Dissimilarities Among Nursing Properties, Assisted Residing & Continuing Care Retirement Communities


Benjamin Franklin claimed it very best – “nothing in everyday living is specified apart from demise and taxes” but with each day advancements in science, technological know-how and health care, People are dwelling for a longer time than ever prior to*. This blessing nonetheless, has developed a unique dilemma for modern day American family members: How to system for and prepare for one’s retirement several years.

Have you taken a highway-excursion lately? Nearly each and every freeway is graced with massive invoice-boards furnishing the destinations of new prepared communities exactly where partners can invest their retirement years devoted to leisure pursuits. I question you will find a community newspaper that does not have at least a single ad endorsing the amenities uncovered at a neighborhood assisted living facility. Consider to lookup for “nursing houses in Virginia” on the Net and thousands of web internet pages will show up. Every single and every single working day new services giving distinct courses are becoming developed and promoted across the condition.

Is such a facility proper for you and your relatives? If so, which facility? We frequently listen to the terms “retirement local community,” “nursing home,” and “assisted dwelling facility” but rarely look at what these phrases in fact imply. The variances even so, are striking and it is vital to fully grasp these dissimilarities when producing alternatives for by yourself or your beloved ones.


In Virginia, a nursing house signifies any facility with the major purpose of furnishing extended-time period nursing treatment, nursing companies and well being-relevant expert services on a continuing foundation, for the therapy and inpatient care of two or additional non-connected people today**. Set only, a nursing property is a facility made for another person who wants considerably less treatment than a medical center, but needs each day overall health treatment aid.

The Virginia Office of Overall health licenses these types of amenities and has established guidelines regulating different aspects of their functions, programs, and staffing needs, and many others***. For instance, a nursing household should: (a) have composed procedures and procedures relating to the cure of people and the management of resident treatment which are obtainable to inhabitants and their family members (12VAC5-360-20) (b) offer crisis professional medical products and services inside of 15 minutes, beneath ordinary circumstances (12VAC5-360-50) (c) be matter to unannounced on-website inspections of the nursing facility by Point out staff (12VAC5-371-60) (d) have a published agreement with a person or far more doctors licensed by the Virginia Board of Medication to serve as health care director (12VAC5-371-230) and (e) each resident shall be under the treatment of a medical doctor licensed by the Virginia Board of Medication (12VAC5-371-240).

In addition, residents of nursing houses are also given specified legal rights as defined by Virginia Code §32.1-138. See http://leg1.point out.va.us/cgi-bin/legp504.exe?000+cod+32.1-138. Nursing households are the most regulated and structured residential solutions for our Seniors requiring some degree of each day wellbeing treatment. If the facility presents care by way of Medicare and Medicaid systems, it is deemed a “Accredited nursing facility” (Virginia Code §32.1-123 Virginia Code §32.1-127) and have to be in compliance with both federal and point out regulations.

Of class, the a lot more procedures and polices that outline and control the day-to-day operations of a nursing residence, the greater the obligation of the workers. These are the folks who will be charged with the day by day job of caring for your beloved 1, and producing sure they are in compliance with state and federal guidelines. No subject how wonderful and or attractive the facility could be, the staff will make the variation between your beloved just one being cared for and inspired, or not.

A nursing house is finest suited for somebody:

  • Who calls for daily health and fitness care – this sort of as assistance receiving in and out of mattress using medicine or making use of the restroom.
  • Who may perhaps have dementia or Alzheimer’s and as a outcome, is unable to take in and or bathe day-to-day without having reminder or assistance
  • Who is recovering from a drop or accident and is for that reason unable to wander, costume and or take in with no help


“Assisted residing facility” means an grownup treatment home which has been licensed by the Virginia Department of Social Services to present a amount of support for adults who may perhaps have actual physical or psychological impairments and require at least reasonable help with the actions of everyday dwelling. Within just assisted living, there are two varieties: normal assisted dwelling for all those seniors (generally) who have to have guidance with a single or additional each day activity and intense assisted residing for anyone who may possibly be incapable of performing actions owing to mental and/or severe bodily impairment (12VAC30-120-450).

The Virginia Section of Social Services licenses assisted residing services but does not regulate in the way the Division of Overall health regulates nursing residences. When there are Virginia guidelines regulating features of assisted living facilities, they are restricted: An assisted residing facility ought to: (a) deliver or coordinate individual and health and fitness treatment services and (b) give 24-hour supervision.

