There are numerous types of facility-based programs that provide a range of long-term care services. Some facilities provide only housing and related housekeeping, but many also include help managing medications, assistance with personal care, supervision and special programs for individuals with Alzheimer's disease, or 24-hour nursing care. The services available in each facility are often regulated by the state in which the facility operates (for example, some states do not allow some types of facilities to include residents who are wheelchair bound or who cannot exit the facility on their own in an emergency). Facility-based care is known by a wide variety of names, including board and care, assisted living, adult foster care, Continuing Care Retirement Communities (CCRCs), and nursing homes.
Facility-based service providers include the following:
Adult Foster Care
Adult foster care can be provided for individuals or for small groups of adults who need help functioning or who cannot live safely on their own. The foster family provides room and board, 24-hour availability, help managing medications, and assistance with Activities of Daily Living. Licensure requirements and the terminology used for this type of facility vary greatly from state to state.
Board and Care Homes
Board and care homes, also called residential care facilities or group homes, are smaller private facilities, usually with 20 or fewer residents. Most board and care homes accept six or fewer residents. Rooms may be private or residents may share rooms. Residents receive meals, personal care and have staff available 24 hours a day. Nursing and medical attention are usually not provided on the premises. State licensure and the terminology used for this type of facility vary greatly.
Assisted Living
Assisted living is designed for people who want to live in a community setting and who need or expect to need help functioning, but who do not need as much care as they would receive at a nursing home. Some assisted living facilities are quite small – with as few as 25 residents – while some can accommodate 120 or more units. Residents often live in their own apartments or rooms, but enjoy the support services that a community setting makes possible, such as:- up to three meals a day;
- assistance with personal care;
- help with medications, housekeeping, and laundry;
- 24-hour security and onsite staff for emergencies; and
- social programs.
The cost of assisted living varies widely, depending in part upon the services needed by the resident and the amenities provided by the facility. Assisted living is regulated in all states, however, the requirements vary.
Continuing Care Retirement Communities (CCRCs)
Continuing Care Retirement Communities (CCRCs) are also called life care communities. They offer several levels of care in one location. For example, many offer independent housing for people who need little or no care, but also have assisted living housing and a nursing facility, all on one campus, for those who need greater levels of care or supervision. In a Continuing Care Retirement Community, if you become unable to live independently, you can move to the assisted living area, or sometimes you can receive home care in your independent living unit. If necessary, you can enter the onsite or affiliated nursing home. The fee arrangements for CCRCs vary by the type of community. In addition to a monthly fee, many CCRCs also charge a one-time “entrance fee” that may be partially or completely refundable (often on the sale of the unit).
Nursing Homes
Nursing homes, also called Skilled Nursing Facilities (SNF) or convalescent care facilities, provide a wide range of services, including nursing care, 24-hour supervision, assistance with Activities of Daily Living, and rehabilitation services such as physical, occupational, and speech therapy. Some people need nursing home services for a short period of time for recovery or rehabilitation after a serious illness or operation, while others need longer stays because of chronic physical, health or cognitive conditions that require constant care or supervision.
