Often, yes. A parent with a Foley or suprapubic catheter can live in assisted living when state rules and the community's policy allow it. In California, staff taught by a skilled professional, such as a nurse, may empty the bag, but only that professional may insert, remove or irrigate the catheter. Medicare Part B can help pay for the supplies. Ask the community who does each task.
Key facts
- California's rule lets a community accept or keep a resident with an indwelling catheter if the resident can handle all of its care except insertion and irrigation. (Cornell LII, n.d.)
- Under California's rule, only an appropriately skilled professional may insert, remove or irrigate an indwelling catheter, and staff may empty the bag only after that professional has taught them how. (Cornell LII, n.d.)
- Medicare Part B covers urological supplies as prosthetic devices when a doctor or other provider orders them, and after the Part B deductible the patient pays 20% of the Medicare-approved amount. (Medicare.gov, n.d.)
- CGS, a company that handles Medicare equipment claims, says Medicare pays for one catheter per month, with exceptions such as a catheter that comes out by accident, stops working or gets blocked. (CGS Medicare, 2025)
- The CDC says a catheter-associated urinary tract infection (CAUTI) is one of the most common infections linked to health care, and that it can be prevented and treated. (CDC, 2025)
The hospital papers say your mom is going home with a catheter. The assisted living community you liked said on the phone that a catheter is "usually fine." Nobody has said who empties the bag at night, who changes the catheter next month, or who notices if something is wrong.
This post covers what state rules allow, which tasks need a nurse, infection signs, who pays for supplies, and the care plan. One question that is easy to forget, about a catheter that stops draining at night, is in the tour section.
This post explains how catheter care works in assisted living. Whether your parent needs a catheter, which kind, and how it is cared for are decisions for their doctor.
Can a parent with a catheter live in assisted living?
Often, yes. It depends on state rules, the community's policy, and how much of the care your parent can do alone.
Two kinds of catheter stay in place. An indwelling catheter, often called a Foley, is a tube that sits in the bladder and drains urine into a bag outside the body. A suprapubic catheter also stays in, but it goes into the bladder through the lower belly.
The community decides whether it can meet your parent's needs at the care assessment. Bring the doctor's orders for the catheter and the name of the supply company.
What do state rules say about catheter care in assisted living?
Each state writes its own rules. Two states show the range.
California licenses assisted living as residential care facilities for the elderly. Its rule on indwelling urinary catheters says:
- A community may accept or keep a resident with an indwelling catheter if the resident can handle all of its care except insertion and irrigation.
- Only an "appropriately skilled professional" may insert, remove or irrigate the catheter, and only under a physician's orders.
- If the resident needs help, that professional changes the bag and tubing.
- Staff may empty the bag once a skilled professional has taught them how. The professional writes down which staff were taught and checks their work at least once a year.
- Care must be given in private.
California defines that professional as someone trained and licensed for the procedure, such as a registered nurse or a licensed vocational nurse. The person may work for a home health agency, for the community or for the resident.
Pennsylvania handles it through approvals. An assisted living residence there needs a written decision from the state to serve someone who needs "insertions, sterile irrigation and replacement of a catheter." No approval is needed for routine upkeep of a urinary catheter if your parent can do it or a licensed health care professional does it.
The residence asks in writing, with a support plan, and the state must answer within 5 business days. Your parent can ask the residence to apply, and the residence records its answer on a state form.
Other states may be stricter or looser, and a community can add limits of its own. To find your state's rule, search the assisted living licensing agency's website for "catheter," or ask the community which rule it follows.
Who empties the bag, and who changes the catheter?
California's rule splits the work like this, which makes a good map for questions in any state:
| Task | Who does it under California's rule | Ask the community |
|---|---|---|
| Emptying the bag | Your parent, or staff a skilled professional has taught | How often, and who checks it at night? |
| Changing the bag and tubing | Your parent, or a skilled professional if your parent needs help | Who switches the day bag and the night bag? |
| Daily cleaning around the catheter | Not spelled out in the rule | Do aides help with this as part of bathing, or is it a nursing task here? |
| Inserting, removing or changing the catheter | A skilled professional, under a physician's orders | Your nurse, a home health nurse, or the doctor's office? |
| Irrigation (flushing the catheter) | A skilled professional, under a physician's orders | Who does it, and how fast can they come? |
| Watching for problems | Not spelled out in the rule | Who calls the doctor, and when do you call us? |
MedlinePlus says people may get a small bag for the day and a larger one for the night, so that switch happens twice a day.
