Skilled Nursing Facility vs Assisted Living Facility: What’s the Difference?

Skilled Nursing Facility vs Assisted Living Facility: What’s the Difference?

With so many available options for senior care, the distinction between different types of facilities can be confusing at first glance. Two of the most common are skilled nursing facilities and assisted living facilities. 

While both of these environments assist residents with medical care and activities of daily living, they’re distinct in many ways. If you’re interested in a career in senior care, understanding the differences between these two settings can help you decide what type of facility you’d like to work in and what’s best for your career.

Here’s everything you need to know about the differences between skilled nursing facilities and assisted living facilities.

What Is a Skilled Nursing Facility?

A skilled nursing facility (SNF) is an inpatient medical treatment and rehabilitation center. Also known as intermediate care nursing facilities or, simply, nursing homes, SNFs offer round-the-clock medical care and assistance with activities of daily living in addition to many other long-term treatment skills. 

Medical professionals such as nurses, speech-language pathologists and audiologists, and physical and occupational therapists all work at SNFs.

Many services at SNFs are covered by Medicare, including skilled care. According to Medicare, skilled care refers to “nursing and therapy care that can only be safely and effectively performed by, or under the supervision of, professionals or technical personnel.” 

This may include skilled nursing care, physical or occupational therapy, speech or swallowing therapy from a speech-language pathologist, medications and medical supplies/equipment, medical social services, and dietary counseling. Meals and semi-private rooms are also typically covered.

What is an Assisted Living Facility?

An assisted living facility, often referred to as assisted living, senior living communities, or adult foster care, refers to housing for individuals seeking medical and personal care. 

Assisted living facilities offer a home-like setting and typically focus on promoting residents’ independence, with staff providing support for daily living activities. The physical living spaces may include individual rooms, apartments, or shared rooms.

These types of facilities vary in what they offer, but they typically include one to three meals a day, medication monitoring and select medical services, and 24-hour emergency care. 

They also tend to include assistance with activities of daily living, such as housekeeping, laundry, and personal care. Many assisted living facilities also offer social and recreational activities for residents.

Differences Between Skilled Nursing and Assisted Living

While both skilled nursing facilities and assisted living facilities provide residents with medical and daily living assistance, the exact services and how they are carried out vary. That means the types of skills and patient care acuity will vary also.

Here are the ways in which skilled nursing and assisted living differ.

Level of Care

The level of care and the skills you’ll use to care for residents is the biggest difference between the two facilities. 

In an assisted living facility, depending on your job responsibilities, you’ll assist with activities of daily living, mental health, medication management, social support, and financial management. 

Assisted living facilities are generally for residents who can mostly live independently and just need or want assistance with a few activities of daily living. In general, these residents don’t struggle with movement, are receptive to assistance, and don’t have other behavioral problems.

While assisted livings offer some medical care, they don’t often provide the 24/7 comprehensive skilled care that SNFs do. 

Skilled nursing facilities are generally used for individuals with extensive, chronic, or complex medical needs and require assistance with mobility or are resistant to assistance from health care professionals. 

However, it should also be noted that a person’s level of need can change over time. Each facility sets its own guidelines and standards on what qualifies a resident to move into or stay living in their facility. 


Assisted living facilities are residential settings. Housing can look like stand-alone buildings, apartments, shared spaces, and everything in between. 

Conversely, a skilled nursing facility is a medical setting. Skilled nursing is typically provided in rehabilitation centers or nursing homes. However, some SNFs are seeking to make their facilities look and feel more home-like than in the past.

Staff Availability

SNFs are typically required to have a registered nurse on-site for at least eight hours every day, with additional medical support staff onsite round-the-clock. This means that there are often many options of shifts, sometimes two 12-hour shifts or three 8-hour shifts, so you can choose a shift that best works for you.

Assisted living facilities have staff nurses on-call and accessible at all times, but they may not be required to always be on-site for daily care or emergency situations.  

Length of Stay

A skilled nursing facility is usually considered a short-term placement, often following a hospital stay or a sharp decline in health. The skills you’ll need to provide care to patients will vary based on the severity of their health concerns.

Conversely, an assisted living facility is considered a long-term solution, in which residents tend to stay as long as it meets their current health and needs. 

Goal of Residency

The goal of residency for each of these facilities ties closely into the length of stay. SNFs work toward rehabilitation, and eventual return to independent living or a long-term supportive living environment, or to provide ongoing medical care and support in a resident’s final days.

Assisted living facilities are a more permanent fixture. Many residents have sold their old homes or apartments when they went to live in these facilities. As such, the goal is to empower residents to live as independently as possible, while providing extra support for activities of daily living. 

Level of Independence

Due to the intensive and consistent level of medical care required, residents in a skilled nursing facility may have less independence and a more limited schedule. 

However, assisted living residents live highly independent lives, and are largely in control of their schedules and the level of assistance they receive.


Round-the-clock medical care doesn’t come cheap, so SNFs generally come with a higher price tag. However, Medicaid, Medicare, and long-term care insurance can help cover many of these costs. 

What that means for nursing staff is that you’ll need to be extra diligent in your charting, as Medicare, Medicaid, and insurance companies rely on that charting to accurately reimburse facilities for care. 

Assisted living care is often less expensive than skilled nursing but is typically paid for out-of-pocket by the resident and their family. In some cities, you may also find higher class assisted living accommodations where residents pay a premium for more luxurious standards.

Where you eventually chose to work will depend heavily on your preferences and the availability of jobs and facilities near you. Regardless, nursing practice in long-term care facilities like SNFs and assisted living communities can be a welcome challenge for those nurses who are eager to pursue work in this specialty.

Are you looking to pick up shifts at a skilled nursing facility? Clipboard Health connects nurses and other health care professionals with facilities in need of staffing. We also offer flexible scheduling and 24/7 support. Contact us today to get started.

Michelle Paul

Michelle Paul is an RN Content Specialist at Clipboard Health. She has worked with a variety of patient demographics, ranging from young adults in foreign countries, to elderly residents in skilled nursing facilities, to healthy blood donors in her community. Her experience in content creation gives her a unique perspective on communication within the healthcare field.

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