Understanding Care Facility Types in the United States (December 2025)
Understanding the different types of care facilities in the United States is crucial when making decisions about long-term care for yourself or a loved one. Each care type serves different needs, offers varying levels of medical support, and comes with distinct costs. This comprehensive guide will help you compare apples to apples when evaluating care options both domestically and internationally.
When comparing care costs between the U.S. and Southeast Asia, it's essential to understand what each facility type provides and ensure you're comparing equivalent levels of care.
1. Nursing Homes (Skilled Nursing Facilities)
Nursing homes, also known as Skilled Nursing Facilities (SNFs), offer the highest level of medical care outside of a hospital setting. They provide 24/7 nursing care, assistance with all activities of daily living (ADLs), medication management, rehabilitation services, and specialized care for conditions like dementia, stroke recovery, and post-surgical care.
What They Provide
The highest level of medical care outside of a hospital setting. They provide 24/7 nursing care, assistance with all activities of daily living (ADLs), medication management, rehabilitation services, and specialized care for conditions like dementia, stroke recovery, and post-surgical care.
Staff Qualifications
- Registered Nurses: Must be present 24/7, with minimum staffing requirements varying by state
- Conducts patient evaluations, develop care plans, administer medications and treatments, and coordinating care with physicians and other team members.
- Often supervise Licensed Practical Nurses and Certified Nursing Assistants.
- Licensed Practical Nurses (LPNs):
- Provide basic medical and nursing care, such as administering medications, changing dressings, monitoring vital signs, and ensuring resident comfort, all under the supervision of a Registered Nurse or physician
- Must have at least one Registered Nurse for at least 8 straight hours a day, 7 days a week, and either a Registered Nurse or Licensed Practical Nurse on duty 24 hours per day
- Certified Nursing Assistants (CNAs):
- Direct, hanDs-on personal care, assisting residents with daily living activities such as bathing, dressing, eating, and mobility. They also monitor residents' conditions and report any changes to licensed staff
- must have completed a nurse aide training and competency evaluation program within 4 months of their employment. They must also pursue continuing education each year. Certified Nursing Assistants provide care to nursing home residents 24 hours per day, 7 days a week
- Director of Nursing:Top-level management position, the DON oversees all nursing activities within the facility, ensuring quality standards and regulatory compliance are met.
- Therapy Staff: Usually comprised of Physical Therapists (PTs), Occupational Therapists (OTs), Dietitians, Nutritionists
- Administrative/Support Staff:Administrator/Executive Director (certified caregiver, Licensed Practical Nurse, or skilled nursing facility administrator - varies per state), Activities Coordinator, Pharmacists *All care staff must receive training on building safety and emergency measures, emergency response including CPR and first aid giving
Care Standards & Regulations
Federal regulations require nursing homes to maintain minimum staffing ratios. The national average Registered Nurse coverage is approximately 0.5-0.7 hours per resident per day, though this varies significantly by state. New federal requirements (effective 2024) mandate:
- Minimum of 33 minutes of Registered Nurse time per resident per day
- Total nurse staffing of at least 3.5 hours per resident per day
- 24/7 Registered Nurse presence required on-site
Costs by State (2024 Data)
| State | Median Monthly Cost (Semi-Private) | Median Monthly Cost (Private) | Registered Nurse Time (hours/day) |
|---|---|---|---|
| Alaska | $30,371 | $30,371 | 1.78 |
| Hawaii | $15,087 | $16,364 | 1.43 |
| Connecticut | $14,612 | $16,303 | 0.88 |
| National Average | $9,200 | $10,400 | 0.5-0.7 |
| Texas (Lowest Cost) | $5,475 | $7,087 | 0.38 |
How We Excel at Better Care Today
Our Nursing Home Partners in the Philippines
🌟 TRUE 1:1 NURSING CARE - YOUR OWN DEDICATED REGISTERED NURSE
For late-stage dementia and complex care needs, we provide 1:1 nurse-to-resident ratios - meaning your loved one has their own dedicated Registered Nurse. This level of personalized care is virtually impossible to obtain in Western countries at any price.
