Three years after approving legislation to establish a category of "assisted-living" housing in the state, Pennsylvania officials are preparing to make those long-term care facilities a reality.

The Department of Public Welfare published guidelines in Saturday's Pennsylvania Bulletin that spell out changes to its 2008 assisted-living proposal and will take effect in six months.

Numerous facilities have advertised themselves as offering assisted living for the frail elderly and others with disabilities, but the term lacked any official definition. They fell under the one-size-fits-all category of some 1,600 personal care homes, regulated by the welfare department to offer housing without the medical services of nursing homes.

Legislators, the long-term care industry, advocates for the elderly and others spent years discussing the need for an intermediate assisted-living category -- offering a higher level of services than most personal care homes but in a more homelike environment than nursing homes.

After a law finally passed in 2007, criticism of proposed regulations by both industry and consumer groups prevented any smooth implementation of the new category. Revisions this year were sufficient to overcome many objections and win approval from the state's Independent Regulatory Review Commission June 3.

Pennsylvania AARP was among the supporters, viewing the new category as recognition that people in long-term care settings would like to age where they are instead of being required to shuttle among institutions.

Assisted-living facilities, which will have to meet more stringent regulations than personal care homes for staffing, training and other aspects, will be able to retain many residents in failing health instead of automatically sending them to nursing homes.

"For such a long time ... you were regulating these mom-and-pop facilities with four or five residents the same as you were regulating a facility that might have 80 to 100 residents and had all the bells and whistles," noted Ray Landis, advocacy manager for the state AARP chapter.

Welfare department spokeswoman Beth Myers said state officials are expecting about 150 facilities to apply for assisted-living status in the first six months after the regulations take effect. Those are likely to be among the biggest of the current personal care homes. Those failing to obtain the new status will be unable to use "assisted living" in their marketing.

Enforcement of the new regulations will be handled by the state Office of Long-Term Living, which is jointly under the departments of welfare and aging and will need to hire new staff.

One critical pending change connected to assisted living is the possibility of new government payments to support low-income residents living in that category, which up to now has largely been viewed as an option for more affluent residents.

Pennsylvania officials will apply to the federal Centers for Medicare & Medicaid Services to use government funds to cover some individuals' assisted-living costs, as an alternative to more expensive nursing home care. Similar government waivers are used now to provide assistance to people in their own homes, to avoid institutionalization.

Looking for more from the Post-Gazette? Join PG+, our members-only web site. You'll get exclusive sports content, opinion, financial information, discounts from retailers and restaurants, and more. Our introduction to PG+ gives you all the details.