Assisted Living vs. Skilled Nursing

Whether you are researching senior care options for yourself or a family member, it can be difficult to understand and differentiate between all of the options. For example, what is the difference between assisted living and skilled nursing? While both are need-based, one is residential and the other is typically part of a post-hospitalization care plan and focuses on healing. In this article, we’ll help you understand the key differences between these senior care environments.

What Is Assisted Living?

An assisted living community is a residential community where seniors get assistance throughout the day from well-trained staff but still live somewhat independently, however, it is not the same as independent living. Assisted living residents usually need help with one or more activities of daily living, like bathing, dressing and medication management.

Additionally, assisted living residents enjoy amenities and services such as:

  • Fine dining in a restaurant setting
  • Local transportation
  • Housekeeping
  • Home maintenance

What Is Skilled Nursing?

A skilled nursing facility is a similar to a hospital where patients receive around-the-clock care and medical treatment from specially trained staff, including licensed nurses, doctors and therapists. Although there are similarities to a hospital in medical treatment, most of these providers are in no way institutional. Skilled nursing facilities are a community of caretakers focused on physical rehabilitation and healing. Because skilled care is a prescribed step in the recovery process, often case workers will refer individuals to a skilled nursing facility.

A skilled nursing facility can meet your needs if you:

  • Have recently undergone surgery and need help recovering
  • Suffer from a chronic illness that demands constant care
  • Need ongoing preventative long-term care
  • Need specialized rehab therapy, including occupational, physical, respiratory, cognitive and vocal

Assisted Living vs. Skilled Nursing

To really understand the differences between these senior living options, it’s helpful to compare assisted living vs. skilled nursing based on the levels of care, setting and staff they offer, as well as the goals of each.


The primary difference between assisted living and skilled nursing is the setting. Skilled nursing facilities are medical settings, usually located within a nursing home, assisted living community or rehabilitation center. While skilled nursing facilities may have beds, it is not a residential setting in the same way that a hospital is not a residential setting.

This is different from assisted living, which is a residential setting that usually offers residents private apartments. Assisted living communities are about creating day-to-day enrichment for residents.


At an assisted living community, the level of care can vary depending on how much support the individual needs. Residents can choose to receive assistance with tasks like bathing, dressing and medication management. Some communities do not offer care 24/7 while others like Concordia do.

In a skilled nursing facility, care is offered 24/7. And the level of medical care patients receive is much deeper, including restorative therapy, wound care, nutritional care, medication management, IV care, hospice care and more.


Skilled nursing is required to have a registered nurse on the premises for a minimum of eight hours a day, seven days a week. It also will have doctors and therapists on-site for medical treatment and physical therapy. These medical professionals are present to provide higher-level care.

Assisted living communities, on the other hand, will typically have a registered nurse on-site throughout the week, as well as a nurse on-call 24/7. The exception is with CCRC communities. Because CCRC’s offer various care levels, assisted living residents within the CCRC will have access to a nurse 24/7. Assisted living is additionally staffed by aides, medical attendants and personal care assistants that help with day-to-day personal care needs of residents.

Length of Stay

Skilled nursing is typically viewed as a temporary arrangement. Older adults stay in skilled nursing facilities while they are recovering from an illness or injury.

Meanwhile, assisted living settings are long-term residential communities for older adults. They are communities where residents participate in health, wellness and social programs as well as enjoy amenities like a fitness center and movie theatre. 

Personal Goals

In comparing skilled nursing vs. assisted living, it is also important to weigh the resident’s personal goals in each.

Older adults who move into an assisted living community plan to live independent and active lives within a group environment. To support those goals, assisted living offers a variety of programs to support physical, emotional, spiritual and mental wellness. Assisted living also offers maintenance-free living so its residents can spend their time exploring passions and hobbies.

Skilled nursing facilities are places where people go to get well. Though these facilities are welcoming, the focus is not on community activity or residential entertainment, but rather physical rehabilitation. First and foremost, residents must focus on their health. 

Cost and Coverage

Because skilled nursing facilities provide a higher level of medical care, they are often more costly than an assisted living community. Skilled nursing is typically associated with insurance and Medicare coverage. Occasional situations warrant private pay sources but generally, it is medical in nature. Assisted living communities are residential, so health insurance and Medicare do not cover this.

Live Life to the Fullest at Concordia

As a Life Plan Community, Concordia excels in providing individuals and their families with access to a continuum of care. Nestled on 15 lush acres in northwest Oklahoma City, our community provides both independent living, assisted living, memory care, skilled nursing and long-term care. As such, our staff are well-versed in all senior living options and can answer any questions you have about transitioning to a Continuing Care Retirement Community like Concordia. For more information, contact us today.

General Information