Assisted Living Facilities VS Skilled Nursing Facilities

In this episode of the Assisted Living Podcast, Andy Hernandez and co-host Lonnie Steckler break down one of the most common points of confusion families face when navigating senior care: the difference between Assisted Living Facilities (ALFs) and Skilled Nursing Facilities (SNFs).

Many families hear terms like nursing home, skilled nursing, and assisted living used interchangeably, but they represent very different levels of care, environments, and costs. In this conversation, Andy and Lonnie explain how each setting works, who each type of care is designed for, and how families can determine the right placement for their loved ones.

They also discuss how the continuum of care works after a hospital stay, why rehabilitation in skilled nursing can be critical before moving to assisted living, and how behavior, independence, and medical needs help determine the appropriate level of care.

In this episode, you’ll learn about:

• The key differences between assisted living and skilled nursing facilities
• The level of medical care and supervision provided in each setting
• Why skilled nursing facilities are typically more clinical and higher cost
• When a senior may need skilled nursing instead of assisted living
• How hospital, skilled nursing and assisted living transitions work
• Signs your loved one may be in the wrong level of care
• How families can evaluate the right environment for their loved one

If you’re trying to understand where your parent or loved one should go after a hospital stay or simply want to better understand the senior care system  this episode provides clear, practical guidance to help families make informed decisions.

#assistedlivingfacility #skillednursingfacility #seniorcare

Transcript

SPEAKER_02 0:00

Welcome to another episode of the Assisted Living Podcast. My name is Andy Hernandez. My partner in crime, Lonnie Steckler. Welcome. Thank you, sir. So today we're going to get into a skilled nursing facility versus assisted living facility. This is another one that a lot of people are confused on. They think it's they're the same thing. So when I hear nursing home, sometimes they're referencing assisted living. Assisted living, they think, you know, so it's back and forth thing. So what is the difference between a skilled nursing facility and an assisted living facility?

SPEAKER_01 0:32

Level of care. Assisted living, nursing homes provide a much higher level of care, higher acuity level than assisted living facilities. It's more clinical environment, whereas assisted living is more home like. Even though they need assistance, we want them to be as independent as they possibly can be.

SPEAKER_02 1:00

Yeah, the way I always explain it, I, you know, when people ask me is if if they're in a skilled, they're in a skilled nursing, there's a skill, right? There's nursing being provided, physical therapy, that's all being provided. When it's an assisted living, exactly what you said, it's a community, it's a home, it's more of that. Uh definitely more social. It is, you know, more activities because nursing homes don't have activities uh for the most part.

SPEAKER_01 1:23

They they have activities, but it's not on the same level as assisted living schools.

SPEAKER_02 1:28

Correct, correct. So, what are some of the misconceptions that families? I mean, we just touched on skilled nursing versus assisted living, but are there any other misconceptions that they have?

SPEAKER_01 1:36

Uh the financial stuff, um, the cost involved. Nursing homes are gonna be much more expensive because they have more care staff there.

SPEAKER_02 1:48

Yeah.

SPEAKER_01 1:48

Um, they have more nurses there, more uh uh acute care type of doctors rounding. Exactly. Um, so the the cost is is definitely higher in nursing homes than it is assisted living.

SPEAKER_02 2:03

Yeah, so who what who belongs in a skilled nursing home and who belongs in assisted living? Right? So yeah. So who belongs in a skilled nursing home versus an assisted living is the better question.

SPEAKER_01 2:15

Well, to answer that, I'll I'll tell you who assisted living facilities can't provide care for. You know, if if if you're if you need a uh uh if you have a feeding tube, um if you um if you're confined to a bed uh or if you need a mechanical lift to get you out of bed, um then chances are you're you're better suited for a nursing home, a skilled nursing facility. Now there are certain types of assisted living facilities that can take a higher level of care and with a specialized license called extended care. Um uh but there aren't too many of those.

SPEAKER_02 2:56

So let's say you're an assisted living, you end up in a skilled nursing facility. Can you go back to an assisted living facility?

SPEAKER_01 3:01

You can, yes. A lot of a lot of assisted living residents will go to a skilled nursing facility at one time or another because they need short-term rehab or uh IV therapy, uh, some type of specialized skilled nursing that that you can't provide an assisted living, but it doesn't mean they can't come back. They can they can come back as long as they finish their skilled service and uh they can come back to their home.

