The Laureate Way

Articles to Help Families and Older Adults Manage the Challenges of Aging

The Differences and Similarities Between RCAC and CBRF

Assisted living care

Assisted Living is a term used to describe a type of residential care for older adults. But assisted living services and accommodations vary greatly, depending on the organization. The reality of assisted living in Wisconsin is that when you have seen one assisted living facility, you have seen just one assisted living facility.

Through legislation, the State of Wisconsin has created three types of assisted living facilities:

  • Adult Family Homes (AFH)
  • Residential Care Apartment Complexes (RCAC)
  • Community Based Residential Facilities (CBRF)

Below are the differences and similarities of RCAC and CBRF communities.

1. The Building Distinction

Across the State of Wisconsin, nearly 80% of the CBRFs have a capacity of 20 residents or less. Often casually called “group homes,” many people think of CBRFs as small environments with individual bedrooms, shared bathrooms and living room and dining room areas that would be similar to those in a traditional house.

Residential Care Apartment Complexes (RCAC)

This assisted living is an independent apartment complex where five or more adults reside. All RCACs are required to provide individual apartments complete with locked entrances, kitchens and bathrooms – shared kitchens and bathrooms are not allowed.

Community Based Residential Facilities (CBRF)

This type of assisted living is where older adults reside to receive care, treatment or services that are above the level of room and board. The rules allow for CBRFs to be quite large. All of the Laureate Group’s CBRFs are home to 70 or more residents, which is quite uncommon. In this case, every person has his or her own apartment complete with a kitchenette, bathroom and shower.

The Laureate Group Difference

Whether CBRF or RCAC, all Laureate Group communities offer private studio, one or two bedroom apartments complete with kitchens and bathrooms.

2. The Regulatory Distinction

Although there are both significant and subtle differences in the administrative rules for RCACs and CBRFs, the primary difference in the rules as they relate to caring for older adults surrounds the issue of competence.

Residential Care Apartment Complexes (RCAC)

In order to move into a RCAC, a person must be competent upon admission. For this purpose, competence is defined as someone who does not have an activated Durable Power of Attorney for Health Care or a Legal Guardian. People who live in RCACs are expected to manage their satisfaction through the legal system, meaning the person is expected to provide their own complaint to the court system, if needed.

Community Based Residential Facilities (CBRF)

Vulnerable people are protected by various State agencies that play a role in assuring the level of service provided in a CBRF. If a person took issue with a CBRF, the State would manage the complaint.

The Laureate Group Difference

We operate both CBRFs and RCACs and comply with all applicable rules. We participate in many forums, which help direct industry best practices.

3. The Care Distinction

Residential Care Apartment Complexes (RCAC) and Community Based Residential Facilities (CBRF)

The assisted living operator is expected to identify the people they are going to care for, along with the amount and type of care they will provide up to the maximum allowed.

With 40% resident turnover per year (the industry average), the occupancy and the acuity of facilities varies greatly over a period of months and years.

Sometimes people think that the amount of staffing and care provided is a function of its license type. In fact, the amount of staff and the amount of care that is provided is the operator’s choice and should be determined by who is living in the facility today.

The Laureate Group Difference

Our staffing model, which can be adjusted daily, is managed by each community’s full time RN. The staffing plan ebbs and flows with the occupancy and acuity care needs of the people who live in the building.

4. Aging in Place

Residential Care Apartment Complexes (RCAC) and Community Based Residential Facilities (CBRF)

Both assisted living types can care for people with very complex needs as long as they have the trained staff needed to meet the needs of their residents. All assisted living rules allow the people who live in the facilities to “age in place,” meaning that they can stay in residence often for the rest of their life.

The rules differ in terms of how that is to be accomplished – sometimes through outside agencies like a hospice, sometimes a variance is required to exceed a maximum care level, and sometimes in other ways. Everyone recognizes that moving an older person as health declines can be problematic.

The Laureate Group Difference

In addition to our CBRFs, Laureate Group RCACs manage very complex residents, even those with cognitive limitations.

As stated, the beauty of assisted living is that all facilities are not the same – even those in the same regulatory category. Don’t assume that facilities are all the same. Many RCACs are very successful in meeting the needs of high acuity clients while some CBRFs only meet the most basic activities of daily living (ADL) needs of clients.