Assisted living is a state-licensed residence for people who need help with daily care but not a nursing home's level of medical care. Residents live in their own apartment or room and get meals, help with bathing, dressing and medications, housekeeping, activities and 24-hour supervision. It does not usually include continuous skilled nursing. Medicare doesn't pay for it; the 2025 national median was $6,200 a month.
“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 reliably means, where it varies, and which parts of a brochure are standard and which cost extra.
This post explains what assisted living includes, what may cost more, what it doesn't do, who regulates it, who lives there and who pays.
What is assisted living, exactly?
The National Institute on Aging (NIA) defines assisted living as a setting for people who need help with daily care, but not as much help as a nursing home provides. Residents usually live in their own apartments or rooms and share common areas. Facilities range from as few as 25 residents to 100 or more, and typically offer a few levels of care, with residents paying more for extra services.
The national assisted living association (AHCA/NCAL) calls it a combination of housing, personal care services and health care, designed to promote independence, and describes it 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, which NIA describes as usually having 20 or fewer residents, with personal care, meals and staff around the clock. Federal surveys group all of these together as “residential care communities,” which also include personal care homes, adult care homes and adult foster care.
What's included, what's extra, and what isn't provided
Exact arrangements vary by facility and by state, as NIA puts it. This table shows the usual pattern; 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 items to ask about, because pricing models differ: some communities charge one inclusive 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 assisted living communities don't typically provide the continuous 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, according to 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; 62% needed help with three or more daily activities.
- 17% were Medicaid beneficiaries.
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, and whether there are residents your parent's age with similar interests. The answers tell you more about daily life there than any brochure photo.
Who regulates assisted living?
The states. A federal review of state rules (ASPE, 2015) explains that residential care settings are licensed and regulated at the state level, that every state has at least one category, and that requirements vary considerably. 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 receive Medicaid payment, covering things like person-centered planning, privacy, choice of roommate and access to food, according to the same review.
What this means for you: the state agency that licenses assisted living is where you find inspection reports, complaint records and the rules on who a community can admit or keep. Ask each community which license it holds. If you don't know which agency licenses assisted living in your parent's state, the Eldercare Locator (800-677-1116), a public service listed by NIA, can connect you 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, 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 cover some services in assisted living, depending on the state and your parent's eligibility.
- Long-term care insurance may partly cover it, depending 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.
Build your plan in 2 minutesQuestions that show what a community really includes
AHCA/NCAL says communities should willingly give families their base rates, fees for additional services, occupancy levels, staffing and ownership. Use that as your license to ask directly, and 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?
What to say on the first call: “Before we visit, could you email me your current rate sheet, a list of what's included in the base rate, and your care level pricing? I'd like to compare communities on the same basis.”
The full list is in our assisted living tour questions.
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, but not the continuous skilled nursing care a nursing home provides. 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?
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)