SPEAKER_02 3:27

In your experience and in all your years, have you seen cases where they're trying to send them out of the hospital to a skilled nursing facility, but maybe they're more appropriate for an assisted living facility, or vice versa. Have you seen that in your career? And how does a family member distinct that and and know if they're making the right decision with their family member to put them in a skilled versus assisted?

SPEAKER_01 3:49

Um, I see more of the vice versa. The the the person who needs skilled nursing and and comes into assisted living. Um which is a big problem.

SPEAKER_02 3:58

So we had a community down here in South Florida that we were overseeing, and a lot of the uh patients being accepted or the residents being accepted, a lot of them belong on, you know, skilled nursing.

SPEAKER_01 4:10

Yeah. I always try, you know, a lot of assisted living facilities will want them to come directly from the hospital because they don't want to lose that person. I think they're gonna lose that person. I take a different approach to that um because I I'm I'm need focused, I'm care focused. I I I want the best care and services for that person. So, like, and I always say, like, if it were my grandparent or parent, um, I want I want them to it look at it as tiers, like hospital provides the most amount of care. And I always, from a financial perspective, they charge the most, right? Right? They're thousands of dollars a day.

SPEAKER_02 4:49

Um, and that's why you have so many nurses, so many doctors, so many um so the average length of stay for a patient is 3.5 days in a hospital, and it's anywhere between now and today, anywhere between 20 to 30,000 dollars in those three days. Wow, yeah, it's incredible, right? It's amazing, it's a lot of money.

SPEAKER_01 5:05

Yeah, um, so below that are your skilled nursing facilities. Um and and so those cost hundreds of dollars a day. But they they don't have as much staff as as the hospitals, but they have much more than the assisted living facilities, right? So that's it's kind of like a step-down unit. So if you're in the hospital, let's say for an extent if you're in for a few days, that's not such a big deal. But if you're in the hospital for two weeks a month, chances are you you need um intensive rehab. So I always recommend for for the family members who are dealing with this, um to take advantage of your Medicare benefits, your insurance benefits, and get the intensive therapy that you need. That way, once they come into assisted living, they'll be better equipped, better prepared physically.

SPEAKER_02 6:03

So there's been a debate circulating for years in our industry. Are skilled nursing facilities going to be around, right? Because I think that the government has tried to find ways how to start easing them out, right? With the hospital at home programs, how do they factor in home health part of that? So the patient now gets discharged directly at home because it's a lot cheaper to treat the patient at home if you provide these programs. But where are we? Because I know you're you're very heavy in that world. Do you see a world 10 years from now, 15 years from now, where skilled nursing facilities are still in play?

SPEAKER_01 6:36

I I personally see that. And I I see the need for that. Right. Um, and there is a distinct difference between at-home care and skilled nursing. You're talking about round the clock, right, supervision, monitoring, nursing, um not just the physical therapy component, you know. So, and I, you know, I I'm very involved in the skilled nursing world, and and I I know the operators throughout the state, and and they're all the ones that I know are passionate people and provide great care. And I I don't I don't see that going away anytime soon.

SPEAKER_02 7:11

Yeah, and I it's just been a lot of conversation going back and forth because the government continues to try to find ways to cut spending. And one of the hot topic buttons have been skilled nursing facilities. I think I'm I'm with you, they are needed. I don't think that you can uh replicate what a skilled nursing facility does in a home setting. You just it's not conducive for it. I think the hospital at home programs that these hospitals tried to roll out have faltered because hospitals know how to operate within hospitals when it comes to home health. And if you look across uh any hospital system that's been in the home health game, not many are very successful in it because they don't know how to operate in the space.

SPEAKER_00 7:46

Right.

SPEAKER_02 7:46

Yeah, your margins are very you know, razor thin, and hospitals solve things by throwing money at it. And in home health, in skilled home health, that's not your the way that you control money.

SPEAKER_01 7:58

All of these things exist for a reason. Yeah, and home health is very important too, skilled nursing is very important. Uh I to try to reinvent that I think is a mistake. Absolutely. I think what we all of it's needed, and we should put our resources into that because um the better we take care of them in uh post-hospitalization, the less likely they are to be re-hospitalized. Right, right.

SPEAKER_02 8:24

You know, having a good healthcare system is so important, not only for the patients, but it's important for the economy. People don't realize how important this is because we're the backbone of the economy, right? Because if we can't take care of these patients that are going from hospital to a skilled nursing to assisted living, we can't take care of them. Now that puts a burden on a family, they can't go out to work. Now that sets back the economy, they don't understand the importance. And when I see bills that are trying to be passed that hurt us, that we do it the right way, we've grown it, and you keep taking from us, and it's like you're you're you're you're not understanding the bigger picture of how we support this economy. A thousand percent. You know, yeah, yeah. So, yeah, anyways. How can families tell their loved ones uh tell their loved ones are in the wrong care setting?

