Daytona Beach Senior AdvisorWhat separates assisted living from a nursing home in Florida?
Nursing: a nursing home provides licensed nursing care around the clock under Chapter 400, while an ALF provides housing, supervision and personal care under Chapter 429 and may not keep a resident who needs 24-hour nursing supervision or is bedridden (unless on hospice).
Volusia and Flagler have 31 AHCA-licensed nursing homes with 3,667 beds between them; 31 carry a CMS overall rating and 20 of those have four or five stars (Care Compare data as of October 1, 2026). Most nursing homes also run short-stay rehab units, which is where many people go straight from the hospital.
Who belongs in a nursing home rather than an ALF?
Someone who needs skilled nursing every day, cannot transfer even with help, has a stage 3 or 4 pressure sore, needs IV therapy, tube feeding or similar care, or is recovering from surgery with complex wounds belongs in a nursing home, at least for a while.
Many people move to a nursing home for rehab, regain strength over a few weeks, and then move to assisted living or home. Plan for the second move while the first is underway.
How does payment differ?
Medicare can pay for up to 100 days of skilled nursing home care after a three-day inpatient stay, and Florida Medicaid pays for long-term nursing home care once limits are met; for assisted living, Medicare pays nothing toward rent or care and Medicaid pays only for services.
That difference means a family with modest savings may find a nursing home more affordable over the long run than assisted living, even though its sticker price is higher. Florida's 2025 medians are about $10,342 a month for a shared nursing home room and $5,500 for assisted living.
How do we compare the quality of each?
For nursing homes, start with CMS Care Compare: overall, inspection, staffing and quality stars, nurse hours per resident per day and staff turnover; for ALFs, use AHCA's inspection history and sanctions, because Florida does not rate assisted living.
Our directory puts both kinds of record on one page per facility, with the two-county medians for comparison.
What should we decide first after a hospital stay?
Ask the discharge planner what level of care is being recommended and why, whether the stay qualifies for Medicare skilled nursing coverage, and which nursing homes have a bed; choose the rehab setting first and the longer-term home second.
Our hospital discharge guide walks through the timeline step by step.
At a glance
| A nursing home | An assisted living facility | |
|---|---|---|
| Nursing | Licensed nurses 24 hours a day | Personal care, with limited nursing under LNS or ECC |
| Ratings | CMS stars and federal inspections | AHCA inspection records, no stars |
| Payment | Medicare for rehab, Medicaid for long stays | Mostly private, Medicaid for services only |
Sources: Chapters 408, 429 and 651, Florida Statutes; Florida Administrative Code chapters 59A-36 and 65A-2; publications of AHCA, DCF, OIR and the Department of Elder Affairs; and the CareScout and VA tables named on the page. See our editorial standards for how figures are checked.
