Why are residents who need full care in ALF? Shouldn't they be in a nursing home? I thought ALF is just to assist. If a nursing home is the last stage of life, why isn't memory care in a nursing home and a rehabilitation center at a ALF? It makes no sense to me. Why can an uncertified aide administer meds in a ALF? Why do aides in ALF have to do cooking, meds, etc.. Since it's more expensive living, shouldn't we have better options instead of the aide being every job title?
Skilled Nursing of course means that the person needs care that an AL or MC can't give. The resident must meet a certain requirements especially if Medicaid is going to cover the residents care. These are closely monitored by the State even if privately owned. There is usually a doctor/s associated with it. A DON and a RN at every nurses station. LPNs do medpasses and actually work closely with Patients. Then CNAs are the LPNs aides. They usually do the dirty work. Where my daughter worked as an LPN she was in charge of the CNAs, the RN was over the LPNs and DON was over them all.
A CNA, unless a Medtech, should not be doing med passes under any circumstances. Thats a Hospital, AL, MC or SNF. They are not medically trained. To do med passes they must be Medtechs. It was suggested on another post to call the Board of Nursing in your State to see if this has changed because of COVID. In my Moms AL the aides did help out at meal time. There was a cook. The aides made the table, served the food and did the clean up. They may have helped getting the food on the plates but I didn't see that.
Generally the ability to perform the ADLs is one of the determining factors as to the appropriate level of care facility.
Staff training and certification will vary too.
I know there have been cases where a couple stays in a lower level of care facility to allow them to stay together.
The real reason the distinctions are difficult to make is that people are untidy and resist attempts to fit them into nice clear categories.