Assisted living communities and skilled nursing facilities offer some of the same services and amenities, but their goals are very different. While stays in skilled nursing facilities are short and focus on medical assistance, healing, and rehabilitation following injury, illness, or surgery, assisted living communities provide long-term housing and help with daily tasks such as dressing, bathing, and medication management. A one-month stay in a skilled nursing facility costs almost twice as much as one month in assisted living and is more likely to be covered by health insurance or long-term care insurance.
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The main difference between assisted living and skilled nursing is the type and amount of care provided. Assisted living communities offer a long-term housing option for seniors who want to enjoy their independence but need non-medical support, typically help with activities of daily living (ADLs). Skilled nursing provides temporary but more intensive medical care for patients who require 24/7 support after an injury, surgery, or illness.
Niki Gewirtz, a Senior New Hire Support Specialist at A Place for Mom with more than 20 years’ experience in senior living communities, notes that skilled nursing can be short-term or long-term. “People who have extensive care needs that can’t be met in assisted living are typically cared for in a skilled nursing facility, and their care is typically covered by Medicaid,” she says.
“Someone living in assisted living may need little to no help with ADLs, or they may need full care, including help with transferring and diabetes management,” she says. “For people who need more extensive care, such as someone who has a feeding tube, needs wound care, or needs the help of more than one person to transfer, skilled nursing facilities provide 24-hour care and supervision.”
The leading difference between skilled nursing and assisted living is the amount and types of care offered. Skilled nursing and assisted living facilities provide similar services, such as assistance with everyday tasks and medication management, but there are some key differences between skilled nursing and assisted living.
Assisted living communities offer a long-term housing option for seniors that want to enjoy their independence but need some extra help with activities of daily living (ADLs). Skilled nursing provides more intensive medical care to patients that require around-the-clock support for an injury or illness.
Assisted living and skilled nursing facilities provide similar services, such as help with everyday tasks and medication management, but there are some key differences.
Assisted living communities help residents with ADLs and instrumental activities of daily living (IADLs), which can include cleaning and running errands. While assisted living communities may have an on-call nurse, they aren’t typically staffed or licensed to provide around-the-clock medical care.
Amenities provided in assisted living communities focus on convenience and promote residents’ well-being and social interactions. For example, some common amenities in assisted living communities include the following:
Skilled nursing facilities provide access to around-the-clock nursing support and caregiving services. It’s common for these facilities to always have licensed practical nurses (LPNs) on duty, as well as a registered nurse (RN) at least eight hours per day.
Skilled nursing facilities provide medical services, such as:
In a skilled nursing facility, patients focus on recovery, therapy services, and treatments.
Skilled nursing facilities offer amenities designed to support patients’ recovery and rehabilitation following an illness, procedure, or hospital stay. Examples include:
Unlike an assisted living community, where residents intend to stay indefinitely, a skilled nursing facility isn’t intended for long-term housing. Patients typically stay at these facilities until they’re able to live independently again, whether that’s at home or in another supportive living environment.
Determining the level of care your loved one’s needs should be the first step when you’re deciding which type of facility is the right option.
In a skilled nursing facility, a patient may focus more on recovery, therapy services, and treatments. Patients typically stay until they’re able to live independently again, whether that’s at their home or at another supportive living environment.
Skilled nursing facilities provide access to around-the-clock nursing support and caregiving services. Expect to have licensed practical nurses (LPNs) on duty at all times, as well as a registered nurse (RN) at least eight hours per day.
Because rehabilitation is typically the endgame, skilled nursing facilities benefit patients who:
The care needs of residents in assisted living are often significantly less complex than those of people in a skilled nursing facility. Residents might need some help with everyday tasks but don’t require as much extensive medical care as someone in skilled nursing.
Assisted living communities aim to provide an individual with a balance of independence and assistance with ADLs and instrumental activities of daily living (IADLs), which can include cleaning and running errands.
Caregivers are also available around the clock, but constant access to on-site medical personnel isn’t available most of the time like at a skilled nursing facility. Assisted living communities may have an on-call nurse, but they aren’t usually staffed to provide around-the-clock access to nursing care.