SPEAKER_01 9:12

Uh their behavior. Behavior is key. Right. Um, and it depends on on the personality of that person. You know your your loved one the best. Um, you got to be careful though. And and you also got to listen to the care staff as well. So um, you know, you you could find yourself getting a call every day from from your mom, your dad, this place is terrible, the food sucks.

SPEAKER_02 9:34

Oh, my mom walked out. So my mom, God rest her soul, love her to death. I get a phone call from the administrator or the CEO. Hey, uh, your mom's in front of uh in front of the lobby, uh outside waiting for for a taxi. She called the taxi to get back home.

SPEAKER_01 9:51

Okay, so I would say she that's that's impressive. Yeah. But I would say she was truly unhappy.

SPEAKER_02 9:57

Yeah, yeah, she was.

SPEAKER_01 9:58

She was she was uh So that that that's a sign that they're truly unhappy. Yeah. Um, if you're just getting calls uh complaining, uh that doesn't necessarily mean that they're unhappy. Well, let me tell you something.

SPEAKER_02 10:09

My mom would call me every day, she says, get get me out of here, get me out of here, or I'm gonna take matters into my own hands. And she did.

SPEAKER_01 10:15

So she was truly unhappy. She was truly, but like, how many times? Um, I don't know if you ever sent your kids to day camp or camp, sleepaway camp. They're gonna try that for the full. They tell you, they tell you they'll call you, tell you they're miserable or whatever, and then you talk to the counselors and or their friends, and they're saying that they have the bet they have the best time. They're very social, they they're engaged in all the activities. Well, the same applies for our parents in uh these communities. Right. Um, you know, I deal with it personally as well with my parents, right? And um, you know, I get it's a good amount of calls, you know. But uh but you know, but I look at how active they are within the community, apart from the calls, right, and they're participating, they're socializing, they're trying. Um, and and so if as long as I'm seeing those things, uh I know that they're they're as happy as they can be. Um now in your situation and in other situations, there are times when it's not the right fit. Yeah, and the behaviors escalate to a point that you need to consider uh putting in another environment. Because maybe that environment, especially with dementia. So there are different kinds of dementia facilities. There's really big ones and then there's really small ones. Um so you have to be really keen on the behaviors and how they're responding to their environment um with people that have dementia. If if you, for instance, if you put your loved one in a big community, they have you know 60, 70 residents there, and they're just they're they're fighting with people, they're just their their behaviors are escalating to a point that that they that are beyond control, then you might want to think about, okay, maybe that's too much, too much stimulation, too much people, too much noise. Why don't we try to find a smaller place that's more intimate, that's quieter? Let's see how they do there. Um, and I I've had success in in placing people in those situations, and vice versa. You know, you have someone in a smaller place and they're just they're bored out of their minds, they need more action, then a larger community is better for them. So you got to really um tune in to your to your loved one and and their environment.

SPEAKER_02 12:30

Absolutely. So that's all I got on skilled nursing facilities versus assisted living facility. I think there's a lot of information there. Um, and it it's it's a difficult thing because if you don't know and you're not educated, you don't know what the difference is, where do I put them? So again, make sure to DM us. We'll all answer the questions as best as possible. If not, we'll have Lonnie answer them. You know, we have a lot of experience combined between us, it's a lot of years, and we can help you uh through this process. And not that many for me. I'm still young. Yeah, you don't look a day past 50. But, anyways, uh uh but yeah, so we would we would love to help you. You know, the whole point of this podcast is to really educate uh our audience and community. You guys are going through it, you're struggling. I just want to let you know that you're not alone, you're not alone in this process, and we would love to you know give you advice uh on on what to do because I know that sometimes it just gets very lonely. You don't know who to turn to. Um, so we're here to help. Uh, make sure to subscribe, like, comment, turn on the notifications to know when our new content comes out. We're we're putting out a podcast every single week. And check me out on Manect, Andy Hernandez on Manect. If you're an operator, if you just need help with operations, uh marketing, any questions that you have in that uh capacity, you can reach out on Manect and we'll be able to help you. Any parting words, my friend? Take care of your seniors. On to the next one. Thank you, guys.