When a nurse is needed, the visit may come from the community's own nurse, a home health agency or the doctor's office. How often the catheter is changed is the doctor's call. Our post on home health care in assisted living explains when Medicare pays for nurse visits there.
Which infection signs should families and staff know?
A catheter-associated urinary tract infection, or CAUTI, happens when germs get into the urinary tract through the catheter. The CDC says it is one of the most common infections linked to health care, and that it can be prevented and treated. The biggest risk is having a catheter in for a long time.
Signs to report, from the CDC and MedlinePlus:
- Burning or pain below the stomach, or in the bladder or pelvis
- Burning while urinating, or urinating more often than usual
- Fever or chills
- Pain in the sides or lower back
- Urine that smells bad, looks cloudy or changes color
- Discharge or drainage where the catheter enters the body
- Feeling unwell, such as tired, achy or having trouble focusing
- Blood in the urine, leaks around the catheter, or a catheter that seems blocked
Older adults may show one more sign. MedlinePlus lists mental changes or confusion among the signs when an infection spreads to the kidneys. It says that in older people, these are often the only signs of a UTI. If your parent suddenly seems confused, tell the nurse and the doctor.
The CDC's tips for people with catheters work for everyone who helps:
- Clean hands before and after touching the catheter.
- Keep the urine bag below the level of the bladder.
- Don't tug, pull, twist or kink the tubing.
- Ask the doctor from time to time whether the catheter is still needed.
Treatment is for the doctor to decide. The CDC says most of these infections are treated with antibiotics, by removing or changing the catheter, or both.
Who supplies and pays for catheter supplies?
Under Original Medicare, a doctor orders the supplies and a supplier provides them. Medicare.gov lists urological supplies among the prosthetic devices that Part B covers when a doctor or other provider orders them.
- After the Part B deductible, your parent pays 20% of the Medicare-approved amount.
- Medicare only pays if the supplier participates in Medicare.
- The problem with urination must be permanent. CGS, a company that handles Medicare equipment claims, says a condition of "long and indefinite duration" meets that test.
- Medicare pays for one catheter per month, CGS says, with exceptions such as a catheter that comes out by accident, stops working or gets blocked.
With a Medicare Advantage plan, call the plan and ask which suppliers it uses and what your parent will pay. With Medicaid, ask the state Medicaid office. A counselor at your State Health Insurance Assistance Program (SHIP) can help with Medicare questions.
The community's bill is separate. Ask whether help with the catheter raises your parent's level of care and the monthly price. If your parent also uses pads or briefs, those are handled differently, as our post on incontinence care in assisted living explains.
Before move-in, give the supplier the new address, and ask the community who receives and stores the boxes.
What should you ask about catheter care on a tour?
Ask the nurse or the executive director, and get the key answers by email:
- Do you accept residents with a Foley or suprapubic catheter? Is your policy in writing?
- What will aides do, and what must my parent do alone?
- Who empties the bag, how often, and who switches the day and night bags?
- Who changes the catheter itself: your nurse, a home health nurse or the doctor's office?
- Who taught your aides catheter care, and when was their work last checked?
- When is a nurse on site? Who is on call at night and on weekends?
- What happens if the catheter stops draining or comes out at 2 a.m.?
- How will you tell us about signs of infection or a sudden change in my parent?
- Which catheter needs would lead you to say my parent needs more care than you offer?
Question 7 is easy to forget. The answer shows how the building works at night.
Words for the talk with the community nurse: "My dad has a Foley catheter, and his doctor's office changes it. Who would empty and change his bags here? If it stops draining in the middle of the night, who checks it, and who would you call?"
The full assisted living tour questions guide covers staffing, costs and contracts.
