Assisted Living vs. Nursing Homes: Costs, Amenities, & How to Choose


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Assisted living communities and nursing homes offer different types of care, though many people think they’re the same. Over the past few decades, these two types of senior living have grown distinctly different. “Nursing home” is no longer the senior care catchall term it used to be. So what’s the main difference between assisted living and nursing homes? Assisted living communities provide a more social lifestyle for seniors who are generally active but need some help with everyday tasks. Nursing homes, on the other hand, provide long-term medical care for adults with serious health issues. Nursing homes usually cost more than assisted living due to the higher level of care.

Key Takeaways

  1. Assisted living communities help with daily activities. These services include assistance with bathing, toileting, dressing, and more.
  2. Nursing homes provide 24-hour medical care and monitoring. This is the highest level of health care offered outside of a hospital setting.
  3. The national median monthly cost of assisted living is $4,995. Because assisted living involves less intensive care services, these communities cost less than nursing homes.
  4. Nursing homes can cost $9,733 per month. The cost is higher due to the increased level of care provided by medically trained staff.

What is assisted living?

Assisted living is an ideal option for seniors who can no longer live alone but want to remain relatively independent and maintain a social lifestyle. Assisted living communities provide long-term housing for older adults who are generally active but need support with activities of daily living (ADLs), which could include bathing, dressing, and using the toilet.

Additionally, assisted living can cultivate a strong sense of community. Some religious assisted living communities, such as Presbyterian assisted living, feature a robust faith community. Luxury assisted living communities typically offer more amenities and benefits than more budget-friendly options.

While residents can find privacy in their apartments, they’ll usually eat together in the dining room and mingle in comfortable common spaces. Throughout the month, staff members typically organize activities, entertainment, and outings for residents. When you’re touring a facility, it’s important to learn about their staff-to-resident ratio, as this can affect the amount of interaction between residents and staff.

What is a nursing home?

Nursing homes serve seniors and others who require full-time monitoring and medical assistance. These facilities offer the highest level of care for individuals who don’t require hospitalization.

Elderly adults who need long-term care at a nursing home often have severe physical or cognitive health conditions that require 24-hour nursing care. They may be incontinent, unable to eat independently, or unable to transfer from bed to a wheelchair without the assistance of a staff member.

How do services in assisted living and nursing homes compare?

A diagram that displays the differences between assisted living and nursing homes

Assisted living communities offer services and amenities to keep residents as healthy, socially engaged, and independent as possible. While nursing homes offer similar amenities, their main focus is providing round-the-clock medical care to treat more serious health issues.

A key feature of nursing homes, skilled nursing care means that trained medical professionals are available at all times to assist your loved one. If your family member has a serious medical condition, they may need specialized care from licensed health care professionals at a skilled nursing facility. Assisted living senior care aides are highly trained but may not be medically certified.

“Assisted living services are geared toward those who may need some support from staff along with meals and socialization. Therefore, these facilities focus on many different types of activities and entertainment,” says Carol Bradley Bursack, a senior living expert, caregiver, and author of Minding Our Elders: Caregivers Share Their Personal Stories.

“Nursing homes try to offer activities that nourish their residents, but due to their focus on providing actual health care to often severely ill or compromised people, they are, by nature, more medical in their approach,” Bursack explains.

A Place for Mom partners with assisted living communities across the country. The following is a list of the most common services and amenities that our partners provide, as well as the percentage of communities that offer them:[01]

  • 95% provide on-site activities that cater to residents’ interests.
  • 82% offer full medication management.
  • 80% provide housekeeping.
  • 76% provide laundry services.
  • 74% offer off-site activities.
  • 72% offer pet-friendly accommodations.
  • 71% provide complimentary transportation.
  • 66% offer restaurant-style dining.
  • 58% have apartments with kitchenettes.

Additionally, some of our partner communities offer more advanced care services. These include the following:[01]

  • 80% offer on-site hospice care.
  • 61% have on-site nursing.
  • 29% provide wound care.
  • 8% have a skilled nursing facility located on-site.

Nursing homes typically offer more advanced medical care services, such as:

  • Ongoing palliative and preventative long-term care
  • Prescription medication administration, including injections
  • Dialysis
  • Specialized rehabilitative services, such as speech, occupational, physical, respiratory, cognitive, and vocational therapy
  • Emergency and routine dental services
  • Meal options that must meet the daily nutritional requirements and the unique dietary needs of each resident, including pureed and liquid diets
  • Increased safety features and security benefits

Most of the time, medical care services are offered in the community by external companies contracted by the facility. Many modern assisted living facilities may do this as well for already established residents, so that when the time comes, residents won’t have to move to another facility.

“A typical assisted living resident is someone who needs some extra assistance along with meals and socializing,” Bursack says. “Depending on the facility, extra services can be added to the package so that those who need more care can remain there longer. Alternatively, people who need significant medical care from nurses and physicians may qualify for a nursing home. This could include someone who has had a major stroke, a disabling fall, or a chronic disease.”

