Senior Care Consulting
Senior Care Consulting

Levels of Care Defined


Nursing Home. Nursing Homes are designed for individuals who, due to a chronic illness or compromised medical or cognitive condition, can no longer live independently and require up to 24-hour nursing care. While moving to this type of facility is typically on a long-term basis, many residents come to these facilities on a short-term basis to receive skilled nursing and rehabilitation therapies after a hospitalization, then return home.

Assisted Living Facility. Assisted Living Facilities (ALF or AL) provide help with activities of daily living like bathing, dressing, grooming, meal preparation, housekeeping, and laundry services. They may also dispense medication and offer additional services like an activities program as well as getting to and from appointments outside of the facility. Typically residents have their own apartment and eat meals together in the dining room. Social and recreational activities are also provided. Some facilities have health services on site for very limited medical care at an additional cost. They may have increasing level-of-care charges based on resident needs.


Independent Living Facility. Residents in an Independent Living Facility live independently in a larger nice apartment. One to three meals per day are offered as well as a full kitchen in the apartment, activities, banking, call system for emergencies, and various hotel-level amenities.


Continuing Care Retirement Community (CCRC). Continuing Care Retirement Communities offer all facility types including Independent Living, Assisted Living, and Nursing Home care. The concept is to “age in place” with increased assistance and medical services available when needed without having to relocate from the facility or campus. Residents don’t have to enter at the Independent Living level, they can enter the community at any facility type or level of care.  


Intermediate Care Facilities.An Intermediate Care Facility (ICF) is for residents who can no longer live independently but need more assistance and care than what is offered in an Assisted Living Facility. These facilities do not have Medicare covered Skilled Nursing services. There are not too many ICFs in this area.


Residential Care 1. A Residential Care 1 Facility (RCF1) is a state licensed facility that provides 24-hour care to residents who are able to care for themselves with minimal assistance. Residents must be able to self-transfer (i.e. from wheelchair to bed) and be able to physically and mentally negotiate a pathway to safety in the event of an emergency. Residents are provided with shelter, board, and with protective oversight, which may include storage and distribution or administration of medications and care during short-term illness or recuperation.


Residential Care 2. A Residential Care 2 Facility (RCF2) is a state licensed facility that provides 24-hour care to residents who are ambulatory or semi-dependent (use a walker or cane). RCF II provides supervision of diets, meal preparation, social activities, assistance with personal care, housekeeping, storage and distribution of medications, and supervision of health care under the direction of a licensed physician.


Home Plus. A Home Plus facility is usually a licensed private home for eight people or less. A person may share or have a private bedroom. All the people share the common spaces of the home. Meals are provided. Supervised nursing care provided by certified nurse aides is available twenty-four hours a day. Skilled nursing care by a licensed nurse may be provided on an intermittent or limited basis, or on a regular basis if limited in scope.   Assistance and services are the same as in an assisted living facility.


Board and Care. A Board and Care facility is usually a private home for up to ten people. A person may share a bedroom or have his or her own bedroom. All the people share the common spaces of the home. Non-certified or non-licensed staff provide supervision 24 hours per day. The only assistance and services the people may receive are meals, laundry, housekeeping, and supervision for self administration of medication. This type of facility does not provide personal, medical, or skilled nursing care. The resident must be able to walk and manage their own affairs.

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