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

12 minute readLast updated May 19, 2023
fact checkedon May 19, 2023
Written by Claire Samuels
Reviewed by Saul Chapnick, MSWAssisted living executive Saul Chapnick has extensive experience revitalizing distressed facilities and ensuring new ones start strong.
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Assisted living communities and nursing homes differ in many ways, though many people think of them as 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 care types? Assisted living communities provide a more social lifestyle for seniors who are generally active but need some help with everyday tasks. Nursing homes 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.

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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, using the toilet, and managing medications.

Additionally, assisted living cultivates 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 touring a facility, it’s important to learn about their staff-to-resident ratio in assisted living 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.

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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 also focus on these areas and offer similar amenities, they also provide around-the-clock medical care to treat more serious health issues.

Skilled nursing care is a key feature of many nursing homes. That means trained medical professionals are available at all times to assist your loved one. If your family member has a serious medical condition, they likely 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,” explains Bursack.

The following are the kinds of services and amenities you would typically find in most assisted living communities:

  • Restaurant-style dining and happy hours
  • Transportation and outings
  • Social activities tailored to residents’ interests
  • Pet-friendly accommodations
  • Laundry, housekeeping, and maintenance
  • Assistance with activities of daily living (personal care) and medication management
  • Apartments with mini-kitchens and bathrooms

While, nursing homes may offer more advanced medical care services, such as:

  • Ongoing palliative and preventative long-term care
  • Hospice 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

Much 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.

For instance, it’s generally unlikely the nursing home or assisted living facility will have a dentist or dialysis provider on-site all the time — those providers are brought in when necessary. When that isn’t an option, the nursing home or other senior care facility will likely offer transportation to the necessary medical locations.

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 nursing homes 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 ADLs, and on-site amenities.

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 may be a good option for someone who:

  • Requires minor nursing assistance but doesn’t need full-time medical care
  • Needs help with daily activities like dressing and bathing
  • Is interested in a maintenance-free lifestyle without lawn care or home repairs
  • Desires an active lifestyle but doesn’t have access to transportation
  • Is looking for new friends or social activities, like art classes
  • Is currently in good health but knows 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, like Parkinson’s disease or multiple sclerosis
  • Require regular injections for diabetes or other conditions

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

Nursing homes and assisted living serve different populations and have different criteria. While assisted living communities could require residents to meet certain health standards and abilities, nursing homes usually have entry requirements to confirm that the patient requires 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 also might not accept residents with severe cognitive impairment or behavioral issues.

However, 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 might involve getting a physical assessment and a physician’s order.

“A typical assisted living resident is someone who needs some extra assistance along with meals and socializing,” says Bursack. “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.”

Assisted living vs. nursing home costs

The median monthly cost of assisted living was $4,640 in 2022, according to A Place for Mom’s most recent partner community data.[01]

While comprehensive statistics on nursing home costs haven’t yet been published for 2022, the median monthly cost of a semi-private room in a nursing home was $7,908 in 2021, while a private room was $9,034.[01] Considering past cost trends, we can assume nursing home pricing increased slightly in 2022.

“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,” Bursack says. “They have significantly more medically trained staff available as well as a need for more staff in general.”

That said, nursing home and assisted living costs vary by community, location, and services offered. The difference in cost between assisted living and nursing homes is significant because assisted living communities don’t offer full-time medical care. This makes assisted living more affordable than nursing home care.

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 and connect you with local communities, all at no cost to your family.


  1. A Place for Mom. A Place for Mom Proprietary Median Price Index.

  2. Genworth. (2022, June 2). Cost of Care Survey.

Meet the Author
Claire Samuels

Claire Samuels is a former senior copywriter at A Place for Mom, where she helped guide families through the dementia and memory care journey. Before transitioning to writing, she gained industry insight as an account executive for senior living communities across the Midwest. She holds a degree from Davidson College.

Edited by

Danny Szlauderbach

Reviewed by

Saul Chapnick, MSW

The information contained on this page is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.

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