Comparing Nursing Facilities and Assisted Living: Understanding the Key Differences

Libby Hastings • April 19, 2024

When considering long-term care options for yourself or a loved one, it's essential to understand the differences between nursing facilities and assisted living facilities. While both offer supportive environments for individuals needing assistance with daily activities, they serve distinct purposes and cater to varying levels of care needs. Let's delve into the comparative aspects of these two types of facilities to help you make an informed decision.

Medical Services:


Assisted Living: Assisted living facilities primarily focus on providing assistance with daily activities while offering varying levels of medical attention. Residents may receive support such as transportation to medical appointments and assistance with medication management. Additionally, specialized care areas may be available for individuals with conditions like dementia. Assisted living facilities are not regulated by the federal government but, in Kansas, are licensed by the Kansas Department for Aging and Disability Services.
Nursing Home: In contrast, nursing homes, also known as skilled nursing facilities, offer round-the-clock, 24-hour medical care, typically with more staff than an assisted living facility. A nursing home setting may be appropriate for individuals who need extended post-operative care, complex medical monitoring, nursing, medical, social, and rehabilitative care. Moreover, nursing homes provide rehabilitative services such as physical, occupational, respiratory, and speech therapy for residents in need. Nursing homes are subject to more government oversight by both the state and federal governments.


Living Space:


Assisted Living: Residents of assisted living facilities typically reside in individual or shared apartments equipped with kitchenettes, bedrooms, and living areas. Common spaces encourage social interaction and participation in communal activities, including dining areas, activity rooms, salons, and gardens or outdoor walkways . There may be accommodations for pets.
Nursing Home: Nursing homes typically provide individual or shared (semi-private) rooms with en-suite bathrooms. While the living arrangements may be more compact, residents still have access to common areas for meals and activities.


Assistance with Daily Activities:


Assisted Living: Assisted living facilities offer light support with daily tasks like bathing, dressing, and meal preparation, tailored to the residents' needs. Laundry, housekeeping, and meal services are also available.
Nursing Home: Residents of nursing homes often require more extensive assistance with daily activities. Staff members should assist with personal care tasks, medication management, meal preparation, and housekeeping.


Recreational Activities:


Assisted Living: Assisted living facilities prioritize providing a wide range of activities to promote physical and social engagement among residents. From exercise programs to creative expression and volunteering opportunities, these facilities foster a vibrant community atmosphere.
Nursing Home: While recreational activities are also offered in nursing homes, they may be more limited in scope. However, supervised exercise sessions and various enrichment activities contribute to residents' overall well-being.


Meals:


Assisted Living: Residents in assisted living facilities may have the option to cook in their own kitchenettes or dine in communal dining rooms. Meal delivery services may also be available for added convenience and may require an additional cost.
Nursing Home: In nursing homes, dieticians prepare meals for residents, considering their dietary preferences and restrictions. Residents can choose to dine in communal spaces or have meals served in their rooms.


Cost and Insurance Coverage:


In 2023, the average cost for a semi-private nursing facility room in Kansas was $7,483. For an assisted living room, the median cost was $5,850.

Nursing home care tends to be more expensive than assisted living, with costs varying based on factors like location and level of care required. Medicare may cover some expenses for nursing home care (up to 100 days) under certain conditions, whereas assisted living is typically not covered by Medicare. Because Medicaid is a joint federal and state public health insurance program administered by individual states, coverage for assisted living services varies. Medicaid is available for those who need nursing home care but can't afford it or have a restricted income. Medicaid will pay for nursing home care for persons who require that level of care and meet the program's financial eligibility requirements. A person can have no more than $2,000 of "countable" assets in Kansas to qualify for Medicaid. 


Overall, understanding the distinctions between nursing facilities and assisted living facilities is crucial for selecting the most suitable option based on individual needs and preferences. Whether prioritizing medical care, independence, social engagement, or cost, there's a long-term care solution tailored to meet diverse needs. It's advisable to explore available resources, consult with healthcare professionals and KABC, and carefully evaluate each facility's offerings before deciding. KABC is here to help! We offer free Consumer Information Reports on all licensed adult care facilities to help you make an informed decision.

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On March 19, 2026, a Washington Post article highlighted a recent Office of Inspector General for the Department of Health and Human Services investigation that brought renewed national attention to a troubling reality inside America’s nursing homes: powerful antipsychotic drugs are being used not as treatment, but as control. The report found that some facilities are misdiagnosing residents with schizophrenia to justify prescribing antipsychotic medications. These drugs are often not approved for people with dementia and carry serious risks, including falls, strokes, and even death. In many cases, these medications are used to manage behaviors that are not dangerous, such as calling out, resisting care, or expressing distress. The result is what advocates have long warned about: the use of chemical restraints to sedate residents for staff convenience. A National Problem Decades in the Making The misuse of antipsychotic drugs in long-term care has been documented for years. In April 2024, KABC highlighted this issue in our advocacy work, noting that hundreds of thousands of nursing home residents nationwide are given antipsychotic medications, often without appropriate clinical justification. These drugs carry an FDA “black box” warning for use in older adults with dementia due to an increased risk of death. Federal efforts over the past decade have aimed to reduce unnecessary use, yet as of early 2026, approximately 17% of long-stay nursing home residents in the United States are still receiving antipsychotic medications. At the same time, recent federal policy discussions in March 2026 have raised concerns among advocates that loosening reporting requirements could reverse progress made in reducing inappropriate use. Kansas Is Not Immune This issue hits close to home. In 2022, the Kansas Legislature’s Senior Care Task Force released a report to the 2023 Legislature identifying the administration of antipsychotic medications and protections against abuse and neglect as critical areas for reform. The Task Force emphasized that these medications could have serious and even fatal consequences for older adults, particularly when used inappropriately. Advocates in Kansas have reported that up to 26% of nursing home residents, and nearly 40% of those with dementia, have been prescribed antipsychotic medications in recent years, despite well-documented risks. While some facilities have made progress, reductions in use have stalled in recent years, raising concerns that systemic issues remain unresolved. Why It Happens At its core, the misuse of antipsychotic drugs is often a symptom of deeper systemic problems, many of which have been exacerbated since the COVID-19 pandemic. Experts and investigators point to: Chronic understaffing, intensified since 2020 Lack of training in dementia care Pressure to manage behaviors quickly Lack of person-centered practices in care Gaps in oversight and accountability Non-drug approaches, like personalized care, meaningful activities, and addressing unmet needs, are widely recognized as best practice. But they require time, staffing, and resources that many facilities continue to lack in 2026. When those supports are missing, medication restraint becomes the default. What Proper Care Should Look Like Clinical guidance has long been clear, and yet remains unchanged in 2026. Antipsychotic medications should be a last resort, used only when: Non-drug interventions have failed The resident poses a risk to themselves or others The benefits outweigh the serious risks Even then, they should be used cautiously, closely monitored, and regularly reevaluated. The Path Forward for Kansas Kansas has an opportunity, and an obligation, to act. Building on the 2022 Senior Care Task Force recommendations, advocates continue in 2025–2026 to call for: Expanded access to geriatric mental health specialists Stronger oversight and enforcement Improved training in dementia and person-centered care Greater transparency for residents and families Meaningful solutions to the ongoing staffing crisis At its heart, this is about dignity. Older adults in Kansas adult care homes deserve care that respects their humanity, not treatment that silences it.