The Different Types of Assisted Living Facilities

What are the different types of assisted living facilities? What are their specialties?

If you’re looking to start your own assisted living facility, those are two questions you’ll need to ask (and answer).

Essentially, five different groups need assisted living in some form or another:

  • Seniors
  • Dementia patients
  • The developmentally disabled
  • The mentally ill
  • The brain-injured (traumatic brain injury, spinal cord injury, etc)

In this article, we’re going to review exactly what types of assisted living facilities cater to each group so that you can have a better idea of the licensing, possible bed rates, demand, and level of care required to service them.

The Different Types of Assisted Living Facilities: Focus on the Demographic

“Assisted living” has come to mean a lot of things. Naturally, it can get a little confusing.

We’ll use the term “assisted living,” generally but, as you’ll see, you can just as easily replace it with any terms that encompass the same level of medical care and assistance.

Nursing homes are still technically “assisted living facilities” because they assist dementia patients with basic living tasks, so people might refer to their grandparents’ nursing home as an “assisted living facility.”

However, there’s also a specific name for facilities that cater to an elderly crowd that doesn’t yet require serious medical treatment or 24-hour supervision: literally titled an “assisted living facility.”

What’s even more confusing is that the name of the assisted living facility that you’re looking to start might vary from state to state – like we noted in our article on “Starting an Assisted Living Facility in Michigan.

Thus, don’t get hung up on the terminology. Focus, instead, on the group of people you’re looking to help. The terminology will change from state to state, but the people that you’re looking to help will stay the same.

Then, when you’ve found out the type of facility you want, follow our guides on how to get started with financing for those facilities.

Seniors: Assisted Living, Board and Care, Adult Living, Supported Care

It’s a sad fact of life: With old age comes decreased cognitive functioning and increased dependence on others – even for the most basic tasks. Everyone, at some point, will reach the age where they need someone to help take care of them. You and your loved ones are no different.

Assisted living facilities are designed with this purpose in mind. Unless they’re connected to nursing homes, they typically don’t assist people with dementia or other serious illnesses. Instead, they’re focused on helping the elderly with everyday functioning; nursing homes would provide too much care, in this instance, and therefore would probably be too expensive for the care recipient. This way, with these senior care facilities, the owners don’t need to pay for expensive services that the recipients don’t actually need.

Some of these facilities are able to get Medicare, and most of the patients in these types of facilities either pay privately or they qualify for long-term care insurance.

The level of skilled nursing varies from facility to facility. Some seniors haven’t yet reached the point where they need a licensed medical professional to insert a catheter into them, for instance, while others have. Therefore, it’s important to keep in mind that senior care facilities vary. Here are some of the different types of assisted living facilities that are available for seniors who need a little bit of help but haven’t yet reached the point where they need serious medical care:

  • Assisted Living Facilities (also “board and care,” “adult living,” and “supported care”). The key term here – what assisted living facilities actually assist with – is called an “activity of daily living” (ADL for short). According to MedicineNet, typical ADLs include feeding, bathing, dressing, grooming, work, homemaking, and leisure. As we mentioned above, the patients in assisted living facilities typically don’t require a high degree of medical care, so assistance with these tasks can be performed by anyone with a basic degree of training.

Dementia Patients: Memory Care, Long-Term Care, Skilled Nursing, Custodial Care

According to the World Health Organization, the percentage of adults 60 years and older living with dementia at any given time is around 5-8%. The total number of people with dementia is expected to reach 82 million in 2030 and 152 million in 2050. Just like assisted living facilities, there’s a growing market for facilities that cater toward dementia patients.

And, when it comes to informal caregiving, the jury is out: When friends, family members, and other relatives are tasked with the assistance of a person suffering from dementia, both suffer. 98-99% of informal caregivers experienced problems with trying to take care of their loved one by themselves – and it ended up seriously affecting their social lives in the later stages of the illness. A vast majority of them ended up needing additional professional support anyway.

In fact, according to that same study published in The Open Nursing Journal, “The amount of available professional care is, however, not expected to rise in line with the growing demand in the ageing population.” However, this is good news for those of you looking to start nursing homes and other care facilities catered toward dementia patients.

Naturally, these facilities demand a higher level of care: more skilled and more attentive. The facilities themselves are usually on lockdown to prevent any patient from wandering off, and some of them have amenities such as aromatherapy, pet therapy, and greenhouses – in order to keep patients at ease.

  • Memory Care Facility (also called “long-term care facilities,” “skilled nursing facilities,” and “custodial care facilities”). These types of facilities demand a higher level of care than simple assisted living facilities. Licensed medical professionals are typically on staff 24/7 to help with patients’ needs. Typically, these have higher bed rates than senior care facilities. Many researchers believe that professional care for those with dementia won’t scale in proportion to the level of demand, so opening a nursing home might be a smart investment.

The Developmentally Disabled: Facilities Serving People With Developmental Disabilities (FDD), Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID)

Alternatively, there are facilities designed with no age requirements – for people of all ages who need some level of assisted care with their daily activities. Just like most of the other types of facilities designed for these different demographics, there are varying levels of expertise required for those living in a facility for the developmentally disabled.

For instance, some members are relatively high-functioning members of society. They might even have day jobs, so they’ll leave at some point throughout the day. These members only need help with basic tasks (the ALDs we mentioned above, on the bullet-point for “assisted living facilities”): cooking, cleaning, keeping their medication organized, staying above par when it comes to their personal hygiene, and so on.

