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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

My parent is being discharged from an Indianapolis hospital in 72 hours. What now?

Ask the case manager for the discharge plan in writing, confirm whether your parent was admitted as an inpatient or held under observation status (only inpatient stays count toward Medicare's skilled-nursing benefit), and ask which facilities have actually accepted the referral -- not just which ones were contacted.

Does Medicare pay for a nursing home stay after a hospitalization?

Medicare covers a limited skilled-nursing-facility stay only after a qualifying inpatient hospital admission, for rehabilitation, not long-term placement. Time spent under observation status does not count, even after multiple nights in a hospital bed -- ask the hospital directly which status applies.

Which Indianapolis-area hospital systems most often discharge patients to senior care?

IU Health, Ascension St. Vincent, Community Health Network, Franciscan Health and Eskenazi Health handle the bulk of Indianapolis-area discharge planning, alongside Hendricks Regional Health, Riverview Health, and Hancock Regional Health in the collar counties.

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.

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