthly fees to the association, in addition to their mortgages, for the upkeep of common areas. 

Congregate:

    Congregate housing gives residents the opportunity to obtain some support services while living in a residential environment.  These services help residents live semi-independently.  Congregate communities help individuals who have temporary or periodic difficulties with one or more activities of daily living.  Congregate housing is not designed for individuals who need extensive services or need assistance or supervision throughout the day or at night.  These communities, in addition to  providing one meal per day in a communal setting, housekeeping and twenty-four-hour security, may help residents access community-based services that provide personal care.  Additional meals, transportation and recreational activities may also be provided.  Some of these services may require additional fees.  A service coordinator may be available in some facilities to help residents arrange other community services.  Congregate communities are not licensed and do not provide rehabilitation or nursing services, nor do they dispense or monitor the self-administration of medications.  Residents usually live in private apartments and pay rent monthly. 

Continuing-Care Retirement Community (CCRC):

    Continuing-care retirement communities (CCRCs) are also sometimes referred to as life-care communities.  Through contractual agreements, continuing-care communities provide residents living accommodations and a wide variety of services, including long-term health and nursing services.  Various levels of care, such as independent living, assistance with daily activities and nursing-home care, are usually provided on the communities’ campuses.  Residents may move from one level of care to another as their needs change.  Each resident must enter into a continuing-care contract with a CCRC in order to obtain residency; the resident must be independent upon admission.  Every resident is required to pay a substantial, lump-sum entrance fee and monthly fees in exchange for lifetime housing and health-related services.  These fees vary depending upon the community, the type of living unit chosen and whether an individual or couple is the occupant.   Continuing-care communities have different policies regarding the availability and terms of entrance-fee refunds.  Housing units can be apartments in high-rise or low-rise buildings, townhouses, garden apartments, cottages or free-standing homes.  Units can range in size from studios to three bedrooms.  Residents are not generally entitled to have equity in their units; instead, they are entitled to lifetime use of their units.  CCRCs are not licensed in Connecticut, but they must adhere to certain statutory requirements (Chapter 319hh of the Connecticut General Statutes, Management of Continuing-Care Facilities).  Various components of their health-care packages, however, are licensed by the State of Connecticut. 

Cooperative:

    Cooperatives are associations that own and operate housing communities for the benefit of their occupants. The associations may be incorporated and may be for profit or non-profit.   Each resident owns shares in the cooperative corporation that in turn owns all the living units and common spaces associated with the community.  Shareholders are required to cooperate in ownership and management.  Residents lease apartments from the cooperative corporation; only individuals who own shares in the cooperative are allowed to lease  apartments.  These leases grant residents the right to occupy units, but they do not stipulate rent.  Instead, residents are required to pay maintenance charges that are set annually by a board of directors.  Shareholders usually also pay  one-time membership fees.  Residents do not carry mortgages and, as shareholders, are responsible for the debts of the cooperative.  Cooperatives may decide with whom they wish to share ownership as long as they do not violate existing laws prohibiting discrimination.  Residents who wish to move must sell their shares in the cooperative to buyers who must acquire approval from the board of directors.  Similar approvals are also required for subleasing units. 

Independent Living:

    Facilities designated as independent living in this directory are rental housing communities that are restricted to elderly individuals.  In some communities, younger persons with disabilities may also be allowed admission.  Residents are generally permitted to occupy living units by entering into rental contracts for fixed periods of time.  Living units are usually apartments that can vary in size.  These communities are not licensed, but they must comply with building and safety codes regarding the design, construction and safety features of their buildings.  They can be either publicly or privately sponsored, and they may have rent subsidies available to their residents.  Although residents are typically independent, some of them may use support services to help maintain their independence.  Facilities may employ resident service coordinators who help residents live independently by helping them access community-based services.  Some communities may be congregate-meal sites where, usually on weekdays, one afternoon meal in a central dining area is available to each resident.  Some facilities may also provide or arrange recreational activities and/or transportation services.  Communities vary in terms of the amount and types of services they provide.   

Manufactured/Mobile Home:

    Manufactured homes can refer to mobile homes or prefabricated houses that are manufactured off site.  Prefabricated houses can be transported as one unit or in separate sections.  Houses are either set down or erected and finished on site.  After being placed on lots, some mobile homes are configured with peaked roofs and “skirts” to give them a permanent appearance. 

    Manufactured homes are usually less expensive per square foot than housing that is built completely on site.  Standards for the construction of manufactured homes have been regulated by the federal government since 1976.  Homes manufactured after this time have metal plates on them showing that they comply with these standards.  Federal standards specify how strong, durable, fire and wind resistant and energy efficient a home should be.  Notwithstanding these requirements, the cost of casualty insurance is often higher for manufactured homes than for homes built on site.  Local zoning ordinances may restrict or prohibit manufactured homes from residential districts.  Consequently, many residents who live in such homes typically live in mobile home parks.  Residents usually own their homes and site them on spaces they rent from owners of these parks.  Once sited, most homes are not moved.  As a result, individuals interested in manufactured homes have a choice of buying new homes or already-sited, used homes.  Residents are responsible for maintaining their homes.  The parks typically provide common facilities such as laundry and recreation areas, private roads within the parks, maintenance of the grounds, property taxes on lots and utilities. 

    In Connecticut, mobile home parks are licensed by the Department of Consumer Protection.  They must conform with requirements of the State Building and Fire Safety Codes and local ordinances and zoning regulations.  Every park must have a caretaker in charge at all times to keep the park and its facilities and equipment clean, orderly and in sanitary condition.  Each resident must receive a  written rental agreement from the owner of the park before a home or lot can be offered.  Park owners are not allowed to charge residents entrance fees.  Only parks that are restricted to elderly residents are listed in this directory; most of these communities are comprised of mobile homes.    

