The Distinctions Between a Skilled Nursing Facility vs an Assisted Living Facility
Many families reach a point where they need to make decisions about an older loved one’s living arrangements or care. There are many care options to consider, including skilled nursing facilities and assisted living communities.
When you’re seeking a care option, the primary things to consider include the following:
- The individual’s level of independence: Older individuals who are independent will want a living community that allows them to enjoy their independence. Those who require additional support will want a facility that provides the necessary assistance.
- The location: Monument Health Group has facilities throughout Utah. Those with family or friends in Salt Lake City or Bountiful may want to prioritize finding a living facility near their loved ones to make it easier to visit them.
- The individual’s medical conditions: Assisted living and skilled nursing facilities offer varying levels of medical care, and it is essential to ensure that you or your loved one receives the appropriate medical care if needed.
Identifying the differences between a skilled nursing facility (SNF) and an assisted living facility (ALF) can help clarify which senior living facility is best for you or your loved one.
Definitions and Comparisons
Understanding whether a skilled nursing or assisted living facility meets your needs begins with defining each type of facility, and highlighting its key features and essential information.
Skilled Nursing Facility (SNF)
A high level of medical care is provided at SNFs.
The staff includes:
- Doctors
- Registered nurses
Services available at SNFs include the following:
- Cardiac care
- Dietary counseling
- Diabetes care
- Infectious disease control and management
- IV therapy
- Rehabilitation services, such as:
- Occupational therapy
- Physical therapy
- Speech therapy
- Tube feedings
- Wound care
SNFs are ideal for the following:
- Individuals needing medical interventions, such as those needing around-the-clock care, dietary counseling, or rehabilitation services.
- Individuals recovering from surgery.
- Individuals with chronic health conditions.
In some cases, Medicaid and Medicare cover the cost of SNF care.
Assisted Living Facility (ALF)
ALF staff assist with activities of daily living (ADLs) such as the following:
- Bathing
- Brushing teeth
- Dressing
- Medication management
- Using the toilet
Staff are on duty around-the-clock, ensuring individuals can receive personal assistance at any time of the day or night. However, individuals do not have access to 24/7 medical care at ALFs.
ALFs enable individuals to retain their independence where possible, while prioritizing the following services:
- Daily supports, such as dietary oversight, personal care, and medication management.
- Recreation activities.
- Social activities.
- Transportation services.
Some individuals can use Medicaid to cover some services, but even if approved, Medicaid does not cover room and board. Medicare does not cover any ALF services.
Key Differentiators
When comparing a skilled nursing facility vs an assisted living facility, it is helpful to focus on the primary differences between each facility to identify the best option for your needs.
Coverage and Cost
Medicaid and Medicare may cover SNF costs, making it possible for those who need 24/7 medical care to receive SNF services.
While Medicaid may cover some costs for particular residents, most people in ALFs must pay for services themselves. A 2024 report indicated Utah ALF residents pay an average of $4,150 per month.
Level of Independence
ALFs serve individuals with a greater degree of independence, and tailor the level of support residents receive based on their individual needs.
SNFs provide 24/7 care to individuals with medical needs.
Medical vs Social Support
- ALFs provide daily living assistance and social activities.
- SNFs provide around-the-clock medical care.
Key Considerations
Focusing on the following key factors can help you decide if a skilled nursing facility or an assisted living facility is best for your needs:
- Care options and costs: While the monthly cost of staying at an SNF may exceed the monthly cost of an ALF, many individuals can use their Medicare or Medicaid plans to cover those expenses. Individuals must pay for all or most of their ALF costs, since Medicaid only covers a small portion of ALF costs for some residents. It’s a good idea to find out what costs are covered and how much you’ll need to pay out of pocket to ensure you choose an affordable option. Private insurance may cover SNF costs after Medicaid or Medicare benefits are exhausted, but it does not cover ALF costs.
- Disadvantages: ALFs and SNFs offer many advantages to their residents. However, they also have disadvantages. One of the drawbacks of choosing an ALF is the high monthly cost of care. One of the disadvantages of SNFs is the clinical emphasis. SNFs do not offer the same opportunities for recreational and social activities as ALFs.
- Length of stay: Many individuals enter SNFs for a short-term stay. If you expect to be able to leave within 100 days, Medicare may cover your entire stay. You can stay longer than 100 days; however, you will need to have private insurance or the funds to pay for care after the 100-day limit that applies to Medicare coverage.
- Living community preferences: If both an ALF and SNF are suitable for an individual’s needs, consider what type of environment the individual prefers. ALFs offer social opportunities and recreational activities in a warm, homey environment. SNFs are clinical environments that prioritize medical care and treatment.
- Medical conditions: Individuals who need a high level of medical care benefit from SNF services because they have doctors and registered nurses available 24/7 to provide expert medical care. Those with manageable medical conditions who do not require 24/7 access to medical professionals can receive the necessary medication management at an assisted living facility, while enjoying onsite activities and opportunities for social interaction.
- Type of needs: ALF staff provide activities of daily living (ADLs) assistance; they also encourage residents to maintain as much independence as possible. Individuals with severe medical conditions that require intensive oversight from healthcare professionals need the around-the-clock services of medical professionals available in a skilled nursing facility.
Activities and Daily Support
The daily activities and types of support provided at ALFs and SNFs give you a sense of what to expect on a day-to-day basis in each environment.
AFLs prioritize social interactions and recreational opportunities. Staff provide daily activities that residents can enjoy. Meals are provided, and residents can enjoy dining together in a communal setting. Staff provide transportation to appointments or outings, and residents receive mobility support, if needed.
SNFs prioritize medical care. Medical professionals are present 24/7 to provide care as needed. The SNF team’s goal is to help individuals recover from or learn to manage their health conditions. There’s a strong emphasis on rehabilitation services, including occupational therapy, physical therapy, and speech therapy. Residents receive medical supervision during all treatments.
Utah SNF providers, such as Monument Health Group, strive to ensure that residents can enjoy their favorite activities during their recovery. They also strive to provide these familiar activities to residents whose health and ability to function independently are in decline.
Next Steps
To determine whether an assisted living or skilled nursing facility is right for your needs, consider the following:
- ADLs: Does the individual need more than daily living assistance?
- Cost: Will Medicaid, Medicare, or private insurance cover the individual’s expenses?
- Medical needs: Does the individual need around-the-clock medical care?
- Stability: Is the individual’s health stable?
- Social interaction vs medical care: Does the individual need continuous medical oversight? If so, they may need to forfeit the social opportunities available in an ALF.
Consulting with experts in elder care can help alleviate your concerns and provide the information you need to make an informed decision if you or a loved one requires care. Visiting facilities, speaking to staff, and reviewing their amenities and service plans can help you find the right facility for your needs.
Sources:
Does Medicaid Pay for Assisted Living? (2025).
Gerber, C. (2023). Assisted Living Options for Young Adults With Disabilities.
Medicare Coverage of Skilled Nursing Facility Care. (2025).
The Cost of Senior Care in Utah. (2024).
Understanding Assisted Living in Utah: A Comprehensive Guide for Families. (2025).