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.

A close up of a person holding another person 's hand.

Advocacy in Action (June 2025): One Investigator, 70 cases, APS is Stretched Too Thin

May 29, 2025
In a recent article published by The Beacon, reporter Blaise Mesa spotlights a heartbreaking case that exemplifies both the critical importance and serious strain facing Kansas Adult Protective Services (APS). The article, “One elder abuse investigator has 70 cases. Kansas doesn’t say how swamped other caseworkers are,” tells the story of Shirley Crow, an 85-year-old woman with Alzheimer’s whose family trusted a caretaker to manage her daily medications and appointments. That trust was broken. Despite filing a report with APS, Shirley’s family received few updates. Weeks after their report, Shirley passed away. Her case remains open—one of 10,000 APS investigations initiated in Kansas each year. The assigned APS caseworker? She has 70 other cases. This is not a story about blame. As Shirley’s daughter-in-law, Stacy Crow, told The Beacon , “We got an investigator that I truly believe has a heart… I understand they have an overwhelming demand… I don’t fault them. I just want things to change.” And so do we. Systemic Overload and the Urgent Need for Reform The Kansas Department for Children and Families (DCF), which oversees APS, has not publicly disclosed average caseloads. While DCF clarified post-publication that they do track this information, they choose not to release it, citing confidentiality. The lack of transparency and standardization prevents meaningful accountability and reform. National standards suggest 20–25 cases per worker is a manageable caseload. Kansas APS staff, in some cases, are handling double or triple that amount. With cases increasing year over year— 18,056 in fiscal year 2025 alone—the risk of delayed intervention or missed warning signs only grows. This Is a Wake-Up Call. At KABC, we continue to push for better protections for older adults, more robust support for APS investigators, and greater transparency and accountability from state agencies. In our recent blog post, “ What Happens When You Report to Adult Protective Services? ” we outline the crucial role APS plays in protecting vulnerable adults and how reporting suspected abuse can quite literally save lives. To report suspected abuse, neglect, or exploitation of a vulnerable adult in Kansas: For older adults living at home in the community or in facilities licensed by the Kansas Department of Aging and Disability Services when the perpetrator is not a resident of or staff of the facility, report to the following: Adult Protective Services (APS): 1-800-922-5330 If an emergency, call your local law enforcement agency or 911 Reporting initiates a multi-step process involving a prompt in-person visit, interviews, and, when needed, development of a service or prevention plan. The goal of APS is to protect, not to punish- to connect individuals to medical care, housing, legal services, or safety planning. But APS cannot fulfill that mission if it's underfunded, overwhelmed, and operating in the dark.  What Needs to Change: Transparency: Kansas must publicly release average caseload data and investigation timelines. Support for APS Workers: State leaders must prioritize hiring and retaining qualified APS staff and ensure manageable caseloads. Federal Investment: Continued and expanded federal funding for APS is essential—not optional. Public Awareness: Communities need to understand when and how to report suspected abuse, and how they can be part of the safety net. The APS system should be a lifeline, not a last resort.

5 Questions to Ask When Choosing a Long-Term Care Facility

May 21, 2025
Choosing a long-term care facility for yourself or a loved one is one of the most important decisions you can make. Beyond basic safety and cleanliness, the right facility should support a person’s independence, dignity, and overall quality of life. To help you make an informed choice, here are five essential questions to ask, along with key follow-ups that can give you a deeper sense of what daily life will be like at the facility. 1. How does the facility support independence and person-centered care? Person-centered care means that residents are active participants in their care and daily routines. Ask: Can residents choose when to wake up and go to bed? Are meals and activities tailored to individual preferences? Is there flexibility for “early birds” and “night owls”? Look for signs that staff respect residents’ individuality—such as accommodating dietary preferences and encouraging participation in meaningful activities. 2. What medical and rehabilitation services are available on-site? Quality care goes beyond assistance with daily activities. Ask about: Access to hospice care and pain management Availability of wound care and ostomy specialists In-house physical, occupational, speech, and mental health therapies Staffing levels—how many nurses and aides are on duty at different times of day? These services can have a major impact on recovery, mobility, and comfort. 3. What is the atmosphere like during meals and activities? Daily life should be engaging and social. Ask to observe a meal or an activity session. Consider: Are residents out of their rooms and interacting with others? Do meals look appetizing and meet special dietary needs? Is assistance with eating provided promptly and respectfully? Also ask about field trips, volunteer involvement, and whether there is an active activities room or calendar of events. 4. What do current residents and families say about their experience? Talking to those already living in or visiting the facility can give you valuable insight. Ask residents: Do staff respond quickly when you call for help? Do you enjoy your meals and feel your privacy is respected? Are you involved in decisions about your care? Ask families: Are you promptly notified of any accidents or health changes? Do you feel comfortable raising concerns? Is there a Family Council and does the facility listen to it? 5. How transparent and responsive is the administration? A responsive leadership team is key to resolving issues and maintaining quality. When meeting with the Administrator or Director of Nursing, ask: How do you handle complaints? How are staff trained and how long do they typically stay? What’s your policy on resident rights, such as refusing treatment? You can also ask to review the admission contract, learn about costs and refund policies, and understand how care decisions are made if the resident is unable to speak for themselves. Want more questions to ask? Visit our full guide: Is This the Nursing Home to Choose?  It includes detailed sections on services, nursing care, residents' rights, and conversations to have with administrators, staff, and families. At Kansas Advocates for Better Care, we believe everyone deserves compassionate, dignified, and person-centered long-term care. Asking the right questions is the first step to getting it.