Assisted Living vs. Board and Care Homes for Seniors: What’s the Difference?

While assisted living communities and residential care homes provide similar services, their environments are different. Both options include help with grooming, toileting, and basic health monitoring. They also both provide daily meals and aid with mobility. Neither are considered nursing homes where residents receive medical treatment.

Assisted living communities typically have more than 25 residents, while board and care homes for seniors have fewer than 10. While some assisted living communities offer 24-hour care and residential care homes typically don’t, the main differences between the two is in size and the breadth of amenities offered. Luxury assisted living communities especially tend to offer an expansive amount of amenities.

Let’s take a closer look at each of these types of senior living.

Assisted living provides ongoing assistance with activities of daily living in a community based, apartment-style setting. It’s ideal for seniors who need help with some activities of daily living (ADLs) but are interested in leading a social, active lifestyle.

Keep in mind that both assisted living and board and care homes offer less care than nursing homes, and some assisted living communities may have health standards for admitting new residents.

When is assisted living the right fit for a loved one?

Assisted living communities are more like inclusive hotels for retirees and may be the right choice for seniors who:

• Are looking for restaurant-style dining, happy hours, and activities based on resident interest
• Would like to live in a suite or larger apartment
• Need assistance taking medications but don’t require full-time medical care
• Are looking for new friends or social activities
• Would enjoy outings to local stores, theaters, and museums
• Are currently in good health but know they’ll need more help soon
• Need help with activities of daily living such as dressing and bathing
• Want a maintenance-free lifestyle without lawn care or home repairs
• Would prefer an active lifestyle but don’t have access to transportation
• Would prefer to live in faith-based community, such as Jewish assisted living options

How much does assisted living cost?

According to Genworth’s annual cost of care survey ^[01], the median cost of assisted living was $4,500 a month in the United States in 2021.

Because assisted living and residential care homes provide essentially the same services and differ mostly in size and environment, the Genworth survey includes residential care homes in their estimation of assisted living costs. However, this number is still an accurate representation of assisted living costs. This is because the two care types have roughly the same average price, while board and care homes have a wider range of costs.

Assisted living costs depend on many factors, including the following:

• Size of apartment (a studio, or a one- or two-bedroom apartment)
• Types of services needed
• Amenities offered (more expensive communities might include beauty salons, massage therapy, or private dining)
• Location of the community (states in the Northeast and West usually are more expensive than those in the Midwest and Southeast)

Assisted living communities often charge a flat rate that covers many basic services, with additional fees for special services like cable and transportation.

Let our care assessment guide you

Board and care homes are houses in residential neighborhoods that are equipped and staffed to care for a small number of residents, usually between two and 10.

These homes provide comparable care to what’s offered at assisted living communities, but it’s usually less than what a nursing home provides. This means board and care homes can help with daily routines but typically don’t provide 24-hour skilled nursing assistance.

Board and care homes may be referred to as:

• Residential care homes
• Adult family care homes
• Group homes
• Senior group homes
• Adult foster care homes
• Personal care homes

In some regions, one term is more popular than the others. For example, in California, “board and care home” is a common term, while in North Carolina, you may hear “group home.” But don’t let all these names confuse you — they’re essentially the same concept.

State regulations and licensure vary from state to state. Before you choose a residential care home, it’s a good idea to understand your state’s licensing regulations, plus how oversight works.

When is a board and care home the right fit for a loved one?

Board and care homes for seniors may be a better fit for loved ones who:

• Prefer a cozy, intimate, and homelike environment
• Need some help with everyday tasks, such as dressing, bathing, and toileting but don’t need 24-hour skilled care
• Want a home with fewer residents, which allows for more interaction and attention from staff
• Need help with mobility
• Need help with medication management
• Would enjoy a relaxed, unstructured environment
• Want the privacy of a bedroom without all the responsibilities of an entire apartment, such as housekeeping
• Want three full meals a day

How much does a board and care home cost?

Board and care homes are comparable to assisted living in care type and cost, which is why they’re often grouped together or used interchangeably. However, residential care homes have a larger range of prices than assisted living facilities.

The costs of a care home range anywhere from $1,500 to $4,500 a month, but in high real estate markets such as California, the monthly cost might be as high as $10,000.

Because board and care homes are private residences, their wide range of prices is a result of real-estate values across the country. According to the Kansas Department for Aging and Disability Services, “board and care facilities are often less expensive than other housing options, but rates vary greatly depending on services provided and geographic location.” ^[02]

Cost also depends on:

• Room privacy (a shared room costs less than a private room)
• The type of services offered (some charge $5,000 to $6,000 a month, but these are typically homes that specialize in dementia care)

Read more:The Green House Project: The Next Big Thing in Long-Term Care

Talk with a Senior Living Advisor

Residential care homes and assisted living both have an average cost of about $4,500 a month, although residential care homes tend to have more lower-cost options than assisted living facilities. 

For both, however, the price depends on location and other services offered. For instance, a residential care home that offers memory care will cost more, and an assisted living community in California will cost more than one in Kansas.

Because these senior living options provide similar services and the cost for both can be so dependent on location and level of care, deciding between assisted living and residential care homes may come down to personal preference. They offer different living environments that work well for different people.

Senior living choices have expanded as the needs and expectations of older adults have changed over the past several decades. Figuring out the best option for your loved one’s needs is crucial for keeping them healthy, active, and safe. At no cost to you, our 400-plus local experts can guide you through all the senior living options and help you find the right fit for your family.