Comparison of Three Levels of Care

ASSISTED LIVING RESIDENTIAL CARE (rest home) SKILLED NURSING (nursing home)
Regulated by MA Executive Office of Elder Affairs Licensed & Regulated by MA Department of Public Health Licensed & Regulated by MA Department of Public Health
Provide up to 3 meals daily in dining room & social activities Provide 3 meals daily, snacks, social activities & events Provide 3 meals daily, snacks, activities
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 Onsite staff responds to emergencies
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 Administers medications; maintains medical record, takes MD orders; coordinates medical care needs.
Supervision of bathing/dressing for a set number of hours. Additional hours by fee. Provides assistance with bathing dressing Assistance with all personal care needs; total care
Minor nursing services Licensed nurse available at times RN & LPN coverage 24/7; medical director available for consultation
Resident provides furniture Encourage personal belongings; furniture provided Furniture provided; may have special units for rehab, dementia etc.
Primarily private pay; limited Medicaid slots Mostly subsidized by Medicaid, SSI & private pay Medicare, Medicaid, long term care insurance & private pay