As mirrored in the desk below, assisted dwelling facilities have no obligation to present health treatment and/or have overall health treatment personnel available to assist your liked one. In addition, with no obligation to offer these types of services, there is the concern as to whether or not they owe a duty to alert or deal with inhabitants with diseases or ailments that could be transmitted from other inhabitants.

Although a nursing residence will have numerous nurses on workers and physicians hired to keep track of the residents, assisted dwelling is far more analogous to an condominium developing or school dorm where by laundry and food items solutions are furnished and residents are on their have for the rest of the working day.

An assisted living Facility is ideal suited for an individual:

  • Who is basically unbiased but may well not be capable or keen to put together their possess food or generate to doctors’ appointments
  • Anyone who wants to scale back again and anticipates needing help with laundry, cooking, and so forth. in the close to foreseeable future.
  • A pair wherever a person partner is impartial but may perhaps have to have support in feeding and or providing for needs of other partner.


In Virginia you might also see adverts for a retirement community. They are popping up all close to our most loved University Cities and Vacationer places.

A Continuing Care Retirement Neighborhood presents treatment depending on your present requirements. Like an coverage plan, the resident pays an entrance charge and periodic adjustable payments, which in transform provides the resident a deal of residential and healthcare services that the CCRC is obligated to give at the time these residential and overall health care expert services are required. For case in point, if upon entering, all you want is enable with your foods, that is the only support which will be offered. If you have to have intense physical treatment or God forbid, daily help for a Dementia affected person, the CCRC has assisted dwelling products and services or nursing house solutions offered less than your agreement. Continuing care contracts are regulated by the Virginia Bureau of Insurance policies of the Virginia Point out Company Fee.

A lot of CCRCs can have nursing household companies accessible either on-web site, or at licensed facilities off-web-site (12VAC5-360-10). When you may well be getting into the Retirement Community as a pretty healthier unbiased and able resident, as your desires change, so will your deal with the Local community and in turn, the facility’s obligations to you.

A Continuing Treatment Retirement Community Facility is finest suited for an individual:

  • Who is generally impartial but anticipates the want for each day health treatment for them selves or a spouse in the in the vicinity of long run
  • An individual who is bodily disabled and would be not able to treatment for on their own or a wife or husband if the disability grew even worse.

With at least 3 very unique decisions, it is really crucial to do your research:

To research assisted dwelling services in Virginia, go to Department of Social Providers site: http://www.dss.condition.va.us/facility/look for/alf.cgi.

To study nursing houses, go to Medicare’s site: http://www.medicare.gov

AND Last BUT NOT Least

It is often very best to converse to a family member of a existing resident and shell out time finding to know the personnel, no subject what style of facility you are wanting into. If hunting and looking into is not sufficient, then take into account the chart underneath – a comparison of the authorized duties of a nursing property compared to the legal obligations of an assisted dwelling facility in Virginia.

Duty or Prerequisite

NURSING Property


Responsibility to provide nursing care and or check resident’s wellbeing?



Health practitioner required to supervise citizens?



Every resident shall be underneath the treatment of a medical doctor accredited by the Virginia Board of Medicine?



Have to have nurses on workers?



Have to present rehabilitative expert services?



Will have to have ongoing session from a registered dietitian or dietitian on personnel?



24 Hour Supervision necessary?

Of course


Have to acquire a composed prepare on admission of resident?


Of course

Staff need to undergo prison qualifications verify?



Monitored by Virginia Center for Excellent Wellbeing Care Companies and Purchaser Protection

Of course


Monitored by Section of Social Providers



*Lifetime expectancy greater drastically all through the past century, from 47 a long time for People born in 1900 to 77 years for those people born in 2001. These very same factors—improved healthcare care and prevention efforts— that are partly accountable for the extraordinary increases in existence expectancy have also manufactured a big shift in the foremost triggers of death in the United States in the previous century, from infectious diseases and acute sicknesses to serious conditions and degenerative health problems.” The Point out of Getting old and Health in The united states 2004, posted by the Center for Sickness Manage, obtainable at http://www.cdc.gov/ageing/pdf/Condition_of_Aging_and_Well being_in_The us_2004.pdf.

**See normally, Virginia Code §32.1-123, as amended and Virginia Administrative Code § 12VAC5-360-10.

***It is a Felony below Virginia legislation to operate a nursing facility without having a license. See generally, 12VAC5-371-30.

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