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Whereas assisted living communities offer homelike environments, skilled nursing facilities more closely resemble hospitals.
Residents of assisted living communities have their own living space, as well as access to indoor and outdoor common areas. They may have their own apartment, or they may share one with another resident. Apartments, which residents can decorate and personalize, are equipped with:
Assisted living is especially supportive of the differing needs of elderly couples, one of whom may be independent while the other needs help with daily tasks.
Rooms in skilled nursing facilities typically contain either one or two beds and a bathroom. Patients don’t prepare food in their rooms and may eat in their rooms or in a communal dining room. Many skilled nursing facilities also have common areas for socializing.
The cost of one month in an assisted living community is about half the cost of a month in a skilled nursing facility. Residents of assisted living communities are more likely to use personal funds to cover costs, while patients in skilled nursing are more likely to use insurance or Medicare.
Gewirtz notes that skilled nursing care costs more because a skilling nursing facility needs staff who are trained and licensed to provide a higher level of care. “Skilled nursing facilities have CNAs, LPNs, RNs, physical and occupational therapists, and medical directors,” she says. On the other hand, “Assisted living communities have non-licensed caregivers, med techs, and LPNs on staff, and sometimes an RN, depending on state regulations.”
In 2025, the median monthly cost of assisted living is $5,190 per month, according to A Place for Mom’s proprietary data.[01] Residents typically pay out of pocket for assisted living, but some communities may accept payment from Medicare, Medicaid, or long-term care insurance policies.
The median monthly cost of a skilled nursing facility is about $10,646 for a private room and around $9,277 for a semi-private room.[02]
Unlike many assisted living communities, skilled nursing care is often covered by long-term care insurance policies and publicly funded programs such as Medicare and Medicaid.
In 2021, the median monthly cost of a private room in a skilled nursing facility was about $9,000 and around $7,900 for a semi-private room.[02] The median monthly cost of assisted living in 2021 was $4,500 per month.[02]
Costs related to assisted living and skilled nursing facilities vary due to a number of factors, such as size, location, and services offered.
Assisted living communities are generally less costly than skilled nursing facilities since they don’t provide full-time medical care. Many assisted living communities have base fees that include the costs of:
Assisted living communities may also have extra fees such as:
Residents typically pay out of pocket for assisted living, but some communities may accept payment from Medicare, Medicaid, or long-term care insurance policies.
Skilled nursing is generally the most expensive form of senior care due to the higher level of support needed. The monthly rate covers the costs of the following services:
Unlike many assisted living communities, skilled nursing care can be covered by most long-term care insurance policies and government assistance programs such as Medicare and Medicaid.
Choosing the most appropriate setting for someone depends on the type and amount of care the person needs. Assisted living communities, which don’t require a physician’s order to admit residents, may be a good fit for seniors who:
Assisted living is optimal for people who want to preserve their independence as long as possible, while having help available when it’s needed.
“Many assisted living communities have a variety of care plans that allow residents to move in when they’re relatively independent and add care as needed,” Gewirtz explains.
She goes on to say “It’s important to ask a community’s representative what care needs can be met, and what would constitute the need to move to skilled nursing. Most assisted living communities partner with hospice agencies that can provide end-of-life care within the community. Seniors and their families find comfort in the ability to stay in the residential or home-like setting of assisted living.”
Admission to a skilled nursing facility, which requires a physician’s order, is for people who have multiple or complex medical needs. It may also be more appropriate for those who need:
A skilled nursing facility is ideal for someone who was recently discharged from the hospital following an event, such as a heart attack or stroke, or a procedure.
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Use the table below to compare key features of assisted living communities and skilled nursing facilities.
Once you and your loved one have established the best destination, you can start researching, touring, and comparing facilities to find the right match.
Whether you’re looking at assisted living communities or skilled nursing facilities, A Place for Mom’s Senior Living Advisors can help you every step of the way. They’ll take the time to learn about your family’s unique needs and point you to different senior care options in your area.
A Place for Mom. (2025). Cost of long-term care and senior living.
CareScout.com. (2025). Genworth cost of care survey.
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