What's the difference between Assistant Living Facilities and nursing homes?

Its a little different in my area. Assisted living and Memory Care usually are together and self pay. The one in my area is owned by a group of doctors. ALs are limited in what they can do. You just need some assistance. Ratio to CNAs to patients is lower than skilled Nursing. Memory Care comes in when someone with a Dementia really needs to be in lockdown so they won't wander and their Dementia has progressed where an AL can no longer give care. The the other AL in my area is Corp run and has the regular residents and the Dementia residents kept together. When the Dementia resident is beyond the ALs ability to care for the resident, they r usually transferred to Skilled Nursing. At both places there has to be an RN and she overseas any LPNs and CNA/Medtechs.

Skilled Nursing of course means that the person needs care that an AL or MC can't give. The resident must meet a certain requirements especially if Medicaid is going to cover the residents care. These are closely monitored by the State even if privately owned. There is usually a doctor/s associated with it. A DON and a RN at every nurses station. LPNs do medpasses and actually work closely with Patients. Then CNAs are the LPNs aides. They usually do the dirty work. Where my daughter worked as an LPN she was in charge of the CNAs, the RN was over the LPNs and DON was over them all.

A CNA, unless a Medtech, should not be doing med passes under any circumstances. Thats a Hospital, AL, MC or SNF. They are not medically trained. To do med passes they must be Medtechs. It was suggested on another post to call the Board of Nursing in your State to see if this has changed because of COVID. In my Moms AL the aides did help out at meal time. There was a cook. The aides made the table, served the food and did the clean up. They may have helped getting the food on the plates but I didn't see that.

Generally memory care where I live is affiliated with nursing homes and when people's physical needs become too great they are moved to that level of care. A lot of people say they have gotten excellent care at their AL right until the end of life but I am always skeptical since the level of staffing and equipment available there is usually not on par with nursing homes. I'm also skeptical since here in Canada nursing homes are much more strictly regulated but AL's are often run by for profit companies whose eye is on the bottom line rather than on the well being of their residents - I know for a fact they often fail to deliver the level of care they promise.

The levels of care will vary by jurisdiction as will the terminology.

Generally the ability to perform the ADLs is one of the determining factors as to the appropriate level of care facility.

Staff training and certification will vary too.

I know there have been cases where a couple stays in a lower level of care facility to allow them to stay together.

Is there an actual problem, or are you just generally fed up either about trying to identify the right environment for a loved one or about the quality of support someone is being offered?

The real reason the distinctions are difficult to make is that people are untidy and resist attempts to fit them into nice clear categories.