When most people think of a nursing home, they envision a building full of elderly, bedridden people all of whom have multiple medical problems that need care around the clock. And, in a sense, they are right. Individuals that need 24/7 care would likely need the level of care that can be found in a skilled nursing facility which is what most people think of when they think of a nursing home. However, not everyone that needs help with their daily care requires the level of care provided at a skilled nursing facility. There are, in fact, different levels of long term care available to people who need some daily assistance but are not totally dependant upon others. For those who are looking for facilities to help their family members, this is welcome news.

Skilled Nursing Care v. Residential Care 

Skilled Nursing Facility

Missouri has 1,146 long term care facilities. Of those, 495 are considered skilled nursing facilities while 471 are deemed residential care facilities. According to the Missouri Department of Health and Senior Services website, a skilled nursing facility is required to have a licensed nursing home administrator and is the kind of facility that provides 24 hour care for at least three severely compromised individuals. Of course, most nursing homes have far more than three patients, but the state of Missouri requires that the facility have at least three people for the facility to meet the definition of a skilled nursing facility. A skilled nursing facility may only provide skilled nursing care under the supervision of a registered professional nurse. Moreover, medication administration must be administered only after receiving a prescription by a licensed physician. Failure to comply with any of these requirements leaves the facility at risk for license revocation.

Residential Care Facility 

Residential care facilities are divided into two categories; RCF 1 and RCF 2. An RCF 1 facility provides at least three individuals with room, board and care. These are individuals who do not need the skilled nursing care provided at nursing homes, but rather those who may need some additional supervision during a short term illness or for recuperation after an operation, a fall or similar event. Each resident must have the knowledge and physical ability to exit the building safely without the assistance of other individuals. No licensed nursing home administrator is required.

An RCF 2 facility provides additional assistance that is not provided by an RCF 1 facility, but still not to the level of a skilled nursing facility. To qualify as an RCF 2, the facility must provide 24-hour accommodation, board, and care to at least three individuals. Each individual will need or is provided with diet supervision, help with personal care as well as assistance with medication. Typically, this involves assistance with diets, personal care (i.e. getting dressed, grooming, bathing, etc…) and the use of medication. All assistance with health care must be done under the direction of a licensed physician. Like an RCF 1 facility, all residents must be able to make a path to safety without assistance. However, unlike an RCF 1 facility, a license nursing home administrator is required at an RCF 2 facility.