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.