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

17 minute readLast updated March 28, 2025
Written by Susanna Guzman
fact checkedby
Danny Szlauderbach
Reviewed by Sarah Mitchell, MSW, senior living expertSarah Mitchell, MSW, is a senior manager of community onboarding with A Place for Mom and has been helping families for over 25 years.
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The biggest differences between assisted living communities and board and care homes for seniors are the size of the community and the amenities offered. Assisted living communities typically have more than 25 residents, while board and care homes have fewer than 10. Both settings provide help with grooming, toileting, and basic health monitoring. Both also provide daily meals and help with mobility, but assisted living communities tend to offer a wider variety of amenities and services.

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Key Takeaways

  1. Assisted living communities typically host at least 25 residents. They provide the same type of nonmedical care as board and care homes.
  2. Board and care homes are smaller than assisted living communities, providing a home and assistance with daily living to about 10 residents at a time.
  3. Although board and care homes provide higher staff-to-resident ratios, assisted living communities are more expensive because of the amenities, services, and activities they offer.

Levels of care in senior living

The amount of help a person needs to complete activities of daily living, or ADLs, determines the level of nonmedical care they need. Generally, there are three levels of care in assisted senior living:

  • Level 1: Needs little to no help with any ADLs
  • Level 2: Needs help with more than one ADL
  • Level 3: Needs help from more than one caregiver to complete multiple ADLs

What is assisted living?

Assisted living communities provide residents with a private living space and assistance with ADLs in an apartment-style setting.

Because assisted living offers a similar level of care as a board and care home, it’s ideal for seniors who need help with daily tasks like bathing and dressing but don’t need ongoing medical care.

“Each state has its own way of regulating and licensing assisted living facilities, which affects what care the facility can provide,” says A Place for Mom’s Niki Gewirtz, who has more than two decades of experience managing residential care communities.

As with board and care homes, assisted living facilities will vary in what care they provide.

What is a board and care home?

Board and care homes – also known as residential care homes, adult family care homes, group homes, adult foster care homes, and personal care homes – are houses in residential neighborhoods that are equipped and staffed to help residents with their daily routines. Assistance is focused on ADLs and other daily care needs. Board and care homes typically house between two and 10 residents.

Regulations and licensing requirements vary from state to state. Before you choose a residential care home, it’s a good idea to understand your state’s licensing regulations and how oversight works. Some care homes offer additional care services, depending on who the owner or operator is and how they’re licensed. For example, some care homes are led by people in the medical field, such as a nurse or therapist. Each home will vary somewhat in what care is available.

Is assisted living the right fit?

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Services

Assisted living communities and board and care homes are most alike in terms of who lives there and what kind of care services they provide. Nearly all facilities in both settings host men and women, and nearly all offer common personal care services such as:

  • Mobility assistance
  • Incontinence care
  • Bathing and dressing assistance
  • Medication management

“Not all assisted living communities or board and care homes are able to provide health care services like diabetes management or memory care,” says Gewirtz. “Not every community is set up for memory care, and some states require specific criteria be met before a community can advertise that they provide memory care,” she explains.

Amenities

Assisted living communities and board and care homes differ most in terms of the activities, community amenities, and dining options they provide. In general, assisted living communities tend to offer more of each.[01] For example:

  • Onsite devotional activities. About 76% of assisted living communities offer these compared with 38% of board and care homes.
  • Complimentary transportation. Nearly 73% of assisted living communities offer this service, compared with nearly 38% of board and care homes.
  • Room service. About 64% of assisted living communities offer this convenience compared with 20% of board and care homes.

Cost

According to A Place for Mom’s 2025 Cost of Long-term Care and Senior Living report, the national median monthly cost of assisted living is $5,190 while the national median monthly cost of a care home is $4,200.[02]

For both options, the price depends on the size of the resident’s living space, location of the home or community, supply and demand, the local cost of living, and services and amenities offered. For instance, most communities in California cost more than communities in Kansas, and communities that offer dementia care cost more than those that don’t.

It’s worth noting that board and care homes are usually owned and operated by very small businesses and tend to have more lower-cost options than assisted living communities. These smaller businesses may be more open than larger corporations to negotiating prices.

How to choose: Assisted living or a board and care home?

After cost, personal preferences tend to determine whether families choose an assisted living community or a board and care home for their loved ones.

