Sarasota Senior AdvisorWhat is the difference between assisted living and a nursing home in Florida?
A nursing home provides 24-hour nursing care under a nursing home license and federal certification, while an assisted living facility provides housing, meals, personal care and supervision and may not keep residents who are bedridden or need 24-hour nursing supervision, unless they are on hospice.
Nursing homes are inspected for both AHCA and CMS and get CMS star ratings; assisted living facilities are inspected by AHCA and are not rated by any government agency.
Is a nursing home more expensive than assisted living in Florida?
Yes, by about double: CareScout's 2025 Florida medians are $124,100 a year for a semi-private nursing home room against $66,000 for assisted living, but Medicare covers short skilled stays and Medicaid covers long stays far more readily than it covers assisted living.
For a low-income person who qualifies for Medicaid, a nursing home may cost the family less out of pocket than assisted living, because Medicaid will not pay assisted living room and board.
Can someone go from a nursing home back to assisted living?
Yes; many short-term rehab patients return to an ALF after therapy, provided they again meet the ALF's admission criteria, such as being able to transfer with help and not needing 24-hour nursing supervision.
Keep the ALF room if possible: ask the facility how long it will hold a room during a rehab stay and what it charges.
How do I choose between them for my parent?
List the nursing tasks your parent needs each day and night; if any require a nurse at all hours, or the person cannot help with transfers at all, look at nursing homes, and if not, look at assisted living, especially facilities with an LNS or ECC license.
Our nursing home pages show CMS's staffing hours and turnover beside the two-county median, which is often the most telling number.
What does a resident lose by moving from assisted living to a nursing home?
Usually privacy and independence: most Florida nursing home rooms are shared, schedules are set by the facility, and residents give up the apartment-style setting, while gaining round-the-clock nursing and, for those who qualify, Medicaid coverage of room and board.
Many families try hospice in the ALF first when the change is driven by a terminal illness, because s. 429.26 allows it.
At a glance
| A nursing home | An assisted living facility | |
|---|---|---|
| Nursing | 24-hour licensed nursing | Limited nursing, more with LNS or ECC |
| Ratings | CMS star ratings | No government rating |
| Medicaid | Pays long stays for eligible residents | Pays services, not room and board |
Sources include Chapters 408, 429 and 651 of the Florida Statutes, Fla. Admin. Code chapters 59A-36 and 65A-2, AHCA, DCF, OIR and Elder Affairs pages, CareScout and VA rate tables as cited above; see our editorial standards.
