10 Types of Elder Care Facilities
- Reviewed By
Anthony C. Lanzone, Founding Partner
Choosing the right elder care facility depends on your loved one’s medical needs, level of independence, and required support. From skilled nursing facilities and assisted living to memory care and hospice, there are various options to ensure proper care. Researching facilities thoroughly and understanding their services can help you make the best decision for your family.
What Are the Different Types of Elder Care Facilities?
Aged care facilities run a broad spectrum. You can find programs that offer on-site medical care and housing arrangements or simple day programs that encourage mental stimulation. There are 10 basic types of nursing homes to know.
Skilled Nursing Facilities or Nursing Homes
A skilled nursing facility, or SNF, offers 24-hour care for its residents. SNFs are also referred to as nursing homes, convalescent hospitals, or rehabilitation centers.
Loved ones who require constant care for an ongoing, chronic illness may be a good fit for an SNF. As residents, they’ll be under the care of the SNF’s medical director or their personal physician. SNFs sometimes offer specialized support units for patients with dementia, which other types of elder care facilities may not provide.
The California Department of Public Health’s Licensing and Certification Division oversees SNFs. It manages the licensing program and performs regular facility compliance inspections.
SNFs may or may not accept patients with Medicare or Medi-Cal coverage. A facility that treats Medicare or Medi-Cal residents must be licensed and certified. If a skilled nursing facility does accept Medi-Cal, it must meet the federal government’s licensing standards.
Residential Care Facilities for the Elderly or Assisted Living
Residential care facilities for the elderly, or RCFEs, are a tier below SNFs. Medical practitioners sometimes refer to them as assisted living facilities or residential care homes.
Residential care homes combine housing and personal care for an elderly individual. Residents may need help with basic living activities such as making meals, grooming, or going to doctor’s appointments.
An assisted living facility offers services similar to those provided by an intermediate care facility, or ICF. However, ICFs provide short-term support, focusing on stabilizing a patient’s medical condition. In contrast, assisted living facility residents need 24-hour care but still retain some functioning. Their illness may arise sporadically.
The California Department of Social Services, Community Care Licensing Division, oversees RCFEs. It issues licenses and performs regular compliance inspections.
Generally, Medi-Cal doesn’t cover the cost of assisted living. There are some exceptions under the Assisted Living Waiver program.
Adult Day Services Programs
If your loved one doesn’t need 24-hour care, you may look into an Adult Day Service program. There are two types: Adult Day Programs, or ADPs, and Adult Day Health Care, or ADHC. An ADP provides supervision, activities, and dietary help. ADHCs provide everything an ADP does, plus nursing and physician services and occupational, physical, and speech therapy. An ADHC can also assist with mental health needs.
Elderly adults generally attend ADPs or ADHCs several times a week, usually up to eight hours daily. These programs can support caregivers who work or need a break from full-time caregiving responsibilities.
The California Department of Social Services oversees ADPs, while the California Department of Aging manages ADHCs. Medi-Cal may cover an ADHC, but it won’t pay for ADPs.
Memory Care
Memory care facilities provide support targeted for patients with dementia or Alzheimer’s. Your loved one may receive 24-hour nursing and physician care comparable to what’s available through an SNF. Some assisted living facilities offer memory care units for patients who experience sporadic dementia or Alzheimer’s symptoms but don’t need 24-hour care.
A memory care facility includes features that keep patients from wandering off, such as alarmed doors and enclosed outdoor spaces. It can also support a resident’s cognitive health with activities to stimulate mental function.
Most memory care facilities fall under the SNF or RCFE category, so Medi-Cal may cover part of the cost. The categorization also dictates which California governmental agency oversees licensing and inspections.
Hospice Care
Hospice care provides terminally ill patients with palliative care and quality of life support during the final stages of life. The focus isn’t on curing patients but on making them comfortable for their remaining time. Hospices try to minimize their patient’s pain through medication and help with day-to-day activities.
Patients can receive hospice care at home or at a dedicated facility. The choice depends on the patient’s ability to care for themselves and how much caregivers can support their needs. Some patients may only need assistance part-time, while others need 24-hour care from physicians and nurses.
The California Department of Public Health, Licensing and Certification Division, oversees hospice providers. Medi-Cal may cover some of the care costs.
Independent Living Facilities
If your loved one is not suffering from a major illness or does not need constant care, an independent living facility may be a solid alternative. These facilities support people aged 55 or older in a community environment. Residents have their own apartment, which may be a studio or larger—sometimes up to two or three bedrooms.
An independent living facility alleviates some of the challenges of aging, such as finding social outlets or maintaining a house. These facilities offer regular activities for residents to participate and lots of socialization opportunities.
Some independent living facilities provide transportation support for doctor’s visits and other needs, like groceries. It all depends on the program.
While they may sound similar to RCFEs, the residents in independent living facilities are usually pretty active and mentally acute. They don’t require consistent medical or personal care support.
Medi-Cal typically doesn’t cover independent living facilities.
Acute Care Facilities or Hospitals
Your loved one may need medical assistance from an acute care facility if they experience a serious health incident or illness that needs immediate treatment. These facilities keep patients long enough to receive care for their acute medical conditions. Most hospitals are acute care facilities.
After recovering from an immediate crisis, patients may be transferred to a distinct part facility if they require post-acute care. Distinct part facilities are usually adjacent to the hospital and offer rehabilitation services needed for treatment.