When is assisted living the right fit?

Assisted living communities are more like all-inclusive hotels for seniors and may be the right choice for people who are looking for:

  • A variety of dining options and menus, sometimes including happy hours
  • A suite or larger apartment
  • New friends or social activities
  • Outings to local stores, theaters, and museums
  • Minimal to moderate help with ADLs
  • An active lifestyle and access to transportation
  • A faith-based community, such as Jewish assisted living

When a community is a good fit, families and their loved ones often feel at peace. The staff members and amenities also support a smooth transition.

The Keeble family had this to say about Colonial Oaks at Leawood, an assisted living community in Leawood, Kansas: “My brothers and I are thrilled with our mother’s care. It is her home. From the front desk staff to activity staff, culinary staff, and nursing staff, we could not have chosen a better place for our mom. She has actually improved since living there. She is thriving.”

For Nina, whose mother lives at Sunrise at East 56th in New York, New York, activities played a large part in her family’s experience.

“We moved my mom there about 6 months ago and we haven’t seen her this happy in a while. She is busy from sunup to sundown. The staff is beyond caring and wonderful. They are very attentive to all the residents and always have a smile on their face.”

When is a board and care home the right fit?

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

  • Prefer a smaller, cozy, intimate, and homelike environment
  • Want the privacy of a bedroom without all the responsibilities of an entire apartment, such as housekeeping
  • Want more interaction and attention from staff
  • Need help with mobility
  • Enjoy a relaxed, less structured environment

Seniors and their family members who are happy with the care home they’ve chosen report that it feels like home and often appreciate the personalization that comes with living in a small group.

“The owners, management, and staff are very attentive to [my dad’s] needs and make it feel like his home. Because it is only a 16-person facility, they are able to keep it very personal and also provide well above average meals, which is important to my dad,” says Kay Krenek in a review of Fairbanks Court Assisted Living, a board and care home in Houston, Texas.

Sue B. had similar things to say when reviewing Lakota Hills Senior Care in Federal Way, Washington. “My mother has been a resident of Lakota for a little over a year. She gets outstanding care from people who are very competent and most important extremely patient and caring. The [caregivers] treat the residents with respect and give them all the attention and care they require.”

Assisted living questions? Get expert help

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How do I learn more about senior living options?

Senior living choices have expanded as older adults’ needs and expectations have changed. Finding the best option for your loved one is crucial for keeping them healthy, active, and safe. Regardless of whether you’re considering an assisted living community or a board and care home, the best way to ensure a good fit is by touring several communities.

At no cost to you, our Senior Living Advisors can guide you through all the senior living options and help you find the right fit for your family. They’ll show you the options in your area that are best suited to your loved one’s needs and priorities and can even arrange tours for you free of charge.

Please note that communities are listed in this article for illustrative purposes only and A Place for Mom does not recommend or endorse any of these communities.

Families also ask

Yes. There are several residential care options for people who have mental illness. These communities may be called behavioral assisted living or behavioral health assisted living.

Yes, you can certainly visit your loved one in a board and care home. Ask the staff if there are specific visiting hours, and what the guidelines are for joining during mealtimes and activities.

SHARE THE ARTICLE

  1. A Place for Mom. (2025). A Place for Mom proprietary data.

  2. A Place for Mom. (2025). Cost of long-term care and senior living.

Written by
Susanna Guzman
Susanna Guzman is a professional writer and content executive with 30 years of experience in medical publishing, digital strategy, nonprofit leadership, and health information technology. She has written for familydoctor.org, Mayo Clinic, March of Dimes, and Forbes Inc., and has advised Fortune 500 companies on their content strategy and operations. Susanna is committed to creating content that honors the covenant between patients and their providers.
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Danny Szlauderbach is a Video Producer and a former Managing Editor at A Place for Mom, where he's written or reviewed hundreds of articles covering a wide range of senior living topics, from veterans benefits and home health services to innovations in memory care. Since 2010, his editing work has spanned several industries, including education, technology, and financial services. He’s a member of ACES: The Society for Editing and earned a degree in journalism from the University of Kansas.
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Sarah Mitchell joined APFM in 2004 as a Senior Living Advisor and has been a senior manager of community onboarding since 2019. With over 20 years of experience in senior housing, Sarah has guided families on memory care, assisted living, independent living, skilled nursing, and hospice care.
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