Types of Elder Care Facilities


Acute Care

An acute care facility is a health facility having a duly constituted governing body with overall administrative and professional responsibility, and an organized medical staff that provides 24-hour inpatient care, including the following basic services:  Medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, and dietary services.


Adult Day Care

An adult day care (ADC) program is generally operated as a day care facility for elderly adults who need supervision and assistance with activities of daily living such as eating, hygiene, assistance with taking medication, and recreational activities. An adult day care program is defined as any facility, place, or building that is maintained and operated to provide care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living. This also includes the protection of these types of individuals on less than a 24 hour basis.


Assisted Living Facility

In California, the term “assisted living facility” is basically the same thing as a “residential care facility for the elderly” (RCFE). These types of facilities are non-health care facilities that are regulated by California's Department of Social Services and not California's Department of Health Services (which regulates health care facilities such as Skilled Nursing Facilities).


Developmentally Disabled Adult Care

In California, there are two distinct types of care facilities that serve the needs of Developmentally Disabled Adults. These different facilities depend on the type of care required by the disabled adult, and are classified as follows:


Hospice Care

Hospice care is a specialized form of interdisciplinary health care that is designed to provide palliative care to alleviate the physical, emotional, social, and spiritual discomforts of an individual who is experiencing the last phases of life due to the existence of a terminal disease, provide supportive care to the primary caregiver and the family of the hospice patient, and that meets all of the following criteria:


Independent Elder Facility

Independent elder facilities are commonly referred to as retirement communities.

They are designed for people who no longer work, and are generally restricted to those over a certain age (such as 55+ communities).  Such facilities/communities are geared towards independent elders and oftentimes provide extensive amenities for an active lifestyle such as clubhouses, swimming pools, arts and crafts, boating, trails, and golf courses.

Independent elder facilities/communities are typically organized as condominium associations and therefore California condominium law governs such facilities.


In-Home Care

In-home health care is a service which provides personal care and medical services based upon a plan of treatment prescribed by a physician and/or surgeon who is licensed to practice medicine in the state. In-home health care is provided by a person certified by the state department as a home health aide. 


Residential Care Facility for the Elderly

A Residential Care Facility for the Elderly (RCFE) is a non-medical housing facility that caters to elder residents who need assistance with activities of daily living such as eating, grooming, hygiene, taking medications, assistance with walking, going to the toilet, and other daily tasks. Such arrangements are usually entered into by the resident, the resident's guardian, conservator or other responsible person. However, before admission, this type of placement must be approved by a physician as an appropriate placement. This type of housing arrangement is only appropriate when the resident has minimal health care issues. 


Skilled Nursing Facility

A Skilled Nursing Facility or nursing home is a health care facility or a distinct part of a hospital which provides continuous custodial and supportive care to patients whose primary need is skilled nursing care on an extended basis. These facilities provide 24-hour inpatient care and, at a minimum, include a physician, skilled nursing staff, dietary and pharmaceutical services, and an activity program.

Step-Down Facility

An intermediate/step-down facility is defined as a facility which is organized, operated, and maintained to provide for the monitoring and care of patients with moderate or potentially severe physiologic instability requiring technical support but not necessarily artificial life support.

A step down facility can be used after a hospitalization for a patient who is not strong enough to return home. These facilities are also called subacute or transitional units, and are usually located in a hospital or nursing home. They also typically have a greater patient-to-nurse ratio.