Nursing Home, Assisted Living or Supportive Living? How Illinois Licenses Senior Care in Chicago

Information checked October 23, 2026. Rules, ratings and prices change; confirm anything you rely on with the facility and the agency named below. This article is general information, not medical, legal or financial advice.

“Senior living” is a marketing phrase. In Illinois, what a building is allowed to do for a resident depends on its licence, and there are six of them. A nursing home, an assisted living building and a supportive living building can look alike from the street. They differ in who regulates them, what care they can give, and who pays.

This guide explains each type, who licenses it, and where to check a specific Chicago facility yourself. It is part of our guide to choosing care for a parent in Chicago.

The six types at a glance

Type	Illinois licence	Regulator	Who usually pays
Nursing home (skilled nursing, rehab)	Nursing Home Care Act	Illinois Department of Public Health (IDPH); Medicare and Medicaid certification by CMS	Medicaid for long stays; Medicare for short rehab stays; private pay
Assisted living	Assisted Living and Shared Housing Act	IDPH	Mostly private pay
Shared housing (small group home)	Assisted Living and Shared Housing Act	IDPH	Mostly private pay
Supportive living	Supportive Living Program	Illinois Department of Healthcare and Family Services (HFS), the state Medicaid agency	Medicaid pays for services; the resident pays rent
Life plan community (CCRC)	Life Care Facilities Act permit	IDPH Life Care Program	Entrance fee plus monthly fee
55+ or 62+ housing	No care licence; federal fair housing rules	HUD	Rent or purchase; some buildings subsidized

“Memory care” and “independent living” are not on this list because neither is a separate licence in Illinois. Memory care is a unit or program inside one of the licensed types. Independent living is housing, sometimes with optional services sold by contract.

Nursing homes

A nursing home provides round-the-clock nursing care. IDPH licenses it, and almost every one in Chicago is also certified by the federal Centers for Medicare & Medicaid Services (CMS), which publishes inspection results, staffing and an overall star rating for each.

Illinois sets a minimum of 3.8 hours of nursing and personal care a day for a resident who needs skilled care, and 2.5 hours for intermediate care. Medicaid is the main payer: it covered about 70% of Illinois nursing home days in 2023, according to HFS. Medicare pays only for limited short-term skilled stays, typically after a hospital admission.

Quality varies widely. In the CMS file published in September 2026, Chicago had 77 Medicare-certified nursing homes. Thirty-two held the lowest overall rating of one star, and 14 were rated four or five stars. Ratings are updated quarterly, so check the current rating rather than relying on an older list, including this one.

Assisted living

Assisted living establishments are licensed by IDPH. They offer apartments with meals, help with daily activities such as bathing, dressing and medications, and staff on site, but not the continuous skilled nursing of a nursing home. Illinois law treats the resident’s unit as their own home.

Assisted living in Illinois is mostly paid privately. CareScout’s 2025 Cost of Care Survey put the Illinois median at $72,645 a year for a private one-bedroom, and U.S. News cites a Chicago-area median of $7,350 a month from the same survey. Actual prices depend on the apartment and the level of care, so ask each community for its written rate sheet and what triggers a higher care level.

Shared housing

Shared housing establishments are licensed under the same Act as assisted living but are small, house-style settings with a limited number of residents. They can suit someone who wants assisted living in a smaller, quieter setting. Check the IDPH directory to confirm a home is licensed.

Supportive living

Supportive living is Illinois’s Medicaid alternative to a nursing home. HFS certifies these facilities for low-income people aged 65 and older, and some sites serve adults aged 22 to 64 with physical disabilities. Residents have a private apartment with a kitchen, a private bathroom and a lockable door, and receive assisted-living-style services.

Medicaid pays for the care; residents pay for housing from Social Security or other income. Chicago has about 20 supportive living sites on HFS’s Cook County list, and some are certified as dementia care settings. Because most private referral services do not place Medicaid-funded residents, supportive living is easy to miss. Our supportive living guide explains who qualifies and lists the Chicago sites.

Memory care

Any licensed facility in Illinois that advertises an Alzheimer’s or dementia unit must prepare a written disclosure under the Alzheimer’s Disease and Related Dementias Special Care Disclosure Act. Ask for it before touring. It should explain:

what makes the program suitable for people with dementia, and its philosophy of care
how residents are assessed and care is planned
staffing ratios and staff training
the role of family members
the costs of care in the program

A facility that cannot produce this document is a facility to ask more questions of.

Life plan communities (CCRCs)

A continuing care retirement community, or life plan community, offers independent living with assisted living and nursing care on the same campus. In Illinois, a community that charges an entrance fee for a contract that includes care needs a permit under the Life Care Facilities Act. About 90 facilities hold one, most in the Chicago area, according to IDPH.

Entrance fees are large; the Chicago Tribune has reported a typical range of $250,000 to $400,000 or more, plus monthly fees. The Act requires a reserve covering six months of debt payments, but it does not require a community to set aside enough to refund entrance fees. Before signing, read the contract’s refund terms and the community’s financial statements, and consider having an attorney review it. You can confirm a community’s permit with the IDPH Life Care Program.

55+ and 62+ housing

Age-restricted housing is housing, not care. Under federal fair housing rules, a “55 and older” community must have at least one person aged 55 or older in at least 80% of its occupied units, and must publish and follow age-verification policies. A “62 and older” building must be occupied entirely by people 62 or older.

Inside Chicago, most age-restricted housing is affordable or public housing. The Chicago Housing Authority operates 52 senior-designated developments in 65 buildings. Market-rate “active adult” communities are mostly in the suburbs.

How to check a Chicago facility yourself

Nursing homes: Medicare Care Compare shows each home’s star rating, inspection reports, staffing and ownership.
Assisted living and shared housing: the IDPH licensed establishments directory.
Supportive living: the HFS Cook County supportive living list.
Life plan communities: the IDPH Life Care Facilities Program, which can confirm whether a community holds a permit.
Complaints and advocacy: the Illinois Long-Term Care Ombudsman Program advocates for residents of long-term care facilities.
City help: Chicago’s Department of Family and Support Services runs the city’s Area Agency on Aging. Its Senior Services hotline is 312-744-4016, weekdays 9 a.m. to 5 p.m.

Sources

About this guide

This is general information, not medical, legal or financial advice. Talk to your parent’s doctor, an elder law attorney or a financial adviser about your own situation.
ChicagoRealEstate.ai is independent. It is not affiliated with or endorsed by HFS, IDPH, CMS, the City of Chicago or any facility named here.
Naming a facility is not a recommendation. The site does not recommend, rank or refer families to any facility or broker.
Rules, rates and facility details change. Facts were checked on the date at the top of the page; confirm anything you rely on with the agency or the facility.
The site is run by Joe Bjorklund, a licensed Illinois real estate broker with Baird & Warner.
Found an error? Tell us and we will check it against the source.

If you are worried about someone’s safety

If someone is in immediate danger, call 911. To report abuse, neglect or financial exploitation of an adult 60 or older, or of an adult 18 to 59 with a disability living in the community, call the Illinois Adult Protective Services hotline at 1-866-800-1409, 24 hours a day (Illinois Relay: 711). To complain about a nursing home or assisted living facility, call the IDPH Central Complaint Registry at 800-252-4343, weekdays 8:30 a.m. to 4:30 p.m.