Does Assisted Living Count as Healthcare? An In-Depth Look

Oct 7, 2025 4 min read •

senior care healthcare assisted living

According to the Centers for Medicare and Medicaid Services (CMS), Medicare does not cover the costs of assisted living because it is considered "custodial care," not medical care. For families trying to navigate senior care options, this distinction is crucial for understanding coverage and payment methods, directly addressing the question: does assisted living count as healthcare?.

Quick Summary

Assisted living is generally not classified as healthcare by federal standards, like Medicare. It primarily provides custodial care, assisting with daily living activities, while formal healthcare is delivered by licensed medical professionals. The distinction affects insurance coverage and costs, with assisted living typically funded through private pay or specific long-term care insurance policies.

Key Points

Custodial vs. Medical Care: The primary distinction is that assisted living provides custodial, non-medical care, unlike the skilled medical care delivered in hospitals or nursing homes.
Medicare's Stance: Medicare does not cover assisted living costs, such as room, board, or help with activities of daily living (ADLs), classifying them as non-medical.
State-Level Regulation: Unlike federally regulated nursing homes, assisted living facilities are regulated at the state level, which can cause variations in terminology and services.
Financing Options: Payment for assisted living typically comes from private funds, long-term care insurance, or state-specific Medicaid waivers.
Access to Healthcare: While not a medical facility, assisted living communities can coordinate with outside healthcare providers for a resident's specific medical needs.
Focus on Independence: Assisted living is designed to promote an independent lifestyle for seniors who need some support, rather than providing constant, intensive medical attention.

Assisted Living: More Social Support than Medical Facility

Assisted living communities are designed for seniors who require some help with daily activities but do not need the round-the-clock, intensive medical supervision found in a skilled nursing facility. These communities focus on providing a residential, home-like environment that supports independence while offering services that enhance quality of life.

Core services in assisted living

Assistance with activities of daily living (ADLs), such as bathing, dressing, and grooming.
Medication management, which involves staff reminding residents to take their medications on schedule.
Housekeeping and laundry services.
Nutritious meals and snacks.
A robust schedule of social, recreational, and wellness activities.
Transportation services for medical appointments and other outings.
24-hour supervision and security.

The role of medical care in assisted living

While assisted living is not a medical facility, it does facilitate access to healthcare services. Many communities have relationships with visiting doctors, therapists, and home health agencies. If a resident has a specific medical need, like a wound that needs daily care, a home health nurse would visit the facility to provide that skilled service, as assisted living staff are not typically certified for such tasks. This highlights that the healthcare provided is supplementary, not the core function of the facility itself.

The official definition of healthcare

To understand why assisted living doesn't qualify as healthcare, it helps to look at the official definitions and regulations. Healthcare, as defined by the World Health Organization (WHO) and other bodies, involves professional services for the prevention, diagnosis, and treatment of disease, illness, and injury. These services are delivered by licensed healthcare professionals, such as doctors, nurses, and physical therapists.

Healthcare vs. custodial care

The key difference lies in the distinction between skilled medical care and custodial care. Medicare and other federal programs use this distinction to determine what services they will cover.

Skilled Medical Care: Requires the skills of a licensed professional and is ordered by a doctor to treat an illness or injury. Examples include wound care, intravenous (IV) therapy, and rehabilitation services.
Custodial Care: Non-medical care that helps a person with daily living activities. This assistance does not require professional medical skills and is the primary service provided by assisted living staff.

Comparison: Assisted Living vs. Skilled Nursing

Comparing assisted living with a skilled nursing facility (nursing home) makes the distinction clearer. Nursing homes are federally regulated as medical facilities and provide a much higher level of care.


Feature	Assisted Living	Skilled Nursing Facility (Nursing Home)
Primary Purpose	Residential, home-like environment with support for daily activities.	Medical setting with 24/7 skilled nursing care for complex health needs.
Level of Medical Care	Minimal. Access to visiting professionals, but staff are not medical.	High. On-site, 24-hour access to licensed nurses and medical professionals.
Staffing	Caregivers and aides, sometimes with licensed nursing supervision.	Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and certified medical staff.
Typical Resident	Active but needs help with some ADLs, like dressing or bathing.	Requires constant medical monitoring or hands-on assistance with most ADLs.
Environment	Apartment or residential setting with private or semi-private rooms.	More institutional, hospital-like setting, often with shared rooms.
Primary Funding	Private pay, long-term care insurance, or Medicaid waivers (in some states).	Medicare (for short-term stays), Medicaid (for eligible low-income), private pay.
Licensing	Regulated at the state level.	Regulated at both state and federal levels.

Implications for financing and regulations

Because assisted living is not formally classified as healthcare, payment options are significantly different from hospital or skilled nursing care, which are often covered by Medicare. Most assisted living costs are paid out-of-pocket, by private long-term care insurance, or through specific state Medicaid waiver programs.

It is important to remember that Medicare will still pay for a resident's approved medical and hospital services (like doctor visits) when they live in an assisted living community, but it will not cover the cost of room, board, or the personal care services. This financial distinction is one of the most practical consequences of how assisted living is defined.

Conclusion: The difference is in the definition

Ultimately, whether assisted living counts as healthcare depends on the context and the level of care required. From a federal regulatory and insurance standpoint, assisted living is classified as custodial, or non-medical, care. While residents may receive some medical services from outside providers, the core purpose and staffing model of these facilities are centered on daily assistance and social support rather than direct, skilled medical treatment. Understanding this key difference is essential for families making informed decisions about senior care and planning for its associated costs.

One authoritative outbound Markdown link: Explore senior living options from the National Institute on Aging

Frequently Asked Questions

No, an assisted living facility is not officially considered a healthcare facility. It is a residential setting that offers support services and assistance with daily activities, but it does not provide the same level of 24/7 skilled nursing care as a hospital or nursing home.

Medicare does not cover the costs of room, board, or general personal care services in an assisted living facility. However, if a resident requires a specific medically necessary service, such as physical therapy or doctor's visits, Medicare will cover those particular services just as it would if the person were living at home.

The main difference is the level of medical care. Assisted living provides supportive, non-medical (custodial) care in a residential setting, while a nursing home provides a higher level of skilled medical care and constant supervision for more complex health conditions in a more institutional setting.

You can pay for assisted living through a variety of sources, including personal savings, long-term care insurance, or state-based Medicaid waiver programs. Veterans benefits may also be an option for eligible individuals and surviving spouses.

Yes, you can receive medical care in assisted living, but it is typically delivered by visiting healthcare professionals, not the regular facility staff. For example, a home health nurse might provide wound care, and transportation can be arranged for doctor appointments.

HIPAA was amended to address the tax deductibility of certain long-term care expenses, including personal care services for chronically ill individuals, but it did not fundamentally change the custodial classification of assisted living from a regulatory standpoint.

Assisted living facilities are primarily regulated at the state level, with each state having its own licensing standards and terminology for services and facilities.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.