Nursing home: medical care around the clock
A nursing home, also called a skilled nursing facility, has licensed nurses on duty day and night. People go there for rehabilitation after a hospital stay, or for long-term care when they need medical help every day.
Assisted living: help with daily life
In California assisted living homes are licensed as Residential Care Facilities for the Elderly (RCFE). Staff help with meals, bathing, dressing and taking medications. These are not medical facilities: people who need nursing care around the clock generally need a nursing home instead. They range from a house with six residents to buildings with more than a hundred.
Who inspects them
Nursing homes are licensed by the state and inspected under the federal Medicare and Medicaid programs. In California the inspections are done by the Department of Public Health on behalf of the federal agency CMS. Medicare publishes the star ratings, inspection findings and fines. Assisted living homes are licensed and inspected by the California Department of Social Services, which publishes visits, citations and complaint outcomes.
Who pays
Medicare may cover up to 100 days of skilled rehabilitation in a nursing home after a hospital stay of at least 3 days as an admitted inpatient (time under observation does not count), with a daily copayment after day 20. It does not cover long-term care. Medi-Cal can pay for long-term nursing home care for people who qualify. Assisted living is mostly paid privately. Ask each home and your county Medi-Cal office what applies to you.
How to check a home
Look the home up here, read what the findings were about, then call and visit. A record shows what inspectors found on certain days. It does not replace seeing the home yourself.
Guides
How to read a nursing home inspection record
What inspection findings mean: the four severity levels from A to L, how widespread a problem was, why the count alone misleads, and what fines show.
How to choose a care home in California: a short checklist
Six steps for families: decide the kind of care, make a short list, read the official record, call, visit more than once, and check the agreement before signing.