What's The Difference Between Assisted Living and Nursing Homes?

What's The Difference Between Assisted Living and Nursing Homes?

Assisted living and nursing homes are two different types of residential care facilities, each designed to meet the specific needs of individuals with varying levels of assistance and medical requirements. Here are the key differences between assisted living and nursing homes in California:

Level of Care:

    • Assisted Living: Assisted Living is designed for individuals who need help with daily activities such as bathing, dressing, ambulation and transferring, incontinence, and medication management but do not require constant medical supervision or skilled nursing care for medical needs such as feeding tubes or ventilators.
    • Nursing Home: Skilled Nursing or Nursing Homes, also known as skilled nursing facilities, provide a higher level of medical care. They are suitable for individuals with more complex medical needs, chronic conditions, or those who require constant nursing supervision. Nursing homes are also the alternative for low-income individuals who cannot afford to pay for assisted living which, in California, is generally paid privately.
    • Board and Care Homes: Board and Care homes hold the same license as the larger assisted living facilities but provide a higher staffing ratio in a smaller home-like environment. They are often suitable for individuals who require 24/7 oversight but do not have complex medical needs, such as those with dementia, wheelchair-bound, or seniors requiring assistance with all the activities of daily life. They are a frequent alternative to nursing homes.

Medical Services:

    • Assisted Living (including Board and Care Homes): While assisted living facilities have staff to assist with medication management and basic healthcare needs, the ability to provide advanced medical care has regulatory limitations and varies by community. For instance, only certain (limited) assisted living facilities in California have the staffing and regulatory clearance to manage injectables, such as those for diabetes.
    • Nursing Home: Nursing homes have a higher level of medical supervision. They often have skilled nursing staff, therapists, and other healthcare professionals to address complex medical issues.


    • Assisted Living: Residents in assisted living facilities generally have more independence and autonomy. They live in private or semi-private apartments and can participate in various activities and social events. They can come and go as they please, keep a car, bring their pets, and often cook and entertain. Living in assisted living is akin to living at a hotel or apartment building with care services, dining, housekeeping, and activities provided on-site.
    • Nursing Home: Residents in nursing homes may have more significant health challenges and, as a result, may have less independence. The focus is often on medical care and supervision.


    • Assisted Living: In California, most assisted living stays are paid privately, with the individual or their family footing the bill out of social security, savings, pensions, or long-term care insurance. In the Los Angeles area, the cost of assisted living ranges from about $3,000/month for a shared room to $15,000/month for a swank two-bedroom in one of LA’s luxury senior living communities. In some cases, Medi-Cal's Assisted Living Waiver (ALW) program may help cover assisted living for eligible individuals. However, in Los Angeles, the ALW program is limited in availability. Those on Medi-Cal with the need for immediate placement may find that nursing homes are the only option.
    • Nursing Home: Most people do not pay for nursing homes privately since the costs can be exorbitant due to the higher level of medical services provided. Long-term nursing home care is usually covered by Medi-Cal.

Choosing Between Assisted Living and Nursing Homes:

    • Care Needs: In most cases, the care needs for older adults are custodial in nature. In other words, the senior needs help with non-skilled services pertaining to the activities of daily life – dressing, bathing, grooming, ambulation, medication management, etc. These services are performed by trained caregivers or CNAs. An RN, LVN, or doctor is not required to undertake these tasks. If the senior requires regular medical attention or has complex medical conditions, a nursing home may be more appropriate.
    • Financial Considerations: Low-income seniors who qualify for Medi-Cal may find that nursing home care is more financially feasible. Medi-Cal can help cover the costs associated with skilled nursing care, making nursing homes more accessible for individuals with limited financial means.

Have more questions? Assisted Living Locators Los Angeles is here to help. Our locally owned office of Los Angeles senior living experts is available to assist you in understanding your eldercare options and to guide you in the right direction. Assisted Living Locators is provided at no charge to our clients. Visit us at www.assistedlivinglocators.com or call 310-853-8282.