difference between RCFE and SNF

What’s the Difference Between an RCFE and an SNF?

As an assisted living administrator, you are in a position to educate families about the different senior care options.

Families considering options for loved ones will appreciate a simple explanation of the types of facilities available to them. Demonstrate your value early on in the process by helping families navigate this complex decision. 

Additionally, you and your staff can avoid costly mistakes like admitting a resident that may really belong in a SNF. Share this handy post with potential residents so they can make informed decisions. 

Californians care about each other, and the Golden State does everything possible to provide for all its residents at every stage of their lives. This certainly includes the aging process and issues that may develop as personal strength, mental understanding, and physical health decline.

When people start finding daily activities a challenge, whether cooking, keeping up their home, or even bathing and dressing, they have a number of options for assistance. 

The facility choices are abundant, but names and acronyms make it difficult to distinguish the appropriate facility choice. 

RCFE vs SNF – A Closer Look

Let’s explore the difference between the two types of senior care facilities based on:

  • Function
  • Licensing
  • Atmosphere
  • Residents
  • Staff
  • Daily Life
  • Special Activities
  • Payment Options


First off, the purpose at the heart of each of these facilities is quite distinct. The mission of the RCFE and the RCFE administrator revolves around keeping each resident as independent as feasible for as long as possible. 

By contrast, the state entrusts SNFs with providing professional medical services. To put it simply, an SNF is a medical facility, and an RCFE is not.


Not surprisingly, California designates two different state agencies for oversight of these facilities. The California Department of Social Services regulates RCFEs, which include assisted living homes, memory care, and Continuing Care Retirement Communities. 

On the other hand, SNFs fall under the jurisdiction of the Department of Health Care Services.

The Department of Social Services has thorough application, testing, and inspection procedures in place for both the Assisted Living Facility license and the assisted living administrator certification. 

Since the process to obtain these licenses and certifications is complex, aspiring RCFE administrators should familiarize themselves with certification criteria, facility processes, and the RCFE corresponding terminology as early as possible.


When you walk into an RCFE, you typically feel like you are entering a large family home with comfortable communal areas furnished like a living room:

  • Sofas or upholstered chairs
  • Appealing wall colors and pictures
  • Bookshelves and tables
  • Reading materials
  • Puzzles and games

Residents’ rooms are often private, and you may see seasonal decorations on the doors expressing the occupant’s individual taste.

Out of necessity, you may experience a more institutional feel in an SNF since appropriate medical equipment and staff stations are needed. In many facilities, rooms are shared by two patients although some may offer private quarters. Meals are served in dining areas for residents able to sit at the tables, but many occupants may eat meals in their rooms.


As a result of the purpose and limited services of an RCFE, the residents of these homes are typically capable of performing at least 2 or more ADLs (Activities of Daily Living). 

If you think of a spectrum extending from total independence to end-of-life care, an RCFE provides the first step in this progression. Each individual is different, but some may need assistance with personal hygiene or other ADLs. 

Since housekeeping and meals are generally included, residents no longer need to worry about these duties.

Most people who reside in an SNF, however, usually have medical needs and require 24-hour skilled nursing care with physician oversight on a monthly basis. Some occupants may have adequate mobility, others may need walkers or wheelchairs, and a number may be confined to their beds.


Since both types of facilities are under the umbrella of a state agency, staff must meet specific regulations.

All RCFE care staff need to complete specific training within the first four weeks on the job. 

The RCFE administrator must not only complete 80 hours of certification training for an assisted living administrator certificate but also must take continuing education courses. Online assisted living administrator courses ensure staff are trained according to state standards. Specific nursing degrees are not required for RCFE caregivers.

In general, SNFs must have a licensed vocational nurse on duty 24 hours a day while a registered nurse must be present for at least one eight-hour shift each day. Any particular medical services ordered, such as physical or occupational therapy, must be provided by certified therapists.

Daily Life

Since independence is highly valued in RCFE communities, the daily schedule of each resident may look different. In addition, many variations may exist from one RCFE to another. For example, some facilities may cater to persons of a particular religious faith or members of a certain cultural or ethnic group.

Residents have the freedom to choose their own interests and the ways they spend their days. 

Given California’s beautiful climate, many individuals may enjoy time outside whether sitting, walking, or perhaps tending to flower pots or small gardens. Others may prefer a communal room inside or their own private quarters.

Because of physical limitations, residents at an SNF may be limited to more specific routines that include time set aside for specific medical care or therapy sessions. As their capabilities allow, however, they can spend time in communal areas visiting or participating in group projects.

Special Activities

Because many RCFEs provide unique care settings, activities may also be specialized according to the interests, needs, and capabilities of the residents. 

Possibilities are endless, but some common opportunities are offered at many facilities:

  • Exercise classes
  • Book discussions
  • Bible studies
  • Craft projects
  • Group singing
  • Gardening opportunities
  • Shopping excursions
  • Field trips

Efforts are also made to engage residents at SNFs with activities and entertainment. 

When residents are unable to leave their rooms, special projects may be brought in for them to complete. Many SNFs also have volunteer programs to provide companionship and learning opportunities.

Payment Options

Another more major difference is how residents and patients pay for their care needs.  

Skilled nursing facilities are often enrolled as preferred providers for Medicare, Medicaid (Medi-Cal in California), and private insurance. Private pay is also accepted. Not all SNF’s have enrolled as Medicaid providers. These insurance plans do not pay for unlimited, long-term care nor do they pay for 100% of the hospital bill. Medicare typically pays for 100 days per year and a percentage of the charges.

RCFE’s however are not covered by most major medical insurance plans (not a medical model). Some Long-Term Care insurance policies do cover RCFE charges depending on the policy.


Although many differences exist between a Residential Care Facility for the Elderly and a Skilled Nursing Facility, they both provide excellent care for seniors at a particular stage of life. 

If you have questions about online assisted living administrator courses or need help preparing an application for an RCFE license, please contact us. 

People Also Ask

What are the 3 main types of long-term care facilities?

Residential care facility for the elderly, skilled nursing, and independent living.

What does an assisted living facility provide?

An RCFE provides home-like personal care and assistance for people who do not require skilled nursing care. 


About Assisted Living Education
Assisted Living Education has been operating in and improving the growing senior care industry for over 15 years. Founded by certified RCFE administrators, Jane Van Dyke-Perez and Bill Perez, we have licensed more than 1,100 assisted living facilities and built close relationships with the California Department of Social Services, assisted living managers, owners and industry professionals. As senior living care educators ourselves, we strive to contribute our knowledge and skills to continually improve senior care and the satisfaction of those working in the industry.