Assisted living is a state-licensed community for people who need help with daily care but not the medical care of a nursing home. Residents live in their own apartment or room. They get meals, help with bathing, dressing and medications, housekeeping, activities and 24-hour supervision. It does not usually include round-the-clock skilled nursing. Medicare doesn't pay for it, and the 2025 national median was $6,200 a month.
Key facts
- About 1,016,400 people lived in assisted living and similar residential care communities on a given day in 2022. (CDC/NCHS, 2024)
- In 2022, 44% of residential care community residents had been diagnosed with Alzheimer's disease or another dementia, and 62% needed help with three or more daily activities. (CDC/NCHS, 2024)
- Each state licenses and oversees assisted living, and 40 states required training for direct care workers, with required hours ranging from 1 to 80. (ASPE, 2015)
- The CareScout Cost of Care Survey 2025 put the national median for assisted living at $6,200 a month, or $74,400 a year. (CareScout, 2026)
- Medicare doesn't pay for long-term care in assisted living, though it still covers eligible medical care such as doctor visits. (Medicare.gov, 2026)
“Assisted living” covers everything from a small house with a handful of residents to a large building with a hundred apartments or more. Before you tour, it helps to know what the term always means and where it varies. It also helps to know which parts of a brochure are standard and which cost extra.
This post explains what assisted living includes and what may cost more. It also covers what it doesn't do, who makes the rules, who lives there and who pays.
What is assisted living, exactly?
The National Institute on Aging (NIA) defines assisted living as a place for people who need help with daily care, but not as much help as a nursing home gives. Residents most often live in their own apartments or rooms and share common areas. Communities range from as few as 25 residents to 100 or more. Most offer a few levels of care, and residents pay more for extra services.
The national assisted living group (AHCA/NCAL) calls it a mix of housing, personal care and health care, meant to help people stay independent. It describes assisted living as a bridge between living at home and living in a nursing home.
The name changes by state. California, for example, licenses these settings as Residential Care Facilities for the Elderly. Smaller versions are often called board and care homes. NIA says these most often have 20 or fewer residents, with personal care, meals and staff around the clock. Federal surveys group all of these together as “residential care communities.” That label also takes in personal care homes, adult care homes and adult foster care.
What's included, what's extra, and what isn't provided
Exact setups vary by community and by state, as NIA puts it. The table shows the usual pattern. Still, confirm every line with each community in writing.
| Usually part of assisted living | Ask whether included or extra | Usually not provided |
|---|---|---|
| A private or shared apartment or room, and common areas | More hands-on help with bathing, dressing, toileting or moving | Continuous skilled nursing care |
| Up to three meals a day | Help with more medications, or more often | Your parent's primary care doctor (residents generally choose their own) |
| Housekeeping and laundry | Special diets or meal delivery to the room | |
| 24-hour supervision and on-site staff | Escorts to appointments or extra transportation | |
| Social, recreational and spiritual activities | Memory care, if offered | |
| Help arranging outside medical and dental care | Incontinence supplies |
The first column follows NIA's and AHCA/NCAL's lists of typical services. The middle column lists things to ask about, because pricing models differ. Some communities charge one all-in rate. Others add fees by care level or by service. See all-inclusive vs. tiered pricing and assisted living levels of care for how that works.
The last column is where assisted living ends. AHCA/NCAL notes that these communities don't usually provide the round-the-clock skilled nursing care found in nursing homes and hospitals. If that's what your parent needs, read assisted living vs. nursing home.
Who lives in assisted living?
About 1,016,400 people lived in assisted living and similar residential care communities on a given day in 2022. That count comes from the CDC's National Center for Health Statistics. Among them:
- 53% were 85 or older, and 67% were women.
- 44% had been diagnosed with Alzheimer's disease or another dementia.
- 75% needed help with bathing and 71% with walking. In all, 62% needed help with three or more daily activities.
- 17% were on Medicaid.
In other words, assisted living is not only for people who “just need a little help.” Many residents need hands-on care every day. That's worth knowing if your parent pictures a building full of people much frailer, or much livelier, than they are.
National figures only go so far. On a tour, ask about the community's own residents. Roughly how many use a walker or wheelchair? How many need help at night? Are there residents your parent's age who like the same things? The answers tell you more about daily life there than any brochure photo.
Who regulates assisted living?
The states do. A federal review of state rules (ASPE, 2015) explains that each state licenses and oversees these settings. Every state has at least one category, and the rules vary a great deal. For example, 40 states required training for direct care workers, with required hours ranging from 1 to 80.
Federal Medicaid rules from 2014 also set standards for settings that take Medicaid payment, according to the same review. They cover things like person-centered planning, privacy, choice of roommate and access to food.
