State regulatory provisions for residential care settings An overview of staffing requirements

By Paula Carder, J O’Keeffe, C O’Keeffe, Erin White, Joshua Wiener

Residential care settings (RCSs), such as assisted living facilities, provide community-based services for older adults and younger people with disabilities who require long-term services and supports. Within RCSs, staffing adequacy is a key factor for ensuring residents’ quality of care. However, because residential care settings are licensed and regulated by the states, staffing requirements vary considerably among states. This paper provides an overview of state regulations related to staffing in residential care, highlighting the variance among state regulations. The primary data source for this analysis was the Compendium of Residential Care and Assisted Living Regulations and Policy, 2015 Edition, funded by the Office of the Assistant Secretary for Planning and Evaluation/US Department of Health and Human Services. Consumers and regulators need to be aware of the state variance in RCS staffing requirements and assess whether a state’s staffing requirements are adequate to meet residents’ needs.


Carder, P., O’Keeffe, J., O’Keeffe, C., White, E., & Wiener, J. (2016). State regulatory provisions for residential care settings: An overview of staffing requirements. (RTI Press Occasional Paper No. OP-0030-1607). Research Triangle Park, NC: RTI Press.

© 2019 RTI International. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.


Paula CarderPaula Carder, PhD, is an Associate Professor at the Institute on Aging in the School of Community Health at Portland State University.

J O’Keeffe

C O’Keeffe

Erin WhiteErin White, MS, is a research public health analyst in RTI’s Aging, Disability, and Long-Term Care group in Washington, DC.

Joshua WienerJoshua M. Wiener, PhD, is a Distinguished Fellow and program director for Aging, Disability, and Long-Term Care at RTI International.

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