Colorado Springs Senior AdvisorWhat is the real difference between an ALR and a nursing home in Colorado?
An assisted living residence provides housing, meals, personal care and supervision under a CDPHE ALR license; a nursing home provides 24-hour licensed nursing and rehabilitation under a CDPHE nursing facility license and, if certified, federal CMS rules.
The practical line is skilled care. Someone who needs a nurse's judgment every day, daily injections that they cannot manage, complex wound care, or two people to transfer at all hours usually needs a nursing home. Someone who needs help bathing, dressing, remembering medications and getting to meals is usually an assisted living resident.
How do costs compare between assisted living and nursing homes in Colorado?
CareScout's 2025 Colorado medians are about $6,584 a month for assisted living and $10,159 for a semi-private nursing home room, so a nursing home costs roughly half again as much when paid privately.
The payer often differs too. Medicare covers short skilled nursing stays after a hospital admission and never covers assisted living; Health First Colorado covers long nursing home stays and, through the EBD waiver, only the care portion in an ACF.
Who checks quality in each setting in Colorado Springs?
CDPHE inspects both; certified nursing homes also get federal surveys, CMS star ratings, staffing data and penalty records on Care Compare, while assisted living has no federal ratings at all.
That is why our nursing home pages carry CMS stars and our ALR pages carry the CDPHE inspection and occurrence history instead. CDPHE licenses 21 nursing facilities in El Paso and Teller counties with 1,929 beds, and CMS rates 21 of them, 8 at four or five stars overall (Care Compare data as of October 1, 2026).
Can someone move from assisted living to a nursing home and back?
Yes. A short nursing home stay for rehab after a hospital admission is common, and many residents return to their ALR afterward if the residence agrees it can meet their needs again.
Ask the ALR before a crisis how long it holds an apartment during a hospital or rehab stay and whether rent continues. Campuses with both licenses, such as Brookdale Skyline's assisted living and skilled nursing at Patriot Heights, can make the transition easier.
Side by side
| Assisted living residence | Nursing home | |
|---|---|---|
| License | CDPHE ALR (6 CCR 1011-1 Chapter 7) | CDPHE nursing facility, plus CMS certification |
| Care | Personal care and supervision | 24-hour licensed nursing and rehab |
| Medicare | Pays none of the residence's charges | Pays short skilled stays after a hospital admission |
| Ratings | None; CDPHE inspection record | CMS five-star ratings |
Drawn from 6 CCR 1011-1 Chapter 7, CDPHE and HCPF publications, CareScout, CMS, the VA and the Pikes Peak Area Agency on Aging; our editorial standards explain how we check them.