- Nurse-to-Resident Ratios: From 1:3 up to 1:1 for complex cases (24/7, no difference between day and night shifts)
- Registered Nurse Time: 8-24 hours of dedicated Registered Nurse time per resident per day depending on care intensity (1:3 to 1:1 ratios) - vs. 0.5-0.8 hours in U.S.
- Base Monthly Cost: $2,000-$4,000 depending on care intensity (70-85% lower than U.S. for equivalent care)
- Included in Base Rate: All nursing care, therapy, meals, activities, accommodation, housekeeping, and laundry
- Variable Costs: Medications, incontinence supplies (diapers), and optional excursions based on actual consumption - all very affordable
- Quality Edge: Internationally trained Registered Nurses providing round-the-clock specialized dementia care
- Additional Caregiver Support: Beyond our RN ratios, caregivers provide supplementary assistance - a layer of support not even counted in our staffing numbers
Nursing Home Costs: US vs. Better Care Today
Savings Scale
Key Insight: Who Actually Provides Hands-On Care?
When comparing staffing ratios, it's critical to understand who is actually providing the daily hands-on care - bathing, dressing, feeding, and mobility assistance.
| U.S. Nursing Homes | Better Care Today (Philippines) | |
|---|---|---|
| Who does hands-on daily care? | Certified Nursing Assistants (CNAs) | Registered Nurses |
| RN role | Supervisory, assessments (33 min/resident/day) | Direct patient care (8-24 hrs/resident/day) |
| CNA/Caregiver hours | ~2.5 hrs/resident/day (primary care providers) | Additional support (not counted in our ratios) |
The Bottom Line: At BCT partner facilities, the 1:1 to 3:1 ratios are for Registered Nurses providing direct care - the same tasks that CNAs perform in U.S. facilities. Our caregivers provide additional support on top of this.
2. Memory Care Facilities
Provides intensive, specialized care for people with memory issues
What They Provide
Memory care facilities are specialized units designed for individuals with Alzheimer's disease, dementia, or other cognitive impairments. These facilities feature secured environments to prevent wandering, specialized programming for cognitive stimulation, and staff trained in dementia care techniques.
Limitations of this service
Memory care facilities (commonly) do not accept individuals who require a higher level of care than they can provide, such as those needing constant skilled nursing care, extensive medical equipment like a ventilator, or those whose behaviors pose an immediate danger to themselves or others that the facility cannot manage. With worsen condition of the resident, residents usually should move to skilled nursing home facilities.
Staff Qualifications
- Registered Nurses with specialized dementia care training and certifications
- They conduct patient evaluations, develop care plans, administer medications and treatments, and coordinating care with physicians and other team members
- Often supervise Licensed Practical Nurses and Certified Nursing Assistants
- Licensed Practical Nurses (LPNs) / Licensed Vocational Nurses (LVNs) Provide basic medical and nursing care, such as administering medications, changing dressings, monitoring vital signs, and ensuring resident comfort, all under the supervision of a Registered Nurse or physician
- Certified Dementia Practitioners (CDPs) / Certified Alzheimer's Caregivers (CACs) Staff trained in validation therapy, redirection techniques, and behavioral management.
