Regulation Differences between Assisted Living Facilities and Nursing Homes

Regulation Differences between Assisted Living Facilities and Nursing Homes

Deciding to place a loved one in an assisted living facility or nursing home can be trying for several reasons. First comes the emotional upheaval of moving an aging person from their home, somewhere they may have lived for some time. Many people have legitimate anxieties about entrusting the care of their loved ones to strangers, especially when abuse of the elderly so frequently and tragically makes the news. Understanding the differences between various housing options is vital to helping loved ones age well and safely.

For purposes of definition:

Nursing homes are, essentially, places that provide 24/7 medical care and assistance to elderly people who are quite helpless and suffering from one or more chronic ad debilitating illness, Nurses are always on staff, and medical care is the primary focus of daily activities. Food is provided in a cafeteria, and residents do not live independently.

Assisted Living communities, on the other hand, are designed for seniors who are no longer able to live or function on their own optimally or safely, but who do not require the high level of medical care and supervision of a nursing home. Paid for by private individuals, assisted living facilities seek to foster and sustain their residents’ independence as long as possible. Depending on the location, they may offer meals, nursing services, and even community events.

…when consumers want to know what various facilities are legally responsible for…

There are more differences between these types of facilities, however. Legal regulations create guidelines and manage certain aspects of facilities, and these differences are important, especially when consumers want to know what various facilities are legally responsible for, and who is watching to ensure that all of those living in each kind of facility are safe and well cared for.

Assisted living facilities are often loosely regulated. This is set by individual state laws, so, depending on the state, regulations will differ. For information on what assisted living regulations exist in your state, visit the Assisted Living Federation of America ( at their “Assisted Living Regulations and Licensing” page cited below. (ALFA is now Argentum, meaning “silver” in Latin).

In essence, it should be noted that assisted living facilities are generally not monitored regularly by state or local governments and therefore should be thoroughly investigated before placing a loved one inside the facility. To ensure that the facility you choose is right for you, make a list of priorities, questions, and key elements you would like to see or have answered during a visit. Ask around and speak to current residents and their families. Check for complaints against the facility or past complaints against workers.

State regulations also vary, from relatively lax to very tough.

Nursing homes are governed by both federal and state laws, and so offer more potential protection from safety hazards. In order to receive funding and patients through Medicaid and Medicare, all facilities must abide by the Nursing Home Reform Act of 1987, which states that nursing homes must be able to provide care for every resident according to “a written plan of care.” There are numerous addendums to this, but it boils down to this: if a nursing home cannot care for your loved one according to the prescribed help requested by a doctor, that nursing home must tell you so. State regulations also vary, from relatively lax to very tough. For example, in Georgia, each nursing home must be overseen by a licensed nursing home administrator rather than a corporate executive. Nursing homes in Georgia must also have easy access to transfer patients to a local hospital, ensuring that very ill patients have access to care without bureaucratic loopholes.

Residents also have a Bill of Rights. It accommodates a wide variety of rights, but it includes social time and experiences (in other words, nursing homes cannot bar your loved one from social time) with both family and non-family members, the exercise of free speech, and the right “to voice grievances without discrimination of reprisal,” which is vital to ensuring that abuse or neglect is caught and ended.

Reading up on the regulations in your state regarding assisted living and nursing home facilities is vital to finding the right place for your loved one’s care, and ensuring the best care is available to them. Learn as much as you can about types of facilities and specific facilities before placing a loved one anywhere for any length of time.



Argentum. Assisted Living Regulations and Licensing. Available at Retrieved 1/22/2016.

University of Minnesota, School of Public Health. Health Policy Management. Long Term Care. State Regulations by State. Available at Retrieved 1/22/2016.

Nursing Home Alert. Federal Nursing Home Regulations and State Laws. Available at Retrieved 1/22/2016.

Nursing Home Alert. Resident Bill of Rights. Available at Retrieved 1/22/2016.