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Assisted living vs. nursing home: What's the difference?

Mar 02, 2017 01:21AM
By Dennis McGraw

Senior living options are on the rise. With an aged population set to hit 72 million by 2050, housing options are springing up everywhere. Assisted Living (AL) and Nursing Homes (NH) are the fastest-growing alternatives. But what is the difference between NH’s and AL’s?

The short definition is NH’s care for those with moderate to high needs and AL’s care for those with low to moderate needs. However, the complete definition of care in each facility is a lot more involved.

Nursing Homes have been around for a very long time. They have drastically changed in the last 15 years from an extension of hospital wings to ritzy, upscale rehab centers. However, the old stigma of going to the NH to die still lingers. Nursing Homes serve an important purpose and if operated correctly can be a positive experience for many people. They are by definition clinical and are heavily regulated by state and federal government groups.

People living in NH’s often share rooms and have hard-surface floors, separation curtains and shared bathrooms. They have access to RN’s and a house doctor. However, because of staffing ratios, staff time is limited and they often cannot spend the time the patient needs or wants.

I left the NH industry and moved into to the AL industry a few years ago and I love it! AL facilities are usually warm and inviting. The rooms are carpeted, the bathrooms are private, and most facilities have beautiful dining areas, exciting activities and large volunteer groups. For myself, I prefer the smaller-type AL homes. They are in neighborhoods; they feel and look like homes, and the staff to resident ratio is usually very good, which equates to high quality care.

Some people who live in AL’s have higher needs. There are complicated ways to decide if someone qualifies to live in an AL. However, one easy way to tell if you or your loved one can live in an AL is to ask, can they evacuate themselves in an emergency, or can they assist in their own evacuation? If they can help to transfer to a wheel chair, and maybe even wheel it or scoot along with their feet, they may qualify for an AL.

The most common practice of paying for Nursing Home care is Medicaid and Medicare and there often are large daily or monthly co-pays. Private rates for a shared long-term care bed at a Nursing Home range from $5,000 to $6,500 per month.

The most common practices for paying for Assisted Living are private pay and veteran benefits. There is also a newer program called "The New Choice Waiver." This Medicaid program was created to allow people to move out of NH’s and into AL’s and Medicaid pays the costs. Private pay costs in an AL are from $2,000 to $4,000 per month.

When deciding which is best for you, NH or AL, get educated, know your options and tour facilities to find the place that feels the best.

Dennis McGraw is a licensed Nursing Home Administrator, has a B.S. in health care administration and is current owner/operator of Beehive Homes assisted living in Spanish Fork, Salem and Payson.