- Activity Directors Certified in therapeutic recreation for dementia patients
- Certified Nursing Assistants with additional dementia care training (8-16 hours minimum in most states)
Care Standards & Regulations
Memory care facilities bridge the gap between assisted living and skilled nursing homes. Required staff-to-resident ratios typically range from 1:6 to 1:10 during the day. Specialized training requirements include:
- Initial dementia care training (8-24 hours depending on state)
- Annual continuing education in dementia care
- Specialized certification programs (e.g., Certified Dementia Practitioner)
Costs by State (2024 Data)
| State | Median Monthly Cost | Range |
|---|---|---|
| California | $8,500 | $6,000-$15,000 |
| New York | $7,800 | $5,500-$12,000 |
| Florida | $5,500 | $4,000-$8,500 |
| National Average | $6,935 | $4,000-$10,000 |
| Texas | $5,200 | $3,500-$7,500 |
How We Excel at Better Care Today
Our Memory Care Facilities
- Nurse-to-Resident Ratios: 1:3 to 1:5 (consistent 24/7)
- Base Monthly Cost: Starting at $1,600/month for basic dementia care (70-85% lower than U.S. memory care)
- Included: All meals, nursing care, therapy, activities, housekeeping, laundry, and 24/7 supervision
- Variable Costs: Medications, diapers, and optional outings (all affordable)
- Training: All nursing staff receive specialized dementia care training, including person-centered care approaches
- Environment: Dementia-friendly facilities with secure outdoor spaces and natural tropical settings
- Night Coverage: Some facilities offer reduced ratios at night for early-stage cases (family choice based on needs and budget)
- RNs Provide Direct Care: Unlike U.S. memory care where aides do hands-on care, our Registered Nurses personally assist with daily activities, with additional caregivers for support
Memory Care Costs: US vs. Better Care Today
Savings Scale
3. Assisted Living Facilities
What They Provide
ALS (Assited Living Facilities) provide a system of care in a homelike environment for elderly persons and persons with mental health, developmental, or physical disabilities who need assistance with activities of daily living
Limitations of this service
Facility usually will not accept or retain a resident who requires physical or chemical restraints; medical services; nursing services unless the facility complies with specified requirements; behavioral health residential services; or services that the assisted living facility is not licensed or able to provide. With worsen condition of the resident, residents usually should move to skilled nursing home facilities.
Staff Qualifications
- Administrator/Executive Director: A certified caregiver, Licensed Practical Nurse, or skilled nursing facility administrator (varies per state)
- Licensed Nurses (Licensed Practical Nurse or Registered Nurse): Available on-site during business hours (not 24/7) and possibly on call for emergencies
- Medication Aides: Certified to administer medications. Must be supervised by a licensed nurse.
- Personal Care Assistants: Trained in ADL assistance (requirements vary by state)
- Food Service Staff: Some states require a certified dietary manager or licensed dietitian to oversee meal plans
- Housekeeping and Maintenance: Not typically subject to state staffing ratios but are essential for resident well-being
Care Standards & Regulations
Assisted living is regulated at the state level, with varying requirements. Typical standards include:
- Staff-to-resident ratios: 1:15 to 1:25 during the day
- 24-hour staff presence (but not necessarily licensed nurses)
- Individual service plans updated annually
- Minimum training hours: 12-75 hours depending on state
Costs by State (2024 Data)
| State | Median Monthly Cost | Range |
|---|---|---|
| Washington D.C. | $11,000 | $8,000-$14,000 |
| Massachusetts | $9,300 | $6,500-$12,000 |
| California | $6,500 | $4,500-$9,000 |
| National Average | $5,100 | $3,500-$7,500 |
| Missouri (Lowest) | $3,200 | $2,500-$4,500 |
How We Excel at Better Care Today
Our Assisted Living-Level Care
- Enhanced Staffing: All our facilities have 24/7 licensed nurse coverage, exceeding typical U.S. assisted living standards
- Base Monthly Cost: $650-$1,600/month (60-85% lower than U.S. average)
- Nurse-to-Resident Ratios: 1:5, significantly better than U.S. norms (1:15-1:25 staff ratios)
- Included: All meals, housekeeping, activities, wellness programs, basic medical oversight, laundry, and accommodation
- Variable Costs: Medications, personal care supplies, and optional excursions based on use
- Value Difference: U.S. facilities often charge separately for activities, therapy, and additional services - Philippine facilities include more in the base rate
Assisted Living Costs: US vs. Better Care Today
Savings Scale
4. Independent Living Communities
Housing arrangement for older adults who want to maintain their independence in a private home, but within a community that offers amenities and support services
What They Provide
These communities offer minimal to no healthcare services, focusing instead on lifestyle amenities and community engagement.
