Assisted Living Basics: Residential Care Homes vs. Facilities

In Assisted Living, there are variables to the type of environments available. Today, we'll be discussing those variables and how they manifest in the daily life of residents who live in each type of environment starting with the least expensive option and ending with the most expensive option.


Care Homes (Assisted Living Homes, Group Homes, Residential Care Homes): 

The majority of care homes that are licensed by the State of Arizona are usually licensed for five residents and may have either four or five bedrooms.  Some residents may live in their own private room in the home or may share a room with a roommate at a lower monthly cost.


  • The smaller care homes can range drastically in how they are designed, decorated, and managed. The current residents who live in the homes, along with their functioning level (both socially and physically) can vary as well. For the most part, the smaller care homes are quieter environments than the larger settings and can often have only one or two caregivers working the shift at any given time.
  • Dinner is served  “family style” in the dining room of the home and the caregiver/caregivers assist the residents who need assistance with feeding.  Many times in these homes, if the current resident population is high functioning enough to participate in games, they will play cards, have book clubs, and socialization at the dining table throughout the course of the day.  

These smaller care homes are a good option for people who have moderate to heavy care needs, depending on the licensure level of the home and their current staffing because the smaller environment is most commonly associated with:

  • Quieter setting with more intimate socialization
  • Higher caregiver to resident ratio than large facilities
  • Less active resident population
  • Less fall risk as the setting is small enough for caregivers to be more readily available when they see or hear a resident trying to get out of bed or their chair to use the toilet, etc…

Residential Assisted Living “Centers” (larger care homes):


  • These centers, as they are referred to by the State of Arizona Dept. of Health Services Licensing Division, are licensed for 10 to 12 residents and are many times site built or dramatically redesigned to create larger and wider hallways, private bathrooms - many with roll-in showers in each or almost each bedroom.

  • There is most often only one resident per room (private room as opposed to shared room) in these homes, but many of the homes do offer shared room options when they have the option of a compatible roommate who also needs to live in a shared room. Many people who have advancing dementia feel safer in a roommate situation because as their dementia progresses, they feel anxiety if they are ever alone.  


  • It is not uncommon to see a physical therapist working with patients in the hallways of these larger assisted living homes. Home Health companies are able to provide services wherever a patient resides in the assisted living world, whether it be a smaller care home or a large facility.  It is easier to provide physical therapy for gait training (walking) when there is a hallway that is large enough for the patient and the therapist to be working together while other residents and staff have room to walk around them in the hallway. Smaller care homes can utilize outdoor space when interior space is limited for such therapies. Some homes even offer a grand sized dining and living area, and perhaps a large outdoor courtyard area for outdoor activities: BBQs, gardening, sitting benches or walking paths.
  • Staffing ratios in these homes are similar to the ratio in the care homes, and can be that of two to six caregivers for every 10-12 residents, depending on the care needs of the current population in the home.

These homes offer a happy medium between the very quiet setting of a smaller care home, while also incorporating the more active environment of a large assisted living community/facility.


Assisted Living Facility (Assisted Living Community):

The largest of the assisted living options is the facility or community setting.  These facilities can range in size up to hundreds of apartments in one building or in multiple buildings on one campus.  Instead of residents having a room, they have an apartment equipped with their own bathroom and kitchenette. Meals are served in the main dining room, which may require ambulating from the apartment down a hallway and to the elevator if the dining room is on a different floor than the resident’s apartment, but staff is provided to assist residents to and from the dining room for meals or social activities.  

These facilities offer a much more social environment than smaller settings do and they have a lot of planned activities occurring throughout the day, such as live musical performances, happy hours, birthday parties, educational presentations, card games, bingo, well as group outings via the community’s van, which are planned on a weekly or monthly basis

This setting can be a good option for higher functioning residents who do not have heavy care needs that require more one on one attention than a larger corporate environment can offer.  Caregiver ratios in the facilities can range between 1 caregiver for every 15 - 24 residents and staff is required to check on each resident in their apartments at least every 2 hours. Residents are furnished with an emergency call system to alert staff when they need assistance.

Some people feel more comfortable in the larger setting of a facility, while others may feel overwhelmed by the presence of so much activity and so many people at all times.  



Choosing the right environment comes down to the compilation of many factors, including:

  • Price with respect to realistic long term finances
  • Location
  • Caregiver ratio
  • Caregiver experience and ability to provide for the specific care needs of the resident
  • Social setting
  • Current resident population (would the resident be compatible with this group of people?)
  • Availability of rooms or apartments
  • Management staff and if resident and family likes them and their style of management
  • Transportation if this is a regular need for physician appts, etc…
  • Many times, religion is a determining factor as well

Be sure to tune in next week as we will post our blog discussing Memory Care options.

If you have specific questions about the variables in any of these options for your situation, we welcome you to call us at 480-380-2348 or email us at