The three things people call senior care answer to three different authorities. Hospice is federally certified under Medicare and follows the patient anywhere. Skilled nursing is federally regulated and surveyed. Assisted living is licensed by the state, under 51 sets of rules that do not even share a name for it. Assisted living runs about $5,400 to $6,200 a month, and the same apartment can cost $3,000 more as care needs rise.
| Service | Typical |
|---|---|
| Assisted livingNational median | $5,419 to $6,200 per month |
| Memory careNational median | $8,019 per month |
| In-home caregivingNational median | $34 to $35 per hour |
| Nursing home, semi-private roomNational median | $315 per day |
Ranges last checked September 2026. They come down automatically when they are due to be rechecked.
Every figure above comes from a named source we can link to, with the date we last checked it. We publish ranges rather than single prices because a range is what a provider will actually give you: the same job moves with what is being worked on, the materials, how hard it is to get at and how busy the trade is locally. Treat these as the order of magnitude to expect before you call, not as a quote.
The figures here are national. Where a source publishes figures state by state, the state pages carry that local figure instead of this one. We do not scale a national number by a multiplier of our own invention.
Every range carries a review date. When that date passes the number comes down until it is rechecked, rather than sitting here undated.
The word people use is one word, and the thing behind it is three. Knowing which one you are buying tells you who to complain to when it goes wrong.
Skilled nursing is federal. Nursing homes participating in Medicare and Medicaid are governed by 42 CFR Part 483, Subpart B, and are surveyed against those federal requirements by state agencies acting on behalf of the Centers for Medicare and Medicaid Services. Deficiencies are cited and published.
Hospice is federal. Hospices meet Medicare Conditions of Participation at 42 CFR Part 418, and a patient must use a Medicare-approved hospice. Hospice is a benefit rather than a building; it follows the patient into a home, an assisted living apartment, a nursing home or an inpatient unit.
Assisted living is state. There is no federal assisted living license, no federal staffing standard and no federal survey. States establish and enforce the licensing themselves across 51 jurisdictions, and they do not even agree on the name. Alabama, Arizona and Arkansas license Assisted Living Facilities; Alaska licenses Assisted Living Homes; California licenses Residential Care Facilities for the Elderly. What varies between them is not cosmetic: staffing requirements, training hours, who may administer medication, and the criteria for admitting and retaining a resident.
Memory care generally sits inside an assisted living license rather than having a category of its own, sometimes with a dementia-specific state endorsement.
The dividing line is clinical. Continuous medical care means federal oversight. Supportive and personal care means state licensure.
Assisted living is quoted as a monthly figure, and most families hear that figure as the price. It is the base. Care is assessed and charged in tiers on top of it, and the tier is reviewed on a schedule.
Across one large network of communities, the median base one-bedroom runs about $5,300 a month. Low-care services add around $600, medium-care around $1,500, high-care around $2,725. Medication management adds around $550. A resident who moves in at base and progresses to high care with medication management goes from roughly $5,300 to $8,575 a month, in the same apartment, without moving anywhere.
What triggers the increase is worth knowing in advance. A health change such as surgery, an injury or a hospital stay. Staff or family observing decline. And routine scheduled reviews, quarterly, twice a year or annually, which means the bill can rise without anything visible having happened.
The assessments are real instruments rather than an impression: the Katz Index, the Barthel ADL Index, the Functional Independence Measure, alongside practical tests such as a timed get-up-and-go. Ask which one the community uses and ask to see the scoring, because that document is what the price is attached to.
Under the Medicare hospice benefit, covered services carry no charge. Prescription drugs for pain and symptom management carry up to a $5 copayment each as an outpatient, and inpatient respite care carries 5 percent of the Medicare-approved amount. Eligibility requires a terminal illness certified by both the hospice doctor and the patient's own doctor, a life expectancy of six months or less, acceptance of comfort care in place of curative treatment, and a signed election statement.
Here is the part families are surprised by. Medicare does not cover room and board if hospice is provided at home, in a nursing home or in a hospice inpatient facility. A family in assisted living who elects hospice still pays the community's full monthly rate. Two bills, not one.
Every assisted living community has a point beyond which it may not safely keep a resident. When needs pass it, communities give a timeframe to arrange alternative placement, sometimes allow outside private caregivers to supplement, or transfer the resident to memory care or skilled nursing.
Where that ceiling sits is set by state admission and retention rules, so it is not in the same place in two states. It is a fair question to ask on the first tour rather than the last: what would have to happen for you to tell us we have to leave.
Work out which of the three you are actually buying, because it decides who regulates it and what public record exists. Nursing homes and hospices are surveyed and reported federally. Assisted living is not, and the record you can check is whatever your own state publishes.
Ask for the full fee schedule, not the monthly rate. The community fee, the second-person fee, medication management and the care tiers are where the difference between two quotes actually lives.
Ask what the current assessed level is, what the next level up costs, and how often the assessment is repeated. Then ask what the rate increase has been in each of the last three years. This page publishes no figure for that, because no source read gave a typical annual escalator, which is itself worth knowing.
On hospice, confirm the provider is Medicare-approved and confirm separately who is billing for the room. Those are two different organizations and two different bills.
On in-home care, ask about minimum hours per visit before you compare hourly rates. Agencies commonly impose one, and a four-hour minimum turns a one-hour visit into a four-hour bill.
Two authoritative sources differ by about 14 percent. CareScout's 2025 survey gives a $6,200 national median; A Place for Mom's 2026 network data gives a $5,419 median and a $5,830 average. Both are published here because they measure different populations.
A one-time community fee, national median around $3,000 and non-refundable. A second-person fee of about $1,200 a month for couples. Medication management at around $550. Therapy, grooming, parking, pet rent, internet and laundry.
Because care level is re-assessed on a schedule, quarterly, twice a year or annually, as well as after a health event. Across one large network, moving from base to high care with medication management takes a resident from about $5,300 to $8,575 a month in the same apartment.
The state. There is no federal assisted living license, no federal staffing standard and no federal survey. All 51 jurisdictions license it themselves, and they use different names for it, from Assisted Living Facility to Residential Care Facility for the Elderly.
The federal government. Nursing homes participating in Medicare and Medicaid answer to 42 CFR Part 483, Subpart B, surveyed by state agencies on behalf of CMS. Hospices meet Medicare Conditions of Participation at 42 CFR Part 418.
Covered hospice services carry no charge, with up to a $5 copayment per outpatient drug for pain and symptom management and 5 percent coinsurance on inpatient respite. Room and board is not covered, at home, in a nursing home or in a hospice facility.
A national median of $8,019 a month as of June 2026, with a state spread from about $5,538 in South Dakota to $14,399 in Hawaii. It typically runs 15 to 25 percent above assisted living.
About $34 to $35 an hour nationally, which is one of the few figures two independent sources agree on. The state spread runs from roughly $25 in Mississippi to $44 in South Dakota.