Limitations of this service
Those facilities typically do not accept individuals who require a higher level of care than they can provide, such as those needing constant skilled nursing care, extensive medical equipment like a ventilator, or those whose behaviors pose an immediate danger to themselves or others that the facility cannot manage.
Staff Qualifications
- Community Manager: Administrative oversight
- Maintenance Staff: Property upkeep
- Activities Director: Plans social and recreational programs
- Dining Services: Meal preparation and service
- Note: Medical staff not typically present; residents arrange their own healthcare
Care Standards & Regulations
Independent living communities have minimal healthcare regulations since they don't provide medical care. Standards focus on:
- Housing quality and safety
- Food service standards
- Emergency response systems in units
- General staff background checks
Costs by State (2024 Data)
| Region | Median Monthly Cost | Range |
|---|---|---|
| San Francisco Bay Area | $5,500 | $4,000-$8,000 |
| New York Metro | $5,200 | $3,800-$7,500 |
| Los Angeles | $4,800 | $3,500-$7,000 |
| National Average | $3,125 | $2,000-$5,000 |
| Rural Midwest | $2,200 | $1,500-$3,500 |
How We Excel at Better Care Today
Our Independent Living Options
- Enhanced Security: While independent, residents benefit from on-site healthcare professionals available 24/7
- Cost: $800-$1,500/month (50-70% lower than U.S. average)
- Added Value: Includes wellness monitoring and easy transition to higher care levels if needed
- Location Benefits: Tropical climate, cultural enrichment, and expatriate-friendly communities
Independent Living Costs: US vs. Better Care Today
Savings Scale
5. Home Care Services
Provides non-medical support for daily living, fostering a sense of autonomy and enhancing quality of life.
What They Provide
Assistance in bathing, dressing, grooming, light housekeeping, meal prep, companionship, and transportation.
Limitations of this service
Case to case basis - depending on the needs of the resident and the budget of the family.
Staff Qualifications
- Caregiver: Helps with with chores or tasks can maintain the household with meal preparation, laundry, grocery shopping, and other housekeeping items.
How We Excel at Better Care Today
Our Home Care Alternative
- Residential Setting Advantage: 24/7 professional care at facility rates ($1,500-$3,000/month) vs. $18,000-$25,000/month for 24/7 home care in U.S.
- Staff Availability: Immediate access to Registered Nurses, physicians, and specialists without hourly rates
- Cost Efficiency: 90-95% savings compared to 24/7 U.S. home care while providing superior coverage
- Community Benefit: Social engagement and activities included, addressing isolation concerns of home care
Quick Comparison: U.S. vs. Better Care Today Facilities
💡 Important: Understanding Price Comparisons
Philippine Pricing Structure:
✅ Included in Base Monthly Rate:
- All nursing care and 24/7 medical oversight
- All meals and dietary services
- All therapy services (physical, occupational, speech)
- All activities and social programs
- Housekeeping and laundry
- Room and accommodation
💰 Small Variable Costs (consumption-based):
- Medications: Charged based on actual use (significantly lower cost than U.S.)
- Incontinence supplies: Diapers and similar items based on consumption
- Excursions: Optional outings (coffee shops, malls, parks) - just fuel costs covered
These variable costs remain very affordable in the Philippines and are typically much lower than equivalent expenses in Western countries.
