Assisted Living, Nursing Home, Memory Care: What is the Difference?

There are many terms to describe the various kinds of long-term care available in Oklahoma for senior adults, Alzheimer’s patients and patients with other types of dementia. What is the difference between “independent living” and “residential care” and “assisted living” and a “nursing home” and a “memory care” facility?

Oklahoma laws and regulations govern long-term care facilities for senior adults and for people of any age who have physical or mental conditions that require nursing care and/or other forms of assistance.

Residents and their families should understand the legal differences that distinguish the various kinds of long-term care permitted under the law. If a resident is admitted to or continues to stay in a facility that is not designed, staffed and equipped to provide the kind and degree of care a resident needs, the result could be tragic.

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Nursing Home and Assisted Living Differences

Here is a brief explanation of seven kinds of long-term care facilities in Oklahoma, as defined by state laws and regulations.

Independent living:

“Independent living” is not a term that is used in Oklahoma’s “Nursing Home Care Act and Long-Term Care Security Act.” As the term is commonly used, the meaning is a bit ambiguous.

In its purest sense, “independent living” may refer to senior adults who are living in their own homes or apartments or are residents of apartment complexes, retirement homes or other residential facilities that cater exclusively to senior adults who want to live with other seniors and are able to take care of themselves.

However, the term “independent living” is also often used as a synonym for a “residential care home,” which is a term defined and regulated by state law. For example, people often refer to independent living, assisted living and nursing homes as three graduated levels of long-term care. Actually, “residential care home” is the term for the lowest level of long-term care defined in the Nursing Home Care Act.

As the next paragraphs explain, residents of residential care homes take care of themselves and enjoy a significant degree of independence, but they do receive “supportive assistance” as needed.

Residential care home:

A facility for residents who are able to walk and take care of themselves, but who may need “supportive assistance,” such as personal care, housekeeping, meal preparation and medication management.

    Level of nursing care:Residential care homes are for residents who do not need skilled nursing care on a routine basis.

Assisted living center:

A facility that provides the same supportive assistance as a residential care home, but provides more nursing supervision than a residential care home. Unlike residential care, which is for residents who are ambulatory, assisted living residents may need help moving about.

    Level of nursing care: An assisted living center provides “intermittent or unscheduled nursing care.” However, the law expressly forbids AL centers from providing 24-hour nursing care.

Nursing home:

A facility that provides skilled nursing care to patients who require medical, nursing, and/or rehabilitative services to a greater degree than is provided by residential care or assisted living.

    Level of nursing care: The big difference of a nursing home is that it provides residents 24-hour nursing care and supervision.

Specialized facility:

A “home, establishment or institution” that provides “inpatient long-term care services on a 24-hour basis” to residents or patients who have a specialized need. The two most common types of specialized facilities are (a) residential facilities for the developmentally disabled, and (b) facilities for patients of Alzheimer’s or other forms of dementia.

    Level of nursing care: The law does not specify a level of care for a specialized facility, since that depends on the kind of specialized need being addressed and the kinds of services being offered.

Specialized facility for Alzheimer’s patients (memory care facilities):

A facility that specializes in caring for residents with Alzheimer’s disease and other forms of dementia. Although Oklahoma has some stand-alone Alzheimer’s facilities, many such facilities are units of residential care homes, assisted living centers, nursing homes and hospitals.

“Memory care” has become a popular term for facilities that care for Alzheimer’s and other dementia patients. The tern “memory care” is not used in the “Nursing Home Care Act and Long-Term Care Security Act,” but it does define and govern “specialized facilities.”

There are no detailed laws or regulations that dictate exactly what services a specialized facility for Alzheimer’s care must provide. In fact, the law does not forbid a nursing home that does not “specialize” in Alzheimer’s care from accepting Alzheimer’s patients.

However, the law requires that if a facility presents itself as providing special care for Alzheimer’s and dementia patients, it must submit detailed information to the state, in accordance with the Alzheimer’s Disease Special Care Disclosure Act of Oklahoma, and be held accountable to the information it submits.

The facility must document:

  • The scope of services it provides,
  • he process it follows to assess patient needs, to develop patient plans of care, and how the plans are adjusted to patients’ changing needs,
  • The staffing the facility has to provide those services, including staff members who have received specialized training regarding caring for Alzheimer’s and dementia patients.

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Since one of the most common problems of dementia patients is that they wander off, a facility that cares for Alzheimer’s and dementia patients must have safeguards to deter those patients from leaving the specialized unit or facility. That law requires at least two staff members on duty and awake at all times, and at least one of them must have received special training in Alzheimer’s care.

Continuum of care facility:

A nursing home that also provides independent living, assisted living and/or adult day care. The advantage of a continuum of care facility is that a resident can move from assisted living to skilled nursing care without being relocated to an entirely different facility.

Such a facility is also able to accommodate residents whose health care needs fluctuate, e.g., a person who typically can live in an assisted living facility, but whose health occasionally requires skilled nursing care.

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Do you have a loved one who is a resident or patient of a long-term care facility in Oklahoma? Do you understand what you and your loved one have a right to expect regarding services, staffing and equipment in that facility? Is the facility living up to the requirements of the law? Is your loved one receiving the care he or she needs or do you suspect a level of nursing home abuse?

For a free consultation to discuss the legal rights of a resident or patient of a long-term care facility in Oklahoma, contact Hasbrook & Hasbrook by telephone (866-416-4737), email (cth@hasbrooklaw.com).