Operating an MHSU Assisted Living Residence
In British Columbia, the goal of assisted living is to provide individuals with housing, appropriate support and prescribed services that will allow them to live with the optimum level of independence. The principles of assisted living — choice, privacy, independence, individuality, dignity and respect — come from the recognition that adults, although they may need support and assistance in daily life, maintain the right to manage their own lives. Operators of assisted living residences play an important role in supporting and promoting the goal and principles of assisted living.
Obligations of Operators
To become registered in British Columbia and to maintain registration, operators must operate assisted living residences in a way that does not jeopardize the health or safety of residents, which includes:
- Complying with the Community Care and Assisted Living Act, Regulations, Health and Safety Standards, and the Assisted Living Registry’s administrative policies and procedures
- Housing only residents who are able to make a range of decisions necessary to function safely in the residence.
- Maintaining a “watchful eye” over residents’ health and safety.
- Reporting serious incidents to the Assisted Living Registry within 24 hours.
- Establishing and communicating their internal complaint process by:
- communicating the complaint process in a manner that is readily accessible to residents, staff and visitors; and
- not preventing or intimidating anyone from making a complaint
- Communicating the Assisted Living Registry’s complaint process by:
- making the registry’s complaint process and contact information readily accessible to residents, staff and visitors; and
- not preventing or intimidating anyone from making a complaint to the Assisted Living Registry
- Maintaining a 24-hour emergency response system for residents and staff to summon help in an emergency.
- Protecting residents from abuse and neglect by complying with the Criminal Records Review Act to ensure that owners, site managers, employees, contractors and volunteers have a current criminal record review (within 5 years).
- Operating within the number of resident units that are registered.
- Maintaining registration.
The registrant handbook is a guide for day-to-day residence operations, staff training and interaction with assisted living registry staff. It sets out the health and safety standards and guidelines and the registrar’s administrative policies and procedures. The handbook also includes additional reference material to assist operators in fulfilling their responsibilities. Health and safety standards are the same for publically subsidized and private-pay assisted living units and are not optional.
Registry staff provide a copy of the handbook to operators after receiving an application for registration and the application fee. Additional copies can be purchased by contacting registry staff or download your own copy here.
Health and Safety Standards
The registrar sets out minimum provincial health and safety standards and guidelines. Registry staff assist operators in understanding the standards through the registration process, and may further educate operators in the event that a residence undergoes a complaint investigation. There are specific health and safety standards for different resident populations:
Serious Incident Reporting
A serious incident form must be filled in by residence site managers after a serious incident has occurred. Serious incidents include (see form for full description):
- attempted suicide by a resident;
- unexpected deaths;
- abuse or neglect;
- medication errors;
- fire or flood;
- missing persons;
- police calls; and
- other incidents that the site manager believes are serious and should be reported.
Forms must be faxed to the assisted living registry (1-250 952-1119), using a cover sheet, no later than the next business day after a serious incident occurs.
Assisted living provides housing with supports (hospitality and prescribed services) for people on a short term basis, to prepare them for living in the community independently. There are no specific staffing requirements about the maximum number of residents per staff person in assisted living. All staff and volunteers must have the necessary knowledge, skills, abilities and training to perform their tasks and meet the health and safety of residents. Site managers do not need specific background or training, though site management must be effective and appropriate to the resident population. The health and safety standards require that operators:
- ensure that staff are qualified for their roles;
- maintain documentation on staff selection and training; and,
- designate a qualified site manager.
Operators must establish an emergency response system that allows residents to summon help in an emergency, 24 hours a day. In a smaller residence this may be a house phone with emergency contact information posted nearby.
The Role of Health Professionals
Residents of assisted living have access to professional care (such as physician services or nursing care) in the same way they would have if living independently in the community. Residents may access professional services through health authority programs (community nursing, physiotherapy, substance use counsellor) or by purchasing these services from a private agency.
Finding Information About an Assisted Living Residence
All registered mental health and substance use residences (as they become registered) are listed on the assisted living registry website by community. The listing includes contact information of the residence and any substantiated complaint information about the residence.
Assisted living registry staff do not:
- provide information about marketing of assisted living residences;
- promote particular assisted living residences;
- refer individuals or families to assisted living residences; or
- have or provide information about financing or funding for operators of assisted living residences.
Assisted living registry (ALR) staff investigate complaints related to the health and safety of persons living in assisted living residences. Anyone with a concern about the health or safety of an assisted living resident can make a complaint to the registry, including: a resident, a family member, a friend of a resident, residence staff, health authority staff or a member of the public.
Substantiated complaints are posted on the assisted living registry website next to the residence contact information for two years.
Operators of assisted living residences must comply with all applicable legislation, which includes:
British Columbia Building Code Regulation
The B.C. Building Code Regulation establishes minimum standards for health, safety, accessibility, fire and structural protections of buildings and protection of the building from water and sewer damage.
British Columbia Fire Code Regulation
The B.C. Fire Code Regulation establishes minimum standards for health, safety and fire protection of buildings and facilities, including assisted living residences.
Community Care and Assisted Living Act
The Community Care and Assisted Living Act establishes a mandatory registration requirement for all assisted living residences and provides for an Assisted Living Registrar to administer the part of the Act that relates to assisted living residences. It also requires community care facilities, which house a more vulnerable and dependent population, to be licensed under the Act.
Community Care and Assisted Living Regulation
The Community Care and Assisted Living Regulation defines the prescribed services. An assisted living operator may not offer more than two prescribed services to residents. By contrast, an operator of a community care facility may offer three or more prescribed services.
Assisted Living Regulation
The Assisted Living Regulation specifies the length of a registration, application and registration fees, and health and safety standards for medications.
