The choice between an assisted living facility and a nursing home for a loved one can be difficult. If you’re like many families having to make this decision, you may not know the differences between the two. We’re here to help.

We’ll compare the pros and cons of assisted living facilities and nursing home care and provide the information you need to help you make the best decision for your family member.

The Key Difference Between Assisted Living and Nursing Home

caregiver helping a senior adult - difference between assisted living and nursing homeThere’s one key difference between assisted living facilities and nursing homes, and it’s a big one. A nursing home typically resembles a hospital or medical setting. Residents will receive care in what you’d call a more clinical setting. These are best suited for those with serious medical issues or who need around-the-clock medical care.

An assisted living facility is more like a home or apartment lifestyle. Residents receive personal care with ample social opportunities. Assisted living facilities often feel like retirement communities with additional support for health care and basic needs.

While both settings will prioritize care, an assisted living facility will also provide a more independent lifestyle, allowing residents to maximize their quality of life. That’s why most seniors prefer an assisted living facility rather than a nursing home.

Before we compare specifics, let’s define terms to avoid confusion.

  • Nursing homes may also be called skilled nursing facilities or intermediate care nursing facilities.
  • Assisted living facilities may also be called adult foster care or senior living communities.

Care Services

At both facilities, residents will receive assistance with the activities of daily living, including personal care.  Medication is managed as well to ensure residents maintain their prescription regimen.

A nursing home is more likely to provide skilled nursing and access to some additional medical treatments.

Rooms and Living Space(s)

A nursing home features either private or shared rooms with some limited common areas. Typically, there are no outside areas.

An assisted living facility features private or shared apartments and studios. Units will have private bathrooms and sometimes kitchenettes. When it comes to living space, assisted living facilities typically have significant living spaces along with developed and maintained outdoor grounds.


There are more than 15,000 nursing homes across the country and more than 1.7 million beds available, according to the Centers for Disease Control (CDC).

Smaller nursing homes do exist, but most have around 100 residents.

There are almost double the number of assisted care facilities, according to the American Health Care Association (ACHA) but fewer beds are available.  Approximately 28,900 assisted living communities to have nearly 1 million beds.  The average number of residents in an assisted living community is 33.

Cost Comparison

Costs can vary widely based on location, facilities, and care needed. 

A private room in a nursing home costs, on average, $290 a day or $8,821 per month. A semi-private (shared) room averages $255 a day or $7,756 a month, according to

Assisted living communities can range from $2,000 to $7,000 a month, although the average cost in 2020 was $4,300 per month.  Some additional charges may be added depending on the level of care that’s needed.

Insurance Considerations

Nursing home stays are predominantly paid for by Medicaid but require patients to spend their own assets on care before coverage begins. There may also be limits on the length of stays.

At an assisted living facility, residents typically pay out-of-pocket. Financial assistance is available in some states through Medicaid, options for veterans, and assistance to Alzheimer’s patients.

Which Facility Is Right for You?

Senior couple sitting on a bench in Abbey Manor assisted living facility Which facility is right for your loved one will depend on the level of care they need and the lifestyle they want to live. If they need frequent hospital stays or intensive medical treatment, a nursing home may be the better option. Some of the treatments they require may be able to be administered within the nursing home facility and reduce the number of trips to the hospital needed.

Assisted living facilities allow residents to live a more normal life, similar to living in their own home or an apartment, with help when needed. Many assisted living facilities also accommodate individuals with Alzheimer’s or dementia, including monitoring and increased supervision. While some medical care can’t be handled in an assisted living facility, intermittent care is available, and other services make for a more comfortable lifestyle.

While nursing homes primarily provide health care, assisted living facilities also feature activities to keep residents engaged, including things like:

  • Classes and activities
  • Social outings, such as trips to theaters, museums, or shopping
  • Maintenance-free lifestyle (no lawn care or home repairs)

When deciding whether a nursing home or assisted living facility is right for your loved one, some of the questions you’ll want to answer include:

  • How much help is needed for daily activities such as bathing, dressing, or using the restroom?
  • How much medical care is needed?
  • How serious are medical conditions?
  • Do you need all meals provided, or are loved ones able to prepare their own meals?
  • How do you plan to pay for the care you need?

To learn more about assisted living and how your loved ones can continue to live a more independent lifestyle while getting the support they need, contact Abbey Manor.