This article examines recent developments in Switzerland’s policies for long-term care (LTC), focusing on housing for older adults that includes care. Like many European countries seeking to reduce institutional care costs as their populations age, Switzerland has developed housing options that lie somewhere between institutions and individual homes. Since the late 2000s, these have been the focus of several social and health policy reforms. In this paper, we draw on documentary sources and nineteen semi-structured interviews, conducted in 2022, with officials responsible for implementing these housing policies in various Swiss cantons. Using the narrative policy framework, we show how decentralized governance produces divergent care narratives and modes of public intervention. We identify three models of housing with social care policies that reflect standardization, diversification, and government nonintervention. We also explore how the interplay of narratives regarding the state’s role, target populations, and the type of support required shapes policy design, housing supply, and resource distribution. In investigating a policy area that has received little attention in social care policy analysis, our findings contribute meaningfully to the LTC policy literature.