New Orleans Senior AdvisorWhat is the difference between a personal care home and assisted living in Louisiana?
Both are adult residential care providers licensed by LDH, but a Level 1 personal care home serves two to eight residents in a house-like setting and a Level 2 shelter care home serves nine to 16, while Level 3 and 4 assisted living serves 17 or more residents in apartments with kitchenettes.
Metairie and the East Bank of Jefferson Parish have one of the densest clusters of small Level 1 and 2 homes in Louisiana, many on ordinary residential streets. The large buildings sit along main corridors in Uptown New Orleans, Metairie, Kenner, Covington, Mandeville and Slidell. Our roster can be sorted by level and capacity.
Which is better for a parent with dementia?
Neither by default: a small home's quiet, familiar routine and few faces can suit someone with moderate dementia, while a large building with a disclosed specialized dementia care program offers a secured area, activities and trained staff, so the right choice depends on behavior, mobility and the program's written criteria.
In a small home, ask how many staff are awake overnight and what happens if your parent tries to leave; a Level 1 home cannot lock residents in without State Fire Marshal approval either. In a large building, ask whether the dementia program is disclosed to LDH and how residents move into it.
Do small homes cost less than large assisted living?
Often, but not always: small homes frequently charge an all-inclusive monthly rate that can fall below Louisiana's $5,163 assisted living median, sometimes with shared rooms, while large buildings usually charge base rent plus care-level fees.
Compare the total at your parent's assessed care level, and ask whether medication management, incontinence care and escorts to appointments are included. Ask both for the disaster-fee formula; a small home may evacuate with family cars, a large building with chartered buses.
How do staffing and oversight compare?
Every ARCP level must keep at least one awake staff member on duty 24 hours a day and a CPR-trained person on every shift, and none has a numeric ratio, so a small home may have one caregiver for eight residents at night while a large building has several staff for many more residents.
Directors of Level 1 and 2 homes have different qualification criteria from Level 3 and 4 directors. Both are surveyed unannounced at re-licensing and on complaints, and both must post any statement of deficiencies. Ask how a small home covers a staff member's day off; in a home of eight, one absence is a big share of the staff.
Can a parent age in place in a small home?
Up to a point: no ARCP level except Level 4 may provide nursing, so as needs grow a small-home resident relies on outside home health and hospice, and must still be able to evacuate with the help the home provides.
Small homes can be excellent for end-of-life care with hospice, because the staff know each resident well. They are less suited to residents who need two-person transfers around the clock unless the home staffs for it.
At a glance
| A Level 1 or 2 home | A Level 3 or 4 building | |
|---|---|---|
| Size | 2 to 16 residents | 17 or more residents |
| Space | Bedrooms in a house-like setting | Apartments with kitchenettes |
| Nursing | None in-house | Intermittent nursing at Level 4 only |
| Feel | Family-style routine | Activities, dining room, more staff |
Sources include LAC 48:I.Chapter 68 (adult residential care providers), the Louisiana Department of Health's Health Standards Section and Office of Aging and Adult Services pages, the Governor's Office of Elderly Affairs, CareScout and VA rate tables as cited above; see our editorial standards.
