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Differences between Nursing Homes, Assisted Living Facilities and Continuing Care Retirement Communities in Virginia

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Benjamin Franklin said it best - "nothing in life is certain except death and taxes" but with daily advancements in science, technology and health care, Americans are living longer than ever before. This blessing however, has created a unique dilemma for modern American families: How to plan for and prepare for ones retirement years.

Which type of facility is right for you? We often hear the terms "retirement community," "nursing home," and "assisted living facility" but rarely consider what these terms actually mean. The differences however, are striking and it is imperative to understand these differences when making choices for yourself or your loved ones.

In Virginia, a nursing home means any facility with the primary function of providing long-term nursing care, nursing services and health-related services on a continuing basis, for the treatment and inpatient care of two or more non-related individuals. Put simply, a nursing home is facility designed for someone who needs less care than a hospital, but requires daily health care assistance.
Of course, the more rules and regulations that define and control the daily operations of a nursing home, the greater the responsibility of the staff. These are the people who will be charged with the daily task of caring for your loved one, and making sure they are in compliance with state and federal laws. No matter how nice and or attractive the facility might be, the staff will make the difference between your loved one being cared for and encouraged, or not.

A nursing home is best suited for someone:
• Who requires daily health care – such as assistance getting in and out of bed; taking medicine; or using the restroom.
• Who may have dementia or Alzheimer's and as a result, is unable to eat and or bathe daily without reminder or assistance;
• Who is recovering from a fall or accident and is therefore unable to walk, dress and or eat without assistance


"Assisted living facility" means an adult care residence which has been licensed by the Virginia Department of Social Services to provide a level of service for adults who may have physical or mental impairments and require at least moderate assistance with the activities of daily living. Within assisted living, there are two types: regular assisted living for those seniors (typically) who need assistance with one or more daily activity; and intensive assisted living for someone who may be incapable of performing activities due to mental and or severe physical impairment.

Assisted living facilities have no obligation to provide health care and or have health care staff available to assist your loved one. In addition, with no obligation to provide such services, there is the question as to whether or not they owe a duty to warn or treat residents with illnesses or diseases that could be transmuted from other residents.

An assisted living Facility is best suited for someone:
• Who is basically independent but may not be able or willing to prepare their own food or drive to doctors' appointments;
• Someone who wants to scale back and anticipates needing assistance with laundry, cooking, etc. in the near future.
• A couple where one spouse is independent but may need assistance in feeding and or providing for needs of other spouse.

A Continuing Care Retirement Community provides care depending on your current needs. Like an insurance policy, the resident pays an entrance fee and periodic adjustable payments, which in turn gives the resident a package of residential and healthcare services that the CCRC is obligated to provide at the time these residential and health care services are required. For example, if upon entering, all you want is help with your meals, that is the only service which will be provided. If you require intensive physical therapy or God forbid, daily assistance for a Dementia patient, the CCRC has assisted living services or nursing home services available under your contract.
Many CCRCs can have nursing home services available either on-site, or at licensed facilities off-site. While you may be entering the Retirement Community as a very healthy independent and capable resident, as your needs change, so will your contract with the Community and in turn, the facility's obligations to you.
A Continuing Care Retirement Community Facility is best suited for someone:
• Who is basically independent but anticipates the need for daily health care for themselves or a spouse in the near future;
• Someone who is physically disabled and would be unable to care for themselves or a spouse if the disability grew worse.

With at least three very different choices, it is very important to do your research:

To research assisted living facilities in Virginia, go to Department of Social Services website:

To research nursing homes, go to Medicare's website:


It is always best to speak to a family member of a current resident and spend time getting to know the staff, no matter what type of facility you are looking into. If looking and researching is not enough, then consider the chart at – a comparison of the legal duties of a nursing home compared to the legal duties of an assisted living facility in Virginia.

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Lauren Ellerman Social Media Pages: Facebook page url on login Profile not filled in       Twitter page url on login Profile not filled in       Linkedin page url on login Profile not filled in       Instagram page url on login Profile not filled in

Lauren Ellerman is a member of the Virginia State Bar, the West Virginia State Bar, Virginia Trial Lawyers Assocation, Virginia Women's Association of Attorneys and the Virginia Young Lawyers Conference. Mrs. Ellerman is a graduate of The (more...)
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