Nursing Home:

    Two types of nursing facilities that are licensed by the Connecticut Department of Public Health are rest homes with nursing supervision and chronic and convalescent nursing homes.  Nursing homes can elect to be licensed in one or both of these categories.  Before entering nursing homes, prospective residents or their guardians must sign admission agreements.  Nursing homes provide their residents with rooms, meals, recreational activities, help with daily living and protective supervision.  Residents live in private or semi-private rooms.  They usually have physical or mental impairments that keep them from living independently.  Unlike some other facilities, nursing homes employ medical personnel to provide health care to residents.  Some facilities provide sub-acute care, which is medically more sophisticated than traditional nursing home care.  These facilities can usually provide this care at a lower cost than hospitals.  

    The costs of staying in a nursing home vary by facility.  Residents’ options for paying for these costs may include: private pay, long-term-care insurance, Medicare or Medicaid.  Many nursing homes accept Medicare and/or Medicaid as payment; some do not.  Along with meeting stringent standards, Medicare-approved facilities agree to participate in the Medicare program and limit the rates they charge Medicare-reimbursed residents.  Any nursing home can elect to qualify all its beds for Medicare reimbursement or allocate only some beds for this purpose.  Non-Medicare beds can be charged rates above the Medicare limit. 

    Long-Term-Care Ombudsmen help protect the health, safety, welfare and rights of individuals living in nursing homes.  Ombudsmen receive, investigate and resolve complaints made by or on behalf of residents against nursing homes.  Residents wishing to make complaints or receive clarification on residents’ rights, should contact the regional Ombudsman office in their area.  Ombudsmen and their support staff respect the privacy and confidentiality of individuals who make complaints or request information.  Visit the Long Term Care Ombudsman Site by following this link.

Rest Homes With Nursing Supervision:

    Rest homes with nursing supervision are for individuals with chronic conditions who are unable to live independently but do not need constant skilled care.  These individuals typically have controlled and/or stable chronic conditions that require minimal skilled-nursing services, nursing supervision or assistance with personal care on a daily basis.  Residents are normally not confined to a bed and usually have a greater degree of mobility than those individuals who reside in chronic and convalescent nursing homes.  Nursing supervision under medical direction is provided twenty-four hours a day.  A full range of medical, social, recreational and support services are provided. 

Chronic And Convalescent Nursing Home:

    Chronic and convalescent nursing homes are designed for individuals who need continuous skilled-nursing services and/or nursing supervision; these individuals have uncontrolled and/or unstable and/or chronic conditions.  Individuals can also have chronic conditions that require substantial daily assistance with personal care.  Skilled-nursing care is provided under medical supervision and direction to carry out non-surgical treatment and dietary procedures for chronic diseases or convalescent stages of acute diseases or injuries.  Residents need nursing care but do not require hospitalization. 

Residential-Care Home:

    Residential-care homes in Connecticut are licensed by the Department of Public Health.  These homes can also be referred to as homes for the aged, rest homes, personal-care homes or board and care homes.  In Connecticut, a board and care home usually provides fewer services than a facility that is generally considered a residential-care home; it is also not licensed by the State. Residents of residential-care homes may have some health, social and personal-care needs, but they do not require the extensive medical care a nursing home provides.  Most require some assistance with activities of daily living, supervision of medications and/or protective oversight.  Although residents may use devices, they are ambulatory and have some degree of independence, but they are not able to live on their own.  Residents should be able to evacuate their homes unassisted in case of an emergency.   

    Residential-care homes provide residents with a communal living environment.  Residents typically live in a private or semi-private room; lavatories and bathing areas can be either private or shared among residents.  The cost of living in these homes depends upon the home and type of room chosen; private rooms are generally more expensive than semi-private rooms.  Some residents use government assistance to help them pay for their care.  Many of the smaller homes are large, single-family homes that have been renovated.  The owners of these homes often provide services to residents with the assistance of other staff.  Close relationships may develop among residents and between residents and staff that contribute to a home-like atmosphere and family environment. 

    Residential-care homes are required to provide three meals per day, housekeeping and laundry services, personal care, recreational activities, twenty-four-hour supervision and emergency call systems.  Menus for meals must meet requirements set by the Department of Public Health.  The personal-care services that these homes provide do not require the training or skills of a licensed nurse.  Staff is not required to provide nursing services.    Some homes, however, have a nurse on staff.  Staff members can supervise medications that residents self-administer and may help residents schedule their doctors’ appointments.  

Retirement Community:

    Retirement communities are typically designed for independent older people who are in reasonably good health.  Some communities offer rental units, while others require residents to purchase their units.  Units can exist in any form in which housing is created, for example, single-family homes, condominiums, townhouses, apartments, cooperatives or mobile homes. Retirement communities vary in terms of the kinds of services they provide and the fees they charge. Some communities feature extensive recreational and leisure activities.  Some may offer services such as meals, housekeeping, transportation or twenty-four-hour security.  Other communities provide a more comprehensive service package that offers residents a spectrum of health care and support services.  There are also some retirement communities that are strictly independent living; they do not provide residents with assistance in obtaining support services.  Residents in these communities must arrange and pay for their own services. 

    Some retirement communities, in which residents own their units, provide common areas where recreation or other types of services are offered.   Developers, management companies or unit associations may own these areas.  Homeowners are often assessed for the management of these areas.  The fees can remain relatively stable or increase when it is deemed necessary.  

    Retirement communities are commonly moderate to high priced depending upon the services and amenities they provide.  Retirement communities in this directory must be age-restricted communities.  They can be comprised of any particular housing or combination of housing types.  They can also provide any amount of services.