What is the difference between assisted living and a nursing home?
Direct answer
For owners and investors, the difference is the business model. Assisted living provides housing, meals and help with daily activities, is licensed by the state and is paid for mostly by private-pay residents. A nursing home (skilled nursing facility) provides 24-hour skilled nursing care, is funded mostly by Medicare and Medicaid, and needs federal certification as well as a state license.
What to know
Revenue: assisted living depends on private-pay rates and occupancy. Skilled nursing depends on government reimbursement and payor mix.
Regulation: skilled nursing faces heavier oversight, CMS star ratings and a state-licensed nursing home administrator.
Pricing: early-2026 indications run about $120,000 to $200,000 or more per unit for Class A metro assisted living, against about $30,000 to $80,000 per bed for skilled nursing.
Cap rates: core assisted living runs about 7.0%, while skilled nursing runs about 8.0% to 9.5% in certificate-of-need states and 11% to 17% elsewhere.
How Haven helps
Haven brokers both assisted living and skilled nursing communities with 16 or more beds. Read our senior housing market outlook.