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What’s the Difference Between Nursing Homes and Assisted Living Facilities?

More than 80 percent of seniors plan to reside at home as they age, according to a survey conducted by the Retirement Living Information Center. Beyond that, while the majority would prefer to solicit part- or full-time in-home care if and when needed, respondents cited ‘failing health’ as cause to explore other housing options. Interestingly, those polled said they’d choose an assisted living residence over moving in with family.

Senior-centered housing continues to expand. According to the Centers for Disease Control (CDC), there are 15,600 nursing homes in the U.S. occupied by 1.3 million people. That’s in addition to 30,600 assisted living communities with 1.2 million licensed beds, according to the National Center for Assisted Living.

What are Nursing Homes & Assisted Living Facilities

Ashley Chambers, Director of Communications for The Florida Department of Elder Affairs, tells AmeriDisability that assisted living facilities and nursing homes are not interchangeable when it comes to the level of provided care. But what’s the difference? Well, the respective names offer some insight: “Assisted” suggests that, for the most part, seniors live independently (usually in individual apartments); whereas “nursing” homes deliver increased support for those with physical and/or cognitive ailments.

“Generally, assisted living communities offer person-centered care to individuals who need some assistance with activities of daily living, but who do not require round-the-clock skilled nursing care like those residing in nursing centers. Many nursing homes are also known as skilled nursing rehabilitation centers, meaning they offer therapy to individuals following a hospital stay to help them return to the community,” explains Rachel Reeves, spokeswoman for the National Center for Assisted Living. “While assisted living communities may offer some therapy services on-site, they focus more on offering a home-like, long-term care environment that maximizes independence.”

In fact, assisted living residents cannot have health conditions that require 24-hour nursing supervision. The only exception, according to the Florida Department of Elder Affairs, is when an existing resident receives licensed hospice services.

Comparing Nursing Homes vs. Assisted Living Facilities


Typically both options offer levels of care to support daily needs, such as bathing, dressing, health/personal care and medication management. In recent years, assisted living facilities have welcomed residents that once would have been directed to nursing care. And both provide a safe and accessible environment, such as with handrails and emergency call buttons.

Chambers shared, “Florida has an initiative for ‘aging in place’ which would allow a resident in a licensed assisted living facility to remain although their condition has deteriorated to a point where they would no longer meet continued residency criteria.” That may be possible because assisted living facilities may hold specialty licenses – i.e., extended congregate care (ECC), limited nursing services (LNS) and limited mental health (LMH) – to provide additional nursing services.


On-site amenities and services make daily living convenient and accessible at both. From needs like meals, housekeeping, laundry and transportation to recreation and various life enrichment opportunities, although these features are greater and more utilized through assisted living.


According to the National Center for Assisted Living, assisted living is more affordable and the majority of residents use some form of private pay, such as long-term care insurance and personal finances, to cover rent and services. “Although the majority of residents living in assisted living facilities pay privately, there are programs designed to assist with assisted living residency for those who qualify,” shared Chambers, adding, “Although room and board are not covered by Florida Medicaid, services needed by recipients that are enrolled in long-term care plans may be covered.”

Nursing homes can charge upwards of double the cost of assisted living because of increased patient needs. “Nursing home care is primarily paid for by Medicare or Medicaid. Medicare covers skilled nursing care under certain conditions for a limited time; it does not cover long-term care. Many patients use Medicare to cover their nursing home stay for the first month following a hospital visit. Medicaid covers long-term care, and roughly two-thirds of nursing center residents rely on the program,” Reeves said. Other pay options may also be applicable, such VA benefits.


Assisted living communities and nursing homes (in the state of Florida) are licensed and inspected by the Agency for Health Care Administration (AHCA). “It’s important to look at the long-term care options in your surrounding community to properly see the differences and similarities between settings. Assisted living is unique to the population it serves and often varies state by state. Communities may have residents who are mostly independent, residents who need greater medical assistance, or both. Communities that are able to offer more medical services are perhaps closest in similarity to nursing centers. However, as nursing centers increasingly focus on rehabilitation therapy, these centers have also evolved,” Reeves explained.

If you wish to file a complaint against a licensed healthcare facility regulated by AHCA, contact 1-888-419-3456 / 800-955-8771 Florida Relay Service (TDD number) or complete the online complaint form. For resources focused on ‘aging in place,’ visit the National Aging in Place Council online at

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Nancy DeVault
Nancy is the managing editor of AmeriDisability. She is an award-winning storyteller passionate about health and happiness.

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