So the state agency that licenses assisted living is where you find inspection reports and complaint records. It also has the rules on who a community can admit or keep. Ask each community which license it holds. You may not know which agency licenses assisted living in your parent's state. If so, call the Eldercare Locator (800-677-1116), a public service listed by NIA. It can put you in touch with local aging services that know.
Who pays for assisted living?
Mostly residents and their families. NIA notes that most people pay the full cost themselves. The CareScout Cost of Care Survey 2025 put the national median at $6,200 a month, or $74,400 a year. That was up 5% from the year before.
- Medicare doesn't pay for long-term care in assisted living. It still covers eligible medical care, like doctor visits, wherever your parent lives.
- Medicaid may pay for some services in assisted living, based on the state and whether your parent qualifies.
- Long-term care insurance may pay part of it, based on the policy.
- Veterans' benefits may help some veterans and their spouses under certain conditions, according to AHCA/NCAL. Our overview of VA Aid and Attendance and assisted living explains the program.
For the full picture of prices, see how much assisted living costs. For benefits questions, a benefits counselor at your local Area Agency on Aging is a free place to start.
Turn “what's included” into a side-by-side comparison
Parent Move Plan includes 41 tour questions and a weighted comparison of 12 criteria, so each community's answers about care, fees and services land in the same grid. Once you choose, 79 tasks go on real dates counted back from move-in day.
Get your first 3 days freeQuestions that reveal what a community includes
AHCA/NCAL says communities should willingly give families their base rates and fees for extra services. They should also share how full they are, their staffing and who owns them. Take that as your cue to ask directly. Ask for the answers in writing so you can compare them later, when the tours start to blur together.
- What does the base monthly rate include, line by line?
- How do you assess care needs, and what does each care level cost?
- Who helps with medications, and what training do they have?
- Is a nurse on site? Which hours?
- What happens if my parent's needs increase? What needs could you not meet?
- Which services are billed separately, and how often do prices change?
- Can my parent keep their own doctor and pharmacy?
A request for the first call: “Before we visit, could you email me your current rate sheet and a list of what's in the base rate? Could you also send your care level prices? I'd like to compare communities on the same basis.”
The full list is in our assisted living tour questions.
Rules and prices differ by state. Assisted living rules and costs by state lists the medical exam, TB test, move-out notice, Medicaid and the median monthly cost for all 50 states, with sources.
Frequently asked questions
Is assisted living the same as a nursing home?
No. Assisted living provides housing, meals, help with personal care and medications, and 24-hour supervision. It doesn't provide the continuous skilled nursing care of a nursing home. Nursing homes also follow federal rules when they take Medicare or Medicaid, while assisted living is regulated by each state.
Do assisted living residents keep their own doctor?
Generally yes. The national assisted living association notes that residents generally choose their own doctor and dentist, and the community may help arrange medical, health and dental services. Ask how the community coordinates with outside doctors, pharmacies and home health agencies.
How much does assisted living cost?
The CareScout Cost of Care Survey 2025 put the national median at $6,200 a month, or $74,400 a year. Costs vary widely by state, apartment size and the level of care a resident needs, and residents typically pay more when they need extra services.
Can a married couple live together in assisted living?
Ask each community before you tour. Useful questions: Can two people share one apartment? What if only one spouse needs care? Is each person assessed separately, and how is the second person priced? What happens if one spouse later needs memory care or a nursing home?
What is included in assisted living?
Assisted living usually includes a private or shared apartment or room, up to three meals a day, housekeeping and laundry, 24-hour supervision, activities and help arranging outside medical and dental care. Residents also get help with daily care such as bathing, dressing and medications. More hands-on help, special diets, extra transportation and memory care may cost extra, so confirm each item with the community in writing.
What is an assisted living home?
Smaller assisted living settings are often called board and care homes. The National Institute on Aging says these most often have 20 or fewer residents, with personal care, meals and staff around the clock. The name also changes by state. California, for example, licenses these settings as Residential Care Facilities for the Elderly.
Sources
- National Institute on Aging: Long-Term Care Facilities, Assisted Living, Nursing Homes, and Other Residential Care (accessed Sept 2026)
- AHCA/NCAL: Assisted Living Resources for Consumers (accessed Sept 2026)
- CDC/NCHS: Residential Care Community Resident Characteristics, United States, 2022 (accessed Sept 2026)
- ASPE: Compendium of Residential Care and Assisted Living Regulations and Policy, 2015 Edition, Executive Summary (accessed Sept 2026)
- CareScout: Cost of Care Survey 2025 (accessed Sept 2026)
- Medicare.gov: Long-term care (accessed Sept 2026)
- California Department of Aging: Determine the Best Housing Option For Me (accessed Sept 2026)