Differences to Look For

This chart offers a clear comparison of the requirements for licensing of assisted-living or memory-care centers compared with long-term care nursing facilities, such as James L. West.


Comparison Chart

Area of Interest Assisted-living Center Long-term Care or Nursing Center
Education required for facility manager or administrator High school, plus 1 year of experience Professional licensure requires at least a bachelor’s degree + 15 semester hours in long-term care administration, plus internship of 1,000 hours, plus board exam
Continuing education for manager or administrator 6 hours in dementia care annually 40 hours biannually, in medicine, leadership, ethics, and resident care, including dementia care
General staff training 4 hours in dementia care 8 hours orientation and 4 hours annually
Staffing ratio 2 general staff present for 17 or more residents; no education necessary beyond what is mentioned above Direct-care nursing staff who are licensed and certified at 1:6 during the day; 1:10 during the evening; 1:18 overnight; many additional staff members in other departments are also on site daily
Formal quality assessment and improvement process None Required formal interdisciplinary process to continually assess and improve services
Plan of care — initial and review/update 14 days after admission; annually thereafter 14 days after admission and at least quarterly thereafter; required in-person interdisciplinary team, including the family, physician, RN, director of nursing, and directors of social services, activities, dietary, and therapy
Activities Required daily Required to be individually tailored for each resident
Licensed social worker on staff Not required Required
Registered nurse on site every day Not required Required
Type of care Social model of care that offers assistance with bathing and grooming, and medication reminders. Housekeeping and meals may be contracted as needed. Provides total care in all areas of daily living, whenever needed. Includes medical care for health issues, social, emotional, and recreational services. Monthly pharmacist and dietitian review. On-site dentistry, podiatry, and therapy.