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Assisted living & personal care homes
This is the middle ground: a place to live, meals, help with daily tasks, and people around, without a nursing home's medical staff. It goes by several names. Those names are types of license. They do not describe what you will get.
What "assisted living" means
The federal Administration for Community Living (ACL) describes assisted living this way: a room and meals, social activities, and help with personal care and other daily tasks, such as eating, bathing, using the bathroom, taking medicine and getting to appointments as needed. Residents usually pay a monthly rent, plus fees for extra services. They pay for medical and nursing services separately.[1]
ACL also says the amount of help is different from place to place.[1]
About the names, and what we got wrong
An earlier version of this page said personal care homes are smaller, feel more like a home, and can cost much less than assisted living. It also said both have staff 24 hours a day and medication reminders. We took that out. We could not find any national source that ties size, cost or staffing to the name. The license rules, staffing rules, medication rules and number of residents are very different from state to state, and from one home to the next inside a state.
Don't trust the label. Ask the state licensing agency what that type of license requires where you live. Ask about three things: staff at night, who may give or help with medicine, and which residents a home is allowed to keep as their needs grow. Then ask each home the same questions and compare the answers.
Our guide personal care home vs assisted living goes through the pros and cons. Our directory shows the public inspection and safety record for licensed homes where available.
What it costs
CareScout's 2025 survey, done from July to November 2025, found these national medians. (The median is the middle price: half cost more, half cost less.)[2]
- Assisted living: $6,200 a month, about $74,400 a year.
- Nursing home, shared room: $9,581 a month, about $315 a day.
- Nursing home, private room: $10,798 a month, about $355 a day.
ACL notes that costs vary a lot with the size of the living space, the services, the kind of help needed and the location.[1] A warning about sources in general: ACL's own assisted-living page was last updated in 2020 and still quotes a price range from 2001. If a price has no date on it, do not use it.[1] What care costs has the fuller picture.
How it is paid for
Medicare does not pay the rent. Medicare is not a program for long-term housing or for help with daily tasks. Who pays for care explains who pays, and in what order. Most people pay out of their own pocket at first.
Medicaid may help with the care, and it depends on your state. ACL is clear that Medicaid programs and who qualifies are different from state to state. The example it gives is this very one: some states cover assisted living services, while others do not.[3] Where a state does cover it, that is usually through a waiver, and only at homes that take part.
For care outside a nursing home, ACL's rule is that "Medicaid will not pay for your rent, mortgage, utilities, or food."[3] This is the gap families run into: the care may be covered while the room and meals are not. Keep in mind what that rule is about. It covers care at home and in places like assisted living. It does not describe how a nursing home stay is paid for, which works differently. See nursing-level care.
What only your state can tell you
Does your state's Medicaid program cover care in these homes? Which homes take part? Those are state and local facts.
Who to ask: your state Medicaid office; the state agency that licenses assisted living or personal care homes; and your Area Agency on Aging through the Eldercare Locator at 1-800-677-1116.
What to ask them:
- Does this state's Medicaid program help pay for care in assisted living or a personal care home? Under which waiver?
- Which local homes accept it? Is there a waiting list?
- What would we still pay ourselves for the room and meals?
- How do you decide if someone needs enough care to qualify?
- What does this type of license require here for night staff and for help with medicine?
- At what point would a home with this license have to move out a resident whose needs grow?
Free local help. Your Area Agency on Aging will talk through your choices with you for free. As you should see from this section, things change a lot and they are not especially clear to begin with. Reach your agency through the federal Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov (run by the Administration for Community Living).[4] Your state's long-term care ombudsman also speaks up for people living in these homes, for free. To learn about the four kinds of local helpers, see Who helps me locally.
Sources and what they support
Sources checked 2026-09-19 using AI-assisted editorial research. This is a source check, not a facility review.
- ACL / LongTermCare.gov, assisted living. Supports the description of what assisted living provides, the listed help with eating, bathing, the bathroom, medicine and appointments, that residents pay monthly rent plus fees for extras and pay for medical and nursing services separately, that the level of assistance varies by facility, and that costs vary with size, services, help needed and location. This page was last modified in February 2020 and its own dollar range dates from 2001, so it is used here for the description and the variation warning only, never for prices. It also says nothing about staffing levels or qualifications, which is why no staffing claim on this page rests on it.
- CareScout Cost of Care Survey, 2025. Supports the national medians used here: $6,200 a month for an assisted living community, $9,581 a month or $315 a day for a nursing home semi-private room, and $10,798 a month or $355 a day for a private room, collected July to November 2025. A commercial survey with its methodology in a separate document. Medians are not quotes, they do not say what is included, and assisted living commonly adds service fees on top of the base rate.
- ACL, Medicaid long-term care services. Supports that Medicaid covers nursing home services for eligible people 21 and over and home and community-based services for people who would otherwise need a nursing home, the quoted statement that Medicaid will not pay rent, mortgage, utilities or food, the quoted statement that Medicaid programs and eligibility vary from state to state, and the example that some states cover assisted living services while others do not. The rent exclusion is written about community and residential services; it should not be read as a statement about how room and board works in a nursing facility, where the arrangement differs.
- Administration for Community Living, Eldercare Locator. Supports the referral route to a local Area Agency on Aging. It does not licence facilities, determine Medicaid eligibility, or recommend a home.
Removed in this pass, for want of a source: that personal care homes are smaller, more home-like and much less expensive than assisted living, and that both settings have 24-hour staff and medication reminders. Names, licensing, staffing and medication rules differ by state and by facility, so this page now sends you to the licensing agency instead of generalising.