Keep the catheter answers next to each community
Parent Move Plan includes 41 tour questions and a weighted comparison of 12 criteria, so the answers about care and cost sit side by side for every community you see. It works in Google Sheets or Excel, shared with your family.
Get your first 3 days freeWhat should the care plan say about the catheter?
The care plan is where the tour answers become promises the next shift can see. Ask that it covers:
- The type of catheter and the doctor's orders for it, including any irrigation
- What your parent does alone and what staff help with
- Who empties the bag and how often, and who switches the bags
- Who changes the catheter, how often, where, and who books the visit
- The supplier's name and phone number, and who reorders
- Which signs staff report, to whom, and when the family hears about it
- Privacy during care, which California's rule requires
Ask your parent which parts they want to keep doing themselves, and write that down too. It is their body and their routine.
Bring the list to the first care plan meeting, and ask for an update whenever the doctor changes the orders.
When do catheter needs point to a higher level of care?
It's time to ask when your parent's care goes past what the state rule and the staff allow. California's rule starts from a resident who can handle all of the care except insertion and irrigation. Pennsylvania lists continuous skilled nursing care 24 hours a day among the conditions a residence can't serve without an exception.
Talk with the doctor and the community nurse if you notice any of these:
- The catheter blocks or comes out often, and a nurse is needed more often than the community can arrange.
- Infections keep coming back.
- Your parent pulls at the tubing, or can no longer tell staff when something hurts.
- The doctor orders care, such as frequent irrigation, that no one on site is allowed to do.
The next step may be more nursing help in the same building, or a move to a nursing home. Which care fits is for your parent and their doctor to decide with the care team. If a community says it can no longer meet your parent's needs, ask which rule or policy it is relying on.
Frequently asked questions
Can a person with a Foley catheter live in assisted living?
Often, yes, if the state rules and the community's policy allow it. California, for example, lets a community accept or keep a resident with an indwelling catheter when the resident can handle all of its care except insertion and irrigation. A skilled professional does those. Ask the community for its catheter policy in writing.
Can assisted living staff change a catheter?
Not in California. There, only an appropriately skilled professional, such as a registered nurse or licensed vocational nurse, may insert, remove or irrigate the catheter. Staff who have been taught by that professional may empty the bag. Other states set their own rules, so ask the community who does each task.
Does Medicare pay for catheter supplies?
Medicare Part B covers urological supplies under its prosthetic devices benefit when a doctor orders them. Medicare's rules say the problem with urination must be permanent, which a condition of long and indefinite duration meets. After the Part B deductible, your parent pays 20% of the Medicare-approved amount, and the supplier must participate in Medicare.
Can someone with a suprapubic catheter live in assisted living?
It depends on the state and the community. A suprapubic catheter goes into the bladder through the lower belly, according to the CDC. Ask whether the community's policy covers this kind of catheter, who changes it, and who checks the skin where it enters the body.
What are signs of a catheter infection in an older adult?
The CDC lists burning or pain below the stomach, fever, burning while urinating, and urinating more often. MedlinePlus adds cloudy, bad-smelling or discolored urine, pain in the sides or lower back, and feeling unwell. In older people, confusion may be the only sign. Tell the nurse and the doctor about any of these.
Sources
- Cornell LII: Cal. Code Regs. tit. 22, 87623, Indwelling Urinary Catheter (accessed Oct 2026)
- Cornell LII: Cal. Code Regs. tit. 22, 87101, Definitions (accessed Oct 2026)
- Pennsylvania Code: 55 Pa. Code 2800.229, Excludable conditions; exceptions (accessed Oct 2026)
- CDC: Catheter-associated Urinary Tract Infection (CAUTI) Basics (accessed Oct 2026)
- MedlinePlus: Indwelling catheter care (accessed Oct 2026)
- MedlinePlus: Urinary tract infection, adults (accessed Oct 2026)
- Medicare.gov: Prosthetic devices (accessed Oct 2026)
- CGS Medicare, Jurisdiction C DME MAC: Urological Supplies, information for prescribers (accessed Oct 2026)