What’s the Difference Between Assisted Living and Nursing Care?

Although some people use the terms “assisted living” and “nursing care” interchangeably, there are significant differences between them. One is a community geared toward those who need some additional assistance, while the other is more of a medical facility meant to support those who need around-the-clock care.

How Does New Jersey Define an Assisted Living Community?

Assisted living communities offer their residents support, as needed, with daily tasks (ADLs, or activities of daily living). These may include eating, bathing, dressing, toileting, moving about and more. With this assistance, residents live largely independent lives.

To be considered an assisted living residence (ALR) in New Jersey, the community must provide the following to all residents:

  • Health and personal services that are accessible 24 hours a day, seven days a week
  • Surroundings must be “home-like” and not comparable to a hospital or nursing home setting
  • Services should promote “self-direction” and optimize independence of all residents
  • Residents should be encouraged to participate in decisions that affirm their individuality, dignity, privacy and independence
  • Assisted living apartments must – at a minimum – provide one unfurnished room, kitchenette, private bathroom and at least one lockable door securing the apartment’s entrance
  • A licensed assisted living facility in New Jersey must arrange for or provide on-demand assistance for healthcare, pharmacy, personal care, social work and nursing services. Recreational and transportation needs must meet the individual needs of residents.
  • Assistance with and supervision of self-administrated medications by trained staff are required services
  • A licensed registered nurse must be on-call 24 hours a day

Staff members who provide medication assistance for residents of an assisted living community in New Jersey must be trained by a licensed pharmacist or the community’s primary registered nurse on duty. The state’s Department of Health has rigorous guidelines governing the administration of medications to assisted living community residents. Only staff members, certified home health aides and certified nurse aids can medications to residents.

Assisted living communities operating in NJ must have one or more full-time administrators on-site and available at all times when the community has more than 60 apartments. For ALRs with fewer than 60 apartments, an administrator must be on-site at least half the time. Designated or alternative administrators may be on-site on weekends and holidays.

Nursing Home Care in New Jersey

The New Jersey Department of Health defines a nursing home as a residential facility where licensed nursing care and medical supervision is provided for all residents 24 hours a day, seven days a week. Residents of nursing homes require more than daily support with ADLs; they need around-the-clock care.

All forms of medical nursing home care must be under the direction of a physician. A nursing home facility operating in New Jersey must supplement medical care with occupational, physical, speech and other therapies as needed by each resident. Most nursing home residents require full assistance with eating, going to the bathroom, bathing and dressing. Nursing home areas are restricted to secure “wings” and vary somewhat in the degree of assistance provided to residents.

Each nursing home operating in New Jersey must employ a medical director who has a current license to practice medicine. This license must be granted by the New Jersey State Board of Medical Examiners. Medical directors of nursing homes initiate medical care for residents and also handle administrative tasks of medical care. The nursing home’s medical director must approve all medical care procedures and policies before they can be implemented by staff.

New Jersey nursing homes with more than 150 beds must have a registered nurse or assistant director of nursing on duty 24/7. According to state law, at least 20 percent of nursing home care hours (4.8 hours each day) must be provided by registered nurses or licensed practical nurses. If a nursing home maintains an on-site pharmacy, that pharmacy must obtain a license from the New Jersey State Board of Pharmacy.

Who Needs Assisted Living Services and Who Needs Nursing Home Care?

Assisted living community residents are, for the most part, capable of taking care of themselves and living independently. They may need occasional help with certain daily activities, such as making sure they take medications as directed, preparing meals or getting to appointments. Assisted living services provide care on an as-needed basis, but residents do not require nursing homes’ level of medical care. With some support, their lives are still independent.

In contrast, nursing homes are recommended for people who cannot cook meals, groom themselves properly or use the bathroom without assistance. Many nursing home residents have advanced dementia that severely impacts their health. While assisted living residents may be in the early stages of Alzheimer’s or age-related dementia, their physical health has yet to be impaired.

Assisted Living and Memory Care at Homestead at Hamilton

Homestead at Hamilton offers both assisted living and memory care living options. We offer comprehensive assisted living services and a supportive living environment for people who live independently but require help with various daily tasks to maintain that independence. Memory care offers an additional level of support to those dealing with memory loss and dementia, but both options provide much more independence than in a nursing home setting.

If you’d like to learn more about Homestead at Hamilton, download our free community brochure. You can also contact us by completing an online information request form or calling us at (609) 438-9900. We look forward to telling you about the amenities and services in our community!


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