Assisted living vs nursing home: what's the difference?
Both assisted living and nursing homes provide housing plus support, but the level of care, the staffing and the regulation are very different. Picking the wrong one can mean overpaying for help your parent doesn't need — or under-providing for help they do.
Assisted living — who it's for
Adults who can still walk, transfer and dress with reminders, but need help with cooking, medication management, housekeeping and transportation. Most residents have early-stage memory issues at most. Typical admission age is 75–85.
Nursing home — who it's for
Adults who need help with most activities of daily living, have moderate-to-advanced dementia, need wound care or IV medication, or have complex medical conditions that require 24/7 licensed nursing oversight.
Cost (US, 2024 medians)
Assisted living: about $5,350 per month, or $64,000 per year. Nursing home (semi-private): about $9,000 per month, or $108,000 per year. Memory care wings of assisted living typically add $1,000–$2,000 per month.
Who pays
Assisted living is overwhelmingly private-pay. Some states cover it under Medicaid HCBS waivers, but waiting lists are long. Medicare does not cover assisted living. Nursing homes, by contrast, are paid for by Medicaid for about 62% of long-term residents.
Regulation
Nursing homes are regulated federally by CMS and rated on Medicare.gov Care Compare. Assisted living is regulated only by states — there is no national rating system, and inspection results are harder to find. Always ask your state's assisted-living licensing board for the most recent survey.
Frequently asked questions
Authoritative sources
The figures and rules in this guide are drawn from the following official and independent sources. Open any link to verify the latest published numbers.
- Residential care communities
National Center for Assisted Living (NCAL)
- Cost of Care Survey 2024
Genworth
- Assisted living state regulations
National Academy for State Health Policy
About this guide
Written and reviewed by the Nursing Home Match editorial team. We update guides at least annually and verify every figure against the official sources listed above. This guide is general information, not personal, medical, financial or legal advice. Always confirm details on Medicare.gov Care Compare (United States) or My Aged Care (Australia), or speak to a qualified adviser before making decisions.