Nursing home vs home care vs assisted living
People use these words interchangeably, but they describe very different levels of care and different payment rules. Getting the setting wrong is the most expensive mistake families make.
The settings, briefly
| Nursing home | 24/7 skilled nursing and custodial care; clinical supervision, medication management, therapy. Medicare-certified facilities are in this directory. |
| Assisted living | Housing with help for daily activities — meals, housekeeping, bathing, medication reminders. Not skilled nursing; most residents do not need round-the-clock clinical care. |
| Memory care | Specialised assisted living for dementia, with secured areas and dementia-trained staff. Often a unit inside a nursing home or assisted-living community. |
| Home care | Non-medical help at home: companionship, bathing, dressing, meals. Paid privately or through long-term care insurance; usually hourly. |
| Home health | Skilled services at home — nursing, physical therapy, wound care — covered short-term by Medicare when homebound and medically necessary. |
| CCRC / life plan | Campus offering independent living through nursing care; entry fees and contracts vary. |
Cost comparison
For national context, CareScout's 2025 Cost of Care Survey reports a median of about $114,975 a year for a semi-private nursing home room and about $6,200 a month for assisted living, with home care billed hourly and depending on the hours needed. The 14,690 facilities in this directory can be filtered by state and city to compare local options.
Who pays
Medicare pays only for skilled care — a short nursing home stay or home health — not for custodial care. Medicaid pays long-term nursing home care for people who qualify financially. Private pay, long-term care insurance and VA benefits fill the middle. Assisted living is almost always private pay unless a state offers a Medicaid waiver.
How to decide
Match the setting to the clinical need and the hours of supervision required, then to the money. If the person needs 24/7 nursing or can no longer be safely left alone, a nursing home may be the only safe setting. If the need is help with daily living and safety, home care or assisted living may be enough. Reassess regularly — needs change.
Written and maintained by the US Nursing Homes data team · last reviewed 2026-10-24 · sources and methodology.