A nursing home is licensed in Indiana as a Comprehensive Care Facility, providing 24-hour skilled nursing care and carrying a federal CMS star rating. Assisted living is licensed as a Residential Care Facility, a lower level of care with no CMS rating.
The distinction that matters
The two license types are inspected under different rule chapters and different survey cycles, which is part of why a family cannot simply compare one facility's assisted-living inspection history against another building's nursing-home rating -- they are different regulatory instruments entirely. A resident whose medical needs exceed what a Residential Care Facility license allows will typically need to transition to a Comprehensive Care Facility, and several Indianapolis-metro campuses offer both license types on one property specifically to make that transition easier.