Types of senior living compared
Senior living options range from housing with no personal care (independent living) to 24-hour medical care (skilled nursing facilities), with assisted living, memory care and residential care homes in between.[1][2] The right setting depends mainly on how much help a person needs with daily activities and medical care, and on how that care will be paid for; Medicare does not pay for long-term custodial care in any of these settings.[3]
How the settings differ
The main distinction is the level of help provided. Activities of daily living (ADLs) such as bathing, dressing, eating and taking medications are the tasks most long-term care helps with.[4] Settings that provide only housing and hospitality sit at one end; nursing homes, which provide nursing care and 24-hour supervision, sit at the other.[1]
| Option | What it provides | State oversight in California | Medicare pays for ongoing care? | U.S. median cost, 2025 |
|---|---|---|---|---|
| Independent living | Apartments or cottages for people who need no assistance; may include meals, housekeeping and activities[2] | Not a CDSS senior care license type (CDSS licenses RCFEs and CCRCs)[5] | No[3] | Not surveyed[6] |
| Assisted living | Housing, meals, personal care, medication help, 24-hour supervision[1] | Licensed as a Residential Care Facility for the Elderly (RCFE) by CDSS[2] | No[1] | $6,200/month[6] |
| Memory care | Specialized 24-hour care, secure environment and trained staff for people with dementia[2] | Provided within licensed RCFEs or nursing homes; dementia rules apply to RCFEs[7] | No (custodial care)[3] | No separate median published[6] |
| Skilled nursing facility | Nursing care, 24-hour supervision, meals, rehabilitation therapies[1] | Licensed by the California Department of Public Health[8] | Short-term only, up to 100 days per benefit period if eligible[9] | $9,581/month (semi-private)[6] |
| CCRC / life plan community | Independent living, assisted living and skilled nursing on one campus under a continuing care contract[1][10] | Licensed and monitored by CDSS Senior Care Licensing[5] | Some services, depending on level of care[1] | Entrance fee plus monthly fee; no survey median[1] |
| Residential care home (board and care) | Small home, usually 20 or fewer residents; personal care, meals, staff around the clock[1] | Licensed as an RCFE by CDSS[10] | No[1] | Included in the assisted living category in California[6] |
| Respite care | Short-term relief for caregivers, from a few hours to several weeks[11] | Depends on where it is provided | Up to 5 consecutive days for people in hospice[11] | Adult day health care: $95/day[12] |
| Home care | Non-medical help at home with personal care and chores; home health adds skilled services[13][14] | Home care organizations licensed by CDSS since 2016[15] | Home health only, if homebound and eligible; not custodial-only care[14] | $35/hour (non-medical caregiver)[6] |
Cost figures are national medians from the CareScout Cost of Care Survey 2025 (fielded July–November 2025). Individual providers can charge significantly more or less than the median.[6] See Cost of senior living for California and San Diego figures.
How many people use each type of care
According to LongTermCare.gov, someone turning 65 today has almost a 70% chance of needing some type of long-term care services and supports in their remaining years. More people use care at home than in facilities: 65% of people use some care at home (for an average of 2 years), compared with 35% who use nursing facilities and 13% who use assisted living.[16] The CDC counted 14,700 nursing homes with 1.2 million residents in 2022,[17] and the National Center for Assisted Living reports approximately 41,465 assisted living communities with nearly 1.4 million licensed beds.[18]
Choosing between settings
- Needs no hands-on help: independent living or staying at home with support.[2][13]
- Needs help with some daily activities but not constant nursing: assisted living or a residential care home.[1]
- Living with dementia and at risk of wandering or confusion: memory care or a dementia care unit.[2][19]
- Needs daily skilled nursing or rehabilitation after a hospital stay: a skilled nursing facility.[9]
- Wants to plan once for changing needs: a continuing care retirement community.[1]
- Family caregiver needs a break: respite care or adult day programs.[11]
The How to choose guide explains how to check licensing and inspection records before deciding.
Frequently asked questions
What is the difference between assisted living and a nursing home?
Assisted living is for people who need help with daily care but not as much as a nursing home provides; nursing homes focus more on medical care, with nursing care and 24-hour supervision.[1]
Which senior living options does Medicare pay for?
Medicare does not pay for long-term custodial care in any setting. Part A can cover short-term care in a skilled nursing facility after a qualifying 3-day inpatient hospital stay, and Medicare covers home health services for eligible homebound people.[3][9][14]
What is assisted living called in California?
California licenses assisted living as Residential Care Facilities for the Elderly (RCFEs), which are also called board and care homes.[2][10]
See also
References
Web pages accessed September 28, 2026 unless noted. See sources and methodology.
- ^ "Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care". National Institute on Aging (NIH).
- ^ "Determine the Best Housing Option For Me". California Department of Aging.
- ^ "Long-term care (coverage page)". Medicare.gov, Centers for Medicare & Medicaid Services.
- ^ "What Is Long-Term Care?". National Institute on Aging (NIH).
- ^ "Senior Care Licensing Program". California Department of Social Services.
- ^ "Cost of Care Survey 2025: national median costs". CareScout (formerly the Genworth Cost of Care Survey). Survey fielded July–November 2025.
- ^ "California Health and Safety Code §1569.626 (dementia care disclosures)". California Legislative Information.
- ^ "Licensing and Certification Program". California Department of Public Health.
- ^ "Skilled nursing facility care (coverage page; 2026 cost-sharing amounts)". Medicare.gov, Centers for Medicare & Medicaid Services. 2026 amounts.
- ^ "Resources for Residents and Families (Senior Care Licensing)". California Department of Social Services.
- ^ "What Is Respite Care?". National Institute on Aging (NIH).
- ^ "Cost of Care Survey 2025: Median Cost Data Tables (PDF, dated 03/02/26)". CareScout. 2025 data.
- ^ "Aging in Place: Growing Older at Home". National Institute on Aging (NIH).
- ^ "Home health services (coverage page)". Medicare.gov, Centers for Medicare & Medicaid Services.
- ^ "Home Care Services". California Department of Social Services.
- ^ "How Much Care Will You Need?". LongTermCare.gov, Administration for Community Living. Page last modified 02/18/2020.
- ^ "FastStats: Nursing Home Care". National Center for Health Statistics, CDC. 2022 data; page last reviewed February 6, 2026.
- ^ "Assisted Living Facts and Figures". National Center for Assisted Living (NCAL/AHCA).
- ^ "Alzheimer's Caregiving: Finding Long-Term Care". National Institute on Aging (NIH).