Assisted Living Vs. Skilled Nursing: What's the Difference?

Haley Burress

If you are searching for long-term care and support for yourself or your loved one, you have many options.

Senior living communities like independent living and assisted living offer a low-maintenance lifestyle, luxury amenities, wellness resources, and more - a far cry from the traditional nursing home of decades ago. In contrast, skilled nursing communities can offer a level of care that older adults might need for a short, or long, amount of time.

However, with many options can come much confusion. We’re here to help you break down the differences between two common senior living solutions: assisted living and skilled nursing.


What is Assisted Living?

Assisted living facilities are senior living communities that serve older adults who need some assistance with activities of daily living. 

These communities offer around-the-clock caregiver support, three meals served in a social dining room setting, medication management services, events and activities, transportation services, and more on-site amenities.

What is Skilled Nursing?

Skilled nursing facilities, sometimes called healthcare communities, were once referred to as nursing homes. However the term ‘nursing home’ is now outdated as healthcare communities are not providing the stereotypical nursing home care that some people might think of. 

Skilled nursing facilities provide skilled nursing care to residents around the clock, in addition to meals, medication management services, events and recreational activities, transportation services, and other medical services.

Assisted Living vs. Skilled Nursing


Both assisted living and skilled nursing provide long-term care. However, skilled nursing communities do provide short-term care options, especially for those who are recovering from a hospital stay and could benefit from on-site therapy services before returning home.

Residents live in the community. Assisted living residents typically live in their own apartment homes with a kitchenette, living room, bathroom, and bedroom. Some assisted living residences feature outdoor space as well.

Skilled nursing residents typically live in a studio apartment or room. Sometimes the room is private while other times the room is semi-private. Residents might need to share a bathroom.


The biggest difference between assisted living and skilled nursing is the senior care type provided. 

While both senior living options offer assistance with activities of daily living such as grooming, bathing, mobility, and toileting, skilled nursing provides more extensive skilled care.

Who Lives There?

Both assisted living and skilled care facilities serve older adults who need assistance with personal care or other activities of daily living.

Assisted living residents typically live in the community long-term. They might move out if and when their needs become too high for the community to provide.

Skilled care residents fall into one of two categories: short-term residents or long-term residents. The type of care provided for both is the same, but short-term residents are there to recover after a hospital stay, procedure, or surgery. They get residential care and rehabilitation services while they are in the community to get stronger before returning home.

Long-term care residents live in the community because they need skilled care services due to complex medical conditions, chronic pain, or cognitive decline.

Memory Care

For seniors living with Alzheimer’s disease or another type of dementia, assistance with daily activities becomes needed as the disease progresses. 

Memory care communities can provide this extra assistance as well as enhance safety and comfort with specially designed common areas, routines, and trained staff members.

Assisted living communities often offer memory care neighborhoods. These communities are for those living with cognitive decline. 

Skilled nursing communities sometimes offer memory care neighborhoods as well. These communities provide skilled care to residents living with Alzheimer’s disease or other types of dementia.

Family and Friends

Family members and friends are welcome to visit their loved ones at both assisted living and skilled care communities. 

Like any retirement community, an assisted living or healthcare community will often offer special events for families to attend, in addition to having very open visiting hours.


Assisted living communities typically charge residents a monthly fee that includes most expenses. While it is not fully all-inclusive, the monthly fee often covers room and board, utilities, access to caregiver support, and other amenities. On average, assisted living communities to cost $4,500 per month.

While some assisted living communities accept Medicaid as payment, most do not. However, you might offset costs with long-term care insurance, secondary insurance, or Veterans Aid and Attendance benefits. Assisted living communities do not accept Medicare. Otherwise, this monthly fee is paid out of pocket.

Skilled nursing communities bill at a higher rate, ranging anywhere from $7,800 per month for a semi-private room to $8,910 per month for a private room. These costs cover medical care and oversight, meals, room and board, utilities, rehabilitation services, and recreational activities and outings.

Skilled nursing communities accept Medicare for residents who are staying short-term and who have had a 3-night qualifying stay. Some communities also accept Medicaid, though there might be a waitlist. 

Other ways to pay for skilled nursing care can include long-term care insurance, secondary insurance, or Veterans Aid and Attendance benefits.


Which is the Best Option for Your Loved One?

If you are wondering which option might be best for your loved one, begin by considering how much assistance with activities of daily living, or ADLs, they require. Most assisted living communities are happy to provide hands-on assistance with activities of daily living and other personal care tasks. 

However, if your loved one needs hands-on assistance with ADLs as well as pain management, wound care, or other complex medical care, skilled nursing might be the better option.

Next, consider if your loved one is currently in the hospital. If your loved one has been in the hospital for surgery, procedure, or other visit and requires 24-hour supervision as well as extensive therapy in order to return safely home, skilled nursing is the best option. 

Medicare will cover the visit as long as your loved one has days left and has had their 3-day qualifying hospital stay. Double-check with your hospital discharge planner for eligibility information specific to your situation.

Finally, tour a few communities to determine if your loved one would benefit from the care services offered there. Any type of assistance will enhance the quality of life, but you want to be sure your loved one will receive the medical care they need in that specific community. 

Consider speaking with your loved one’s physician for recommendations on which might be best for your family.