Nursing Homes Outperform Assisted Living on Vaccinations — and Residents Pay Fewer Hospital Bills Because of It

A new peer-reviewed study has found that nursing homes are doing something assisted living communities often aren’t: keeping residents vaccinated — and out of the hospital.

The research, published in February 2026, compared vaccination program participation across seven vaccine-preventable illnesses in nursing homes and assisted living communities across the United States. The findings were clear: nursing homes were significantly more likely to run formal vaccination programs for those conditions, and their residents were hospitalized for those illnesses at lower rates as a result.

Researchers used logistic regression models to understand which organizational factors drove the gap, looking at variables like facility size, rural location, and ownership status. The results held up across settings — nursing homes consistently led on both participation and outcomes.

A Tale of Two Settings

The contrast matters because it speaks to a wider divide in how long-term care settings are regulated and resourced. Nursing homes operate under federal Medicare and Medicaid oversight, which includes vaccination reporting requirements through the National Healthcare Safety Network. Assisted living facilities, by contrast, are governed at the state level and face far less uniform pressure to maintain vaccination programs.

That regulatory gap appears to have real consequences. When residents aren’t vaccinated against illnesses like influenza, pneumonia, or shingles, they’re more likely to end up in an acute care setting — and that’s a costly outcome for everyone involved.

Why This Matters Now

The findings land at a moment when the long-term care industry is increasingly focused on keeping residents out of the hospital. As industry reports have noted, that trend extends beyond vaccination: facilities with stronger clinical programs — from structured end-of-life planning protocols to better discharge coordination — are consistently seeing lower acute care transfer rates.

Vaccination is one of the lowest-cost, highest-impact interventions available to nursing homes. The study’s authors suggested their work offers a roadmap for assisted living communities looking to close the gap — particularly as state regulators and families pay more attention to preventable hospitalizations.

For operators running nursing home and assisted living campuses side by side, the message is direct: the vaccination practices already in place on the skilled nursing side of the building are worth extending across the hall.