FDDS: Facilities Serving People with Disabilities

FDDs help patients learn new skills and maintain their current skills. According to the Wisconsin Department of Health Services, an FDD:

  • Provides active treatment, ongoing evaluation, planning, 24-hour supervision, coordination, and integration of health or rehabilitative services to help each individual function at his/her greatest ability.

ICF: Intermediated Care Facility

As you can see, that’s a fairly high level of care that will likely require licensed medical professionals. Meanwhile, an Intermediate Care Facility (ICF) does exactly what it sounds like. It provides an intermediate level of care between basic and intensive. It’s just a step down from an FDD. From Highland Risk:

  • An ICF is typically regarded as a lower-level nursing care facility when compared to a skilled nursing facility, but its residents require more care and attention than those in a residential care facility for the elderly or an adult residential care facility.

As for funding, some pay private, some are taken care of through Social Security, but most of them are placed in an FDD, ICF, or lower, more basic facility for the developmentally disabled through government programs.

Bed rates are usually less than both senior care and nursing homes, and facilities for the high-functioning developmentally disabled, naturally, pay the least in comparison to the others.

  • Developmentally Disabled Care Facilities: Facilities Serving People With Developmental Disabilities (FDD), Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), and other basic facilities for the high-functioning developmentally disabled. These facilities serve all types of people, not just seniors. Some members of Developmentally Disabled Care Facilities are high-functioning, so they have jobs that they go to during the day. Facilities like that, which care for people who need some help but not a lot, don’t make as much money as the others.

The Mentally Ill: Psychiatric Hospitals, Day Treatment Mental Health Facilities, Residential Mental Health Treatment Facilities for Adults or Children, and Separate Inpatient Units in a Hospital

When most people think about mental health facilities, they assume it’s something like One Flew Over the Cuckoo’s Nest. Less like a hospital and more like a prison: constantly on lockdown with  a variety of people suffering from severe, debilitating mental illness – and maybe you could even add electroshock therapy in there, for good measure.

High Demand for Psychiatric Hospitals

Of course, this couldn’t be further from the truth. In fact, only 6.2% of mental health facilities are full-out psychiatric hospitals, and psychiatric hospitals, in actuality, are nothing like the movies. (Sidenote: of that 6.2%, over half are privately owned).

The trend, over the past fifty years, has been to eliminate psychiatric hospitals in favor of outpatient care – and the data shows the demand for inpatient care is actually at an all-time high, with some patients struggling to even find a bed.

The National Association of State Mental Health Program Directors has this to say:

“The shortage of psychiatric inpatient beds has become a major national issue, with the lack of availability identified as a major issue by policy makers, states, mental health families, academics, and popular media. Many reports regarding these shortages start with the major decline in inpatient capacity in state psychiatric hospitals—a decrease of over 500,000 beds since the 1950s.”

Meanwhile, mental health problems in the US are on the rise: Gen Z is more likely than any other generation before it to suffer from serious mental health issues.

Outpatient Care Facilities: Day Treatment

Naturally, though, just like every other type of facility on this list, there are varying levels and demands of care. Most mental health facilities are day facilities. According to the National Mental Health Services survey, roughly 60.8% of facilities are outpatient, day treatment, or partial hospitalization facilities.

Thus, each of these facilities will have different bed rates and qualifications for licensing. Because of the high demand, psychiatric hospitals will have high bed rates, while others will have much lower bed rates.

Also, according to Mental Health America, fewer youth are insured for mental health treatment: “The proportion of youth with private insurance that did not cover mental or emotional difficulties nearly doubled, from 4.6 percent in 2012 to 8.1 percent in 2017.”

So, there’s a variety of payment methods for inpatient and outpatient mental health recipients: private, Medicare, and through a family insurance plan.

  • The Mentally Ill: Day Treatment Mental Health Facilities, Psychiatric Hospitals, Residential Mental Health Treatment Facilities for Adults or Children, and Separate Inpatient Units in a Hospital. Of these listed, psychiatric hospitals are the highest in demand. However, because of the rise of mental health issues across the country (along with care being socially destigmatized), all of them are viable options for your own assisted living facility.

The Brain Injured: Transitional Care and Nursing Homes

Assisted living facilities designed for those suffering from traumatic brain injury, spinal cord injury, and multiple trauma are typically labeled as “transitional care.”

Every year, an estimated 1.5 million people suffer from traumatic brain injury. Of that 1.5 million, 230,000 are hospitalized. That also means there are over 5.3 million people living with a permanent TBI-related disability. The demand for transitional care (and even occasional outpatient care) is, therefore, fairly high.

Also, pay can be collected in a number of ways. Some patients pay privately, some pay through Medicare (depending on the situation and length of stay), and others pay through auto insurance. Auto insurance can be difficult to collect on, so be warned.

  • The Brain Injured: Transitional Care and Nursing Homes.

Conclusion: The Different Types of Assisted Living Facilities

Over the years, “assisted living” has come to mean a lot of different things, so if you’re looking to start an assisted living facility, it can be difficult to gather research on the different types of assisted living facilities.

In this article, we clarified that confusion by focusing on the demographics that each facility serves:

  • Seniors
  • Dementia patients
  • The developmentally disabled
  • The mentally ill
  • The brain-injured (traumatic brain injury, spinal cord injury, etc)

You can quickly go through our list and find names for the type of facility that caters toward each group.

Anyway, we hope our data on the different types of assisted living facilities will help you narrow down your research.

If you have any questions, comments, or concerns, contact us today.