Patients may also go home after their care at an acute care facility. It all depends on their treatment plan and how much support they need. Someone taken to a hospital for severe flu may recover within a few days or weeks and be well enough to return home. That might not be the case for a patient who suffers a dislocated hip, gets surgery, and requires physical and occupational therapy to fully recover.
Medi-Cal covers hospitalization and emergency services. It may also pay for rehabilitation and treatment following a surgery or illness.
In-Home Health Care
Elderly individuals who prefer to remain at home but need some assistance or medical care may get an in-home health care provider. In this situation, the patient stays at home, and medical providers or home care aides stop by regularly. Physicians or other medical providers may offer in-home care for certain illnesses, while aides can assist with personal care needs.
In-home hospice care is also an option for some terminally ill individuals in the final stages of life. In this arrangement, the patient continues to live at home. They receive care focused on their emotional well-being and physical comfort.
Medi-Cal may cover in-home health care through the In-Home Supportive Services Program. Coverage may extend to medical and hospice services for licensed agencies.
The California Department of Public Health oversees home health care agencies and hospice services.
Intermediate Care Facilities
If your loved one is experiencing a transient medical episode, they may stay at an intermediate care facility, or ICF. Intermediate care services are those that help stabilize patients experiencing an immediate health crisis or an acute mental illness episode.
Unlike assisted living facilities, stays in an ICF generally last from a few weeks to a few months. They provide a short-term service for people in a medical crisis.
Intermediate care facilities focus on preventing patients’ conditions from deteriorating. Medication, support services, and therapy help stabilize the patient so that they can return to their normal lives.
Medi-Cal pays for ICF so long as the patient meets the program’s admission criteria and has coverage. The California Department of Health Licensing and Certification Division oversees ICF licensing.
Continuing Care Retirement Communities
Some elderly people decide to enter a continuing care retirement community that offers a full range of support services, from guaranteed housing to skilled nursing care. Residents may not need all the care and services available when they enter the program.
Continuing care retirement communities are a lifetime arrangement. Participants agree to pay a set amount according to their contract for the remainder of their lives. In exchange, they get access to all the medical support the center offers as they age. That can include assisted living and an SNF, which may be on-site or near the community.
Medi-Cal doesn’t cover continuing care retirement communities, and the Department of Aging notes they can be quite expensive. The state’s Department of Social Services oversees compliance issues related to these types of facilities.
Finding the Right Elder Care Facility for Your Loved One
If a parent or other loved one needs support you can’t provide, a residential care facility for the elderly may be the right fit. Look for one that best aligns with the individual’s needs, whether they require full-time nursing assistance or could benefit from personal care support.
Try to find a facility within a short drive of your home. Proximity to the facility enables you to check in on your loved one frequently and ensure they’re adjusting well. You may also discuss daily care routines and staff-patient ratios with doctors and nurses.
The following are a few resources for locating elder care facilities:
- California Department of Social Services – Search for California elder care facilities by type and location.
- LongTermCare.gov – Get Information about long-term care options.
- California Department of Aging: This site offers a one-stop resource for California elder care programs and services.
Be aware that some facilities have a history of elder abuse, which can be harmful to a patient and their family. Carefully research your options for any instances of physical or mental neglect. Avoiding low-quality facilities may help prevent any harm to your loved one. Use the Medicare Compare tool and its information about care results and value to support your research.
Legal Support for Nursing Home Abuse and Neglect
The skilled nursing home abuse attorneys at Lanzone Morgan, LLP, have over 75 years of experience representing California clients in cases of elder abuse and nursing home neglect. If your loved one is suffering at the hands of an elder care facility, we can help.
Contact us to arrange a free consultation with our firm.
- Fact-Checked
This content has been legally reviewed and approved by nursing home abuse attorney, Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.
VIEW SOURCES
Stress and How to Reduce It: A Guide for Older Adults (2023, March 24). https://www.ncoa.org/article/stress-and-how-to-reduce-it-a-guide-for-older-adults/
Elder sexual abuse and warning signs. (n.d.). https://www.michigan.gov/voices4/about/elder
California Code, WIC 15657.01. (n.d.). https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=15657.01
California, S. O. (n.d.). Report Elder Abuse – Long-Term Care Ombudsman | California Department of Aging – State of California. https://aging.ca.gov/Programs_and_Services/Long-Term_Care_Ombudsman/Report_Elder_Abuse_or_Neglect/
California Code, WIC 15610.05. (n.d.). https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=15610.05
- Fact-Checked
This content has been legally reviewed and approved by nursing home abuse attorney, Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.
VIEW SOURCES
Stress and How to Reduce It: A Guide for Older Adults (2023, March 24). https://www.ncoa.org/article/stress-and-how-to-reduce-it-a-guide-for-older-adults/
Elder sexual abuse and warning signs. (n.d.). https://www.michigan.gov/voices4/about/elder
California Code, WIC 15657.01. (n.d.). https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=15657.01
California, S. O. (n.d.). Report Elder Abuse – Long-Term Care Ombudsman | California Department of Aging – State of California. https://aging.ca.gov/Programs_and_Services/Long-Term_Care_Ombudsman/Report_Elder_Abuse_or_Neglect/
California Code, WIC 15610.05. (n.d.). https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=15610.05