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The Difference between Assisted Living and Skilled Nursing Facility

Understanding the difference between Assisted Living and a Nursing Home is essential to weigh your senior living options effectively. Many people confuse Assisted Living Facility (ALF) with Skilled Nursing Facility (SNF). The two are very different. ALFs are licensed through the Department of Social Service and is considered non-medical facility. SNFs are licensed through the Department of Public Health and are federally regulated.


Large Assisted Living is best suited for older adults who do not require complex medical care but may require assistance with activities of daily living, such as dressing, bathing, grooming, meal preparation, housekeeping, and medication monitoring. Care in these type of settings is tailored to each individual’s changing needs. While most Assisted Living Facilities only offer medication management, a limited number of facilities can also take administrator medication, for those requiring insulin injections. Assisted living offers a lifestyle that is maintenance-free and includes access to entertainment, dining, and transportation. Residents live in their private apartment that they can furnish and decorate as they choose. Residents choose what they want to eat at meals in restaurant-style dining rooms, and they have the freedom to decide which activities they wish to participate in or how they want to spend their day. Residents and families are involved in decisions regarding their care and services. Assisted living is a wonderful option for older adults who no longer wish to live alone or may need some help. It is important to note that residences do need to have some degree of independence to reside in these type of communities. Assisted living is private pay only unless you have a comprehensive Long Term Care insurance. Medicare, Medicaid, or any health care insurance do not pay for ALF. Many states cover some assisted living communities under Medicaid; however, the amount of coverage and eligibility requirements vary widely. Again note that assisted living communities are governed by state regulations, which fluctuate from state to state, while nursing homes are federally regulated.


The Skilled Nursing Facility (SNF), also known as a nursing home provides the highest level of care outside of a hospital. SNF deliver 24-hour care to people with complex medical conditions who need hands-on assistance and monitoring by a licensed health care professional. A licensed doctor oversees each patient’s care, a nurse is always on-site, and other medical professionals, such as occupational, physical or speech therapists, are also on hand. Approximately half of nursing home residents have dementia, and more than half are bed or wheelchair-bound. These facilities often offer short-term rehabilitation services where a adults of any age can receive daily physical therapy and nursing care before returning home after a medical operation, strokes, or heart attacks. A nursing home is a right choice for someone whose medical needs require full-time nursing care or who can benefit from daily physical/occupational/speech therapy. Most nursing home residents live there permanently because they have ongoing physical or mental conditions that require constant medical care and supervision.


A critical difference between assisted living and nursing homes is that Medicare covers nursing home care for the medical side of expenses, and by Medicaid for the long term care. People can pay privately as well, or out of long term care insurance.

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