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Nursing Home vs. Assisted Living

Indiana licenses nursing homes as Comprehensive Care Facilities and assisted living as Residential Care Facilities -- two separate rule chapters and two different levels of medical care.

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Short answer

Indiana licenses nursing homes as Comprehensive Care Facilities, providing 24-hour skilled nursing care, and assisted living as Residential Care Facilities (RCF) under 410 IAC 16.2-5, a lower level of care focused on daily-activity help and medication administration.

Why the ratings differ

Nursing facilities are the one senior-care category with a federal CMS Care Compare star rating. Assisted living (RCF) communities are not federally star-rated -- their record lives only in Indiana's own inspection search.

What pushes a resident from one to the other

A resident whose needs exceed an RCF's admission/retention limits under 410 IAC 16.2-5 -- typically a need for 24-hour licensed nursing care -- generally needs to transition to a Comprehensive Care Facility. Several Indianapolis-metro campuses hold both license types on one property specifically to make that transition easier.

You can check any facility's record free. Use the Indiana Long Term Care Survey & Inspection Public Search (hoosierusa.isdh.in.gov) and, for nursing homes, CMS Care Compare. Read the full explanation →

Questions families ask

Can I push back on a hospital discharge date?

Yes, and it is usually less fixed than it sounds, particularly if no safe plan exists yet. Ask the case manager directly what happens if no placement is confirmed by the target date, and involve the hospital's patient advocate if the timeline feels unsafe.

How do I know when it's no longer safe for a parent to live alone?

Look for specific, dated incidents rather than a general impression: a missed medication week, an unreported fall, the stove left on, or a house that has become unsafe rather than merely untidy. Rule out reversible causes first -- a urinary tract infection, medication interaction, or untreated hearing loss can all mimic decline.

What should I do after a parent's first fall?

Treat it as a signal, not an accident -- a first fall is one of the strongest predictors of the next one. Get the cause investigated (medications, vision, inner-ear issues), fix the immediate environment, and ask CICOA Aging & In-Home Solutions about equipment-lending programs.

What should I do right after a dementia diagnosis?

Slow down -- very little has to be decided the first month. Get the specific diagnosis type, since Alzheimer's, vascular dementia, Lewy body and frontotemporal dementia progress differently, and put power of attorney and medical power of attorney paperwork in place now, while capacity is clear.

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