⚠️ U.S. Facilities Often Charge Extra For: Medications, therapy sessions, specialized dementia care, activities, beauty services, incontinence supplies, and transportation - adding $1,000-$5,000+/month to advertised base rates. Philippine facilities have fewer additional charges and lower variable costs.
| Care Type | U.S. Average Monthly Cost | Better Care Today Cost | Savings | Care Quality Difference |
|---|---|---|---|---|
| Nursing Home / Skilled Nursing | $9,200 | $2,000-$4,000 | 70-85% | Up to 1:1 nurse-to-resident ratios; 4-16x higher Registered Nurse time |
| Memory Care / Basic Dementia Care | $6,935 | $1,600+ | 75-80% | 1:3-1:5 nurse-to-resident ratios vs 1:6-1:10 staff ratios; all-inclusive pricing |
| Assisted Living | $5,100 | $650-$1,600 | 60-85% | 24/7 Registered Nurse vs business hours only; 1:5 nurse-to-resident ratio vs 1:15-1:25 staff ratio |
| Independent Living | $3,125 | $800-$1,500 | 50-70% | Added healthcare monitoring |
| 24/7 Home Care | $18,000-$25,000 | $1,500-$3,000 | 90-95% | Community + comprehensive care |
Making Informed Decisions: Comparing Apples to Apples
When evaluating care options internationally, it's critical to ensure you're comparing equivalent levels of care. Here are key factors to consider:
Questions to Ask Any Facility
- Staffing Ratios: What is the nurse-to-resident ratio during day and night shifts?
- Registered Nurse Coverage: How many hours of Registered Nurse care does each resident receive daily?
- Staff Qualifications: What training and certifications do staff members hold?
- Medical Oversight: Is there a medical director? How often are residents seen by physicians?
- Emergency Response: What protocols exist for medical emergencies? Distance to hospital?
- Specialized Care: What experience does staff have with your specific condition (dementia, stroke, etc.)?
- Included Services: What's included in the base rate vs. additional charges?
- Pricing Transparency: What's included in the base rate vs. variable/additional costs? Are medications, supplies, therapy, and activities included or charged separately?
- Communication: How will the facility communicate with family members?
Red Flags to Watch For
- Facilities that won't disclose staffing ratios or care minutes
- Significantly lower costs without explanation of what services are reduced
- Lack of licensed medical staff on premises
- No clear emergency protocols or hospital partnerships
- Limited family communication options
- Unlicensed or untrained caregiving staff
Conclusion: Quality Care Doesn't Have to Break the Bank
Understanding the different types of care facilities in the United States helps you make informed decisions about long-term care. While U.S. facilities provide quality care, costs continue to rise dramatically, with many families spending $100,000-$350,000 annually for 24/7 nursing care.
Better Care Today offers a compelling alternative: facilities in Southeast Asia that meet or exceed U.S. care standards at a fraction of the cost. Our partner facilities provide:
- Superior nurse-to-resident ratios (3-6x better than U.S. averages)
- Higher Registered Nurse coverage (2-8 hours per resident per day vs. 0.5-0.7 in U.S.)
- Internationally trained professionals with the same or higher qualifications
- Comprehensive care that would cost 80-95% more in the United States
- Beautiful environments with tropical climates that promote wellness
When comparing care options, remember to evaluate what truly matters: staff qualifications, care minutes, medical oversight, and quality of life. The location should be secondary to these factors, especially when international options provide superior care at dramatically lower costs.
Ready to explore your options? Contact Better Care Today for a free consultation. We'll help you understand exactly what level of care you need and match you with facilities that exceed U.S. standards while saving thousands of dollars every month.
Sources & Data References
- Cost and staffing data compiled from: Centers for Medicare & Medicaid Services (CMS) Payroll-Based Journal Data (2024) ,
- Genworth Cost of Care Survey (2023-2024),
- American Health Care Association/National Center for Assisted Living (AHCA/NCAL) reports,
- State-specific regulatory agencies, and Better Care Today facility audits (2024). All data represents median values; actual costs vary by facility, location, and level of care required.
- CMS Minimum Staffing Standards Final Rule (2024)
- KFF Analysis of Nursing Facility Staffing Requirements
- A Place for Mom - Cost of Long-Term Care and Senior Living (2024)
- Seniorly - Assisted Living Costs by State (2024)
- Paying for Senior Care - 24/7 Home Care Costs