Will my loved one benefit from assisted living or a nursing home?

Assisted living communities benefit seniors who are generally active but need some assistance with daily tasks. If an elderly loved one develops chronic or severe health problems, then a nursing home may be a better option. The advanced level of care offered in a nursing home versus an assisted living community makes it an ideal choice by providing medical care in addition to companionship, help with activities of daily living, and on-site amenities.


Your loved one’s physician should be included when any type of placement is discussed. Some assisted living facilities require bloodwork or chest X-rays before admission, so if only for that reason, their doctor should be on board. Of course, for nursing home placement, such involvement is required since a physician will determine a person’s eligibility.

Which care type will your loved one benefit from the most? For families needing to choose between assisted living and nursing home care, Bursack offers the following advice.

“If the older adult is relatively self-sufficient but needs extra support for safety and possibly more socialization, then assisted living is likely the right choice. However, if your loved one has significant challenges with activities of daily living, such as dressing or feeding themselves, or has a severe or chronic illness, it’s good to work with a doctor to see what care is best for them.”

Assisted living is an ideal choice for seniors who may:

  • Require minor nursing assistance but don’t need full-time medical care
  • Need help with daily activities, such as dressing and bathing
  • Have interest in a maintenance-free lifestyle without lawn care or home repairs
  • Desire an active lifestyle but don’t have access to transportation
  • Want to make new friends or find social activities, like art classes
  • Have good health but know they may need more help soon

A nursing home is an ideal choice for seniors who may:

  • Require constant care due to chronic conditions or deteriorating health
  • Be unable to feed themselves independently
  • Have significant mobility concerns
  • Have experienced an injury or fall and need significant rehabilitation
  • Have progressive conditions, such as Parkinson’s disease or multiple sclerosis
  • Require regular injections for diabetes or other conditions

How do entry criteria for nursing homes and assisted living differ?

Nursing homes and assisted living serve different populations and have different entry criteria. While assisted living communities could require residents to meet certain health standards and functional requirements, nursing homes usually have entry requirements to confirm that seniors require a higher level of care.

For instance, assisted living communities may require that your loved one is able to eat independently or can transfer between a bed and a wheelchair without extensive assistance. They may also not accept residents with severe cognitive impairment or behavioral issues.

For someone to qualify for nursing home care, an assessment typically must be completed, and at least one physician should sign off on the recommendation, says Bursack. Seniors need to meet the state’s criteria to enter a nursing home. This often involves getting a physical assessment and a physician’s order.


While both assessments are intended to determine an older adult’s need for care and health histories are required, assisted living assessments and nursing home assessments differ. It’s also important to understand that state requirements vary.

An assisted living assessment focuses on how a person scores in completing general activities of daily living (ADLs). The staff will also ask about dietary needs, their level of mobility, and their cognition, so care levels can be determined. Medical needs will also be addressed. Often, extra help can be hired to enhance care, but at an increased cost.

nursing home assessment focuses on debilitating physical illnesses. While the staff typically ask about abilities and preferences, the person’s illness and physical abilities will need to be documented and the admission approved by a physician.

Assisted living vs. nursing home costs

The national median monthly cost of assisted living is $4,995, according to A Place for Mom’s proprietary data.[02] Nursing homes are more expensive than assisted living: The national median monthly cost of a private room is $9,733.[03]

“Other than for memory care in an assisted living facility, nursing homes are nearly always more expensive than assisted living due to their need to provide ongoing medical care,” says Bursack. “They have significantly more medically trained staff available as well as a need for more staff in general.”

The following chart summarizes the national median costs for assisted living, memory care, and nursing homes of different room sizes using A Place for Mom’s proprietary data and Genworth’s cost of care survey.

Care Type Room Monthly cost
Assisted living One bedroom $5,000 [02]
Assisted living Shared room $3,489 [02]
Memory care Private room $6,500 [02]
Memory care Shared room $5,000 [02]
Nursing home Private room $9,733 [03]
Nursing home Shared room $8,669 [03]

Nursing homes are more expensive than assisted living. Both nursing homes and assisted living costs vary by community, location, and services offered. However, nursing homes offer full-time medical care, which is always costlier. This makes assisted living more affordable than nursing homes.

There are a variety of sources families can use to pay for each care type. Seniors may rely on private funds, savings, and personal assets to cover the majority of assisted living costs, while government assistance may be available to help lower-income residents pay for nursing home care.

How do you decide which type of senior living is best?

In the past several decades, senior living choices have expanded as the needs and expectations of older adults have changed. Finding the option that best meets your loved one’s needs is an important part of keeping them healthy, active, and safe.

If you’re unsure which care type fits your parent’s needs, reach out to one of A Place for Mom’s Senior Living Advisors. They can answer your questions about senior living options, connect you with local communities, and schedule tours, all at no cost to your family.

This article originally appeared on APlaceForMom and was syndicated by MediaFeed.

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