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All nursing homes are licensed by each state and meet each state’s health and safety standards. Nursing homes can choose to participate and be certified in the Medicare and Medi–Cal (California) Medicaid (national) programs. Federally certified facilities must meet federal standards as well as the state requirements.

There are several types of licensing and certification categories for nursing homes:

Skilled Nursing Facilities (SNFs) are institutions for chronically ill, usually elderly patients that provide long-term nursing care, rehabilitation, and other services.
A Distinct Part/Skilled Nursing Facility (DP/SNF) is a hospital–based skilled nursing facility.

Assisted Living (ALF) is a living arrangement for seniors, who cannot live independently in their own home, but who do not need the 24-hour medical care provided by a nursing home. There is no nationally recognized definition of assisted living in the US.

Types of services: Meals, housekeeping, laundry, personal care and supervision, assistance with activities of daily living (ADLs), activities and coordination of services by outside health care providers. Assisted Living facilities are regulated and licensed at the state level.
Type of accommodation: Private room or shared. Some communities offer studios and multiply bedrooms and bath
Types of residents: Ambulatory, non-ambulatory, bedridden, dementia, Alzheimer’s, hospice and palliative care, respite.
Size: Fifteen to 300 + residents.
Payment options: Primarily private pay. Long Term Care Insurance, supplement with Veterans Benefits, SSI accepted for limited number communities for a shared room. SSI accepted with contribution from family.

Residential Care is a type of living arrangement provided in a private home. The term may vary depending on the state. Small care homes are referred to as board and care and rest homes and are licensed by each state. Typically the frail seniors who require a higher level or care reside in these types of homes.

Type of services: Meals, housekeeping, laundry, personal care and 24 hour supervision, assistance with activities of daily living activities, coordination of services by outside health care providers
Type of residents: Ambulatory, non-ambulatory, bedridden, dementia, Alzheimer’s hospice and palliative care, respite.
Size: Less than 15 residents
Payment options: Primarily private pay. Long term care insurance, supplement with Veterans Benefits, SSL accepted for a shared room limited number of facilities. SSI accepted with contribution from family.

Alzheimer’s Care can be provided in either small or large residential and or assisted living facilities provided they meet the additional state requirements for a safe and secured environment, specialized staff training and activities to promote the highest level of functioning.

Type of services: Meals, housekeeping, laundry, personal care and 24 hour supervision, assistance with activities of daily living activities, secured and or locked perimeters, coordination of services by outside health care providers
Type of residents: Ambulatory, non-ambulatory, bedridden, dementia, Alzheimer’s, wanderer, hospice and palliativecare, respite.
Size: Large or small
Payment options: Primarily private pay. Long term care insurance, supplement with Veterans Benefits, SSL accepted for a shared room limited number of facilities. SSI accepted with contribution from family.

• Personal experience strengthens the relationship with the admitting facility.
• Direct contact means no middle man is paid a fee for a resident admission.
• Without paying a referral fee there is more flexibility to admit respite, short term or end stage resident.
• The direct contact strengthens facility marketing and business skills.
• Increases facility profitably and bottom line.
• Because this is what the consumer wants – they prefer to establish the relationship directly with the facility.

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