Comparison of Three Levels of Care

ASSISTED LIVING RESIDENTIAL CARE (rest home) SKILLED NURSING (nursing home)
Regulated by MA Executive Office of Elder Affairs – Tenant Landlord Agreement Licensed & Regulated by MA Department of Public Health Licensed & Regulated by MA Department of Public Health
Provide up to 3 meals daily, social activities, & events Provide 3 meals daily, snacks, social activities & events Provide 3 meals daily, snacks, social activities & events
Housekeeping & laundry services (may require an extra fee) Housekeeping & laundry included Housekeeping & laundry included
Offer 24 hour security 24 hour supervision & security 24 hour skilled nursing, IV drugs, oxygen, injections, mechanical lift transfers
Onsite staff responds to emergencies call 911 Onsite staff respond to emergencies; gives first aid & calls 911 when appropriate Onsite staff respond to emergencies; gives first aid & calls 911 when appropriate
May provide oversight of a resident’s self-administration of medication (extra fee) Administers medications; maintains medical record, takes MD orders; coordinates medical care needs incl. x-rays, lab, & other services on site Administers medications; maintains medical record, takes MD orders; coordinates medical care needs incl. x-rays, lab, & other services on site
Supervision of bathing/dressing for a set number of hours. Additional hours by fee. Provides assistance with ADL Provides assistance with ADL to total care
Minor nursing services RN or LPN available; medical director available for consultation RN & LPN coverage 24/7; medical director available for consultation
Resident provides furniture Encourage personal belongings; furniture provided if desired by resident Furniture provided; may have special units for rehab, dementia etc.
Primarily private pay; limited Medicaid slots; VA A&A elligible Mostly subsidized by Medicaid, SSI, long term care insurance, & private pay VA A&A eligible Medicare, Medicaid, long term care insurance & private pay