The staff members of an assisted living residence help to create a nurturing environment.  The size of the residence will affect the composition of the staff. Large complexes that also have a skilled nursing facility may share staff with their assisted living unit.

In the case of smaller assisted living residences, specialized or skilled nursing care is often contracted out to a third party. For instance, they may have a registered nurse on call, available at all hours, but not necessarily present on-site full-time.

Large or small, in most cases assisted living residences have a number of key staff members in place in various specialized roles:

Activities Director

The activities director organizes a variety of events to both entertain residents and keep them healthy. This can vary from scheduling in-house activities like exercise classes to arranging trips to town for shopping, or trips to the park for nature walks.

Ideally, the activities director also encourages spontaneous interactions for the residents throughout the day. A key role is to interact with the residents, along with staff and family members, and to identify activities that are of particular interest to the residents.  A skilled and enthusiastic activities director brings their exuberance to the residence, which results in much more engaged, happy and well-adjusted residents.

Medical Staff and Medical Director

The type of medical staff within a residence depends largely on the level of care provided. Assisted living residences with healthy and able-bodied seniors may not need to have a licensed nurse on the premises full-time. In contrast, a large complex may have medical care provided by a variety of staff members and a Medical Director who oversees all of the healthcare activities provided in the residence.

Medical Directors are usually nurse practitioners or other advanced practice skilled nurses themselves, and oversee a staff that consists of RNs (registered nurses), LPNs (licensed practical nurses), nurses’ aides and medical technicians.

In smaller residences, nurses or med techs may administer medication, but larger complexes typically have a dedicated medication technician whose sole function is to manage the prescriptions and administer the medication. In the state of Maine, a certified medication aide must be on duty at all times.

Executive Director

The Executive Director of an assisted living residence or complex oversees all aspects of the life of the residents, ranging from ensuring that medical needs are being met to overseeing maintenance and upkeep of the facility.

The executive director is often the face of the residence, involved in everything from showing the facility to prospective residents to hiring staff. Ideally, the Executive Director has a background in Person-Centered Care to be able to best facilitate an enriching environment for the residents. In small residences, the owner may serve as the Executive Director.

Food and Nutrition Staff

Assisted living residences take pride in their food and do their best to ensure that healthy, nutritious food is provided to all residents. They also ensure that dietary requirements based on preference, religion and medical needs are accommodated.

The involvement of staff members with the food planning and preparation may vary from a contracted professional chef or food service provider who designs a custom menu, to having a dedicated nutritionist or culinary director on staff.

In virtually all cases, residences consult with nutritionists to make sure that their meals are providing optimal nutrition.

Requirements for Background Checks on Staff Members

There are no federal laws governing the need for background checks for the staff members of assisted living residences; however, a number of states have enacted such laws. As of March 2012, Alaska, Florida, Kentucky, Michigan, New Hampshire, New Mexico, Oklahoma, and Rhode Island require background checks, while the state of Washington requires background checks for staff hired after January 1, 2012.

Assisted living residences in other states frequently perform background checks on their staff members, even if it is not required by law.

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