Free senior care guidance for Indianapolis-area families. No cost to you, ever.
Call (463) 208-0977
Indy Senior AdvisorPeople • Places • Possibilities

Nursing Home vs. Assisted Living

Indiana licenses nursing homes as Comprehensive Care Facilities and assisted living as Residential Care Facilities -- two separate rule chapters and two different levels of medical care.

Get matched freeCall (463) 208-0977
Home›Comparisons›Nursing Home vs. Assisted Living
Short answer

Indiana licenses nursing homes as Comprehensive Care Facilities, providing 24-hour skilled nursing care, and assisted living as Residential Care Facilities (RCF) under 410 IAC 16.2-5, a lower level of care focused on daily-activity help and medication administration.

Why the ratings differ

Nursing facilities are the one senior-care category with a federal CMS Care Compare star rating. Assisted living (RCF) communities are not federally star-rated -- their record lives only in Indiana's own inspection search.

What pushes a resident from one to the other

A resident whose needs exceed an RCF's admission/retention limits under 410 IAC 16.2-5 -- typically a need for 24-hour licensed nursing care -- generally needs to transition to a Comprehensive Care Facility. Several Indianapolis-metro campuses hold both license types on one property specifically to make that transition easier.

You can check any facility's record free. Use the Indiana Long Term Care Survey & Inspection Public Search (hoosierusa.isdh.in.gov) and, for nursing homes, CMS Care Compare. Read the full explanation →

Questions families ask

What is RCAP and how is it different from the PathWays Waiver?

The Residential Care Assistance Program (RCAP) is Indiana's Medicaid-funded room-and-board assistance for RCF residents. It pairs with, but is separate from, the PathWays Waiver, which pays for care services. A facility can hold a PathWays agreement, an RCAP agreement, both, or neither -- ask specifically which apply.

Is Indiana's Medicaid expansion (HIP) the same as long-term care Medicaid for seniors?

No. The Healthy Indiana Plan (HIP), Indiana's ACA expansion effective February 1, 2015, covers adults 19-64 based on income. Long-term-care Medicaid for seniors uses a separate, non-MAGI aged/blind/disabled eligibility pathway with different asset and income rules. The two are frequently and incorrectly conflated.

Is there a waitlist for Indiana's PathWays Waiver?

Yes, historically. At the program's July 2024 launch, 9,015 people were on the PathWays waiting list statewide out of 39,842 total slots. Current waitlist figures change; confirm today's status with CICOA Aging & In-Home Solutions, the Area Agency on Aging serving this region.

What is Indiana's Medicaid Estate Recovery Program?

Indiana's Medicaid Estate Recovery Program (MERP) recovers amounts Medicaid paid on a recipient's behalf after age 55, from probate and certain non-probate assets. As of July 1, 2025, the state has 9 months after death to file a claim, and recovery does not proceed while a spouse survives or a child is under 21, blind, or disabled.

Not sure where to start?

Answer five questions and a local advisor will come back with senior care options in your area that actually fit your situation and budget. It is free, and there is no obligation.

Find care options
Find senior care — free