Drinking Water Protection Act and Regulation
Food Premises Regulation
The Food Premises Regulation of the Public Health Act sets out public health requirements for businesses that supply and serve food to the public. Operators of assisted living residences who house seven or more residents must have a food premises permit. Public Health Inspectors (Environmental Health Officers) in the health authorities are responsible for inspecting food premises, issuing permits and investigating complaints.
The Health Act and its regulations deal with a range of public health matters relevant to assisted living residence operators, such as food safety, drinking water safety, personal services establishments, communicable disease management, sewerage systems, and pools and spas.
Health Act Communicable Disease Regulation
The Health Act Communicable Disease Regulation sets out what a reportable communicable disease is, and appropriate control measures.
Personal Services Establishment Regulation
The Personal Services Establishment Regulation specifies that operators of personal services establishments must maintain and operate their establishments, and equipment and instruments used for the service, in a way that prevents health hazards from occurring. Some health authorities require personal services establishments to be inspected and approved before operating.
Sewerage System Regulation
The Sewerage System Regulation to the Public Health Act applies to private sewerage systems; holding tanks and domestic sewage; waterborne waste from the preparation and consumption of food and drink, dishwashing, bathing, showering; and general household cleaning and laundry.
Swimming Pool, Spray Pool and Wading Pool Regulations
Operators are also expected to meet local government bylaws and should consult their local government to find out what bylaws apply to assisted living residences.
Registering an MHSU Assisted Living Residence
If a residence or a part of a residence meets the definition of assisted living according to the Community Care and Assisted Living Act, an operator is required to register the residence with the assisted living registrar, whether publicly subsidized or private-pay. Before approving an application for registration, the assisted living registrar must be satisfied that housing, hospitality services and personal assistance services, such as medication services, or psychosocial supports (referred to as prescribed services) will be provided to residents in a way that does not jeopardize their health or safety.
Refer to Should I register my residence? (PDF, 1.09MB) for assistance with determining whether you will need to register your residence.
The Goal of Registration
The goal of registration is to strengthen services by:
- ensuring individuals have access to accurate and relevant information needed to make informed choices about residences that provide housing, supports and services when planning for their future;
- providing a consistent standard of health and safety, including clear policies and standards;
- strengthening protections for vulnerable individuals from abuse and neglect; and
- increasing transparency and accountability for resolving health and safety concerns and complaints.
The Application Process
An operator should complete the relevant Prescribed Services Worksheet to determine if they are providing prescribed services in any of the six service areas described in the Community Care and Assisted Living Regulation. If an operator is or intends to provide one or two prescribed services, they are required to register their residence. A residence providing more than three prescribed services cannot be registered as an assisted living residence.
- Prescribed Services Worksheet (HLTH 1625) (PDF, 412KB)
Application Form and Package
The application package is available by selecting the link below or by contacting the assisted living registry.
- Assisted Living - Mental Health & Substance Use: Application for Registration (HLTH 1623) (PDF, 640KB)
- Required Documentation Checklist (HLTH 1624) (PDF, 100KB)
Supporting and Required Information
In addition to the completed application form, an operator must also provide copies of information and/or documents as set out in the relevant health and safety standards:
Fees are established in the Assisted Living Regulation. A one-time non-refundable application fee of $250 must be included with the completed application. Applications will not be processed until payment is received.
An annual registration fee of $12.50 per registered unit must be paid separately when the application is approved. For the purpose of registration, a room/suite is counted as one unit regardless of how many people living in the suite are receiving assisted living services.
The registration year runs April 1 – March 31. Registration fees are prorated semi-annually.
- Residences that begin operation between April 1st and September 30th, pay $12.50 per unit.
- Residences that begin operation between October 1st and March 31st, pay $6.25 per unit.
All cheques must be made payable to the Minister of Finance.
Submit the application form, the prescribed services worksheet, required documentation, along with cheques for required fees, to the assisted living registry. The application must be submitted at least two months before opening a residence and and applicant cannot operate an assisted living residence until the application is approved. It is the responsibility of the applicant to meet all registration requirements and follow up with third parties such as local governments and fire departments to obtain supporting documents. If accompanying documents are not available at the time of submission, applicants can submit them as they become available, but they must be received by the assisted living registry before the application can be approved.
The Application Review Process
When an operator’s application is received, registry staff will:
- contact the applicant by phone or by email to inform them that their application has been received;
- send the applicant a registrant handbook and complaint brochures;
- review the application and identify if information is incomplete or missing or if the information does not appear to meet health and safety standards;
- inform the applicant if information is incomplete or missing;
- follow up on any outstanding gaps in the application, or in meeting the health and safety standards that need to be addressed;
- schedule and conduct a telephone interview with the operator and site manager to review the application and ensure the applicant is aware of and complies with the health and safety standards; and
- arrange a site inspection.
Approval of Registration
The application will be approved for registration when the registrar is satisfied that the housing, hospitality services and prescribed services will be provided to residents in a manner that will not jeopardize their health and safety.
When the application has been approved, registry staff will:
- Issue an invoice for the registration fees;
- Upon receipt of payment, issue a registration certificate; and
- Update the assisted living registry and the assisted living registry website listings.
Refusal of Registration
If the registrar is not satisfied that services can be provided in a manner that will ensure resident health and safety, and decides to refuse the registration, the registry staff will advise the applicant in writing of the reasons for the decision and the reconsideration process.
The applicant will then have 30 days in which to submit reasons why the decision should be reconsidered. If the application for registration is still refused, the applicant may appeal to the Community Care and Assisted Living Appeal Board.