A Guide to State Regulations & Terminology
Assisted Living Communities offer housing alternatives for older adults who may need help with dressing, bathing, eating, and toileting, but do not require the intensive medical and nursing care provided in nursing homes.
Assisted living facilities may be part of a retirement community, nursing home, senior housing complex, or may stand-alone. Licensing requirements for assisted living facilities vary by state and can be known by as many as 26 different names including: residential care, board and care, congregate care, and personal care.
A complete list of each state’s terminology and state regulations can be found online.
What services are provided?
Residents of assisted living facilities usually have their own units or apartment. In addition to having a support staff and providing meals, most assisted living facilities also offer at least some of the following services:
- Health care management and monitoring
- Help with activities of daily living such as bathing, dressing, and eating
- Housekeeping and laundry
- Medication reminders and/or help with medications
- Recreational activities
How to choose a facility?
A good match between a facility and a resident’s needs depends as much on the philosophy and services of the assisted living facility as it does on the quality of care.
The following suggestions can help you get started in your search for a safe, comfortable and appropriate assisted living facility:
- Think ahead. What will the resident’s future needs be and how will the facility meet those needs?
- Is the facility close to family and friends? Are there any shopping centers or other businesses nearby (within walking distance)?
- Do admission and retention policies exclude people with severe cognitive impairments or severe physical disabilities?
- Does the facility provide a written statement of the philosophy of care?
- Visit each facility more than once, sometimes unannounced.
- Visit at meal times, sample the food, and observe the quality of mealtime and the service.
- Observe interactions among residents and staff.
- Check to see if the facility offers social, recreational, and spiritual activities?
- Talk to residents.
- Learn what types of training staff receive and how frequently they receive training.
- Review state licensing reports.
The following steps should also be considered:
- Contact your state’s long-term care ombudsman to see if any complaints have recently been filed against the assisted living facility you are interested in. In many states, the ombudsman checks on conditions at assisted living units as well as nursing homes.
- Contact the local Better Business Bureau to see if that agency has received any complaints about the assisted living facility.
- If the assisted living facility is connected to a nursing home, ask for information about it, too. (Information on nursing homes can be found on the Medicare website).
What is the cost for assisted living?
Although assisted living costs less than nursing home care, it is still fairly expensive. Depending on the kind of assisted living facility and type of services an older person chooses, the price costs can range from less than $10,000 a year to more than $50,000 a year. Across the U.S., monthly rates average $1,800 per month.
Because there can be extra fees for additional services, it is very important for older persons to find out what is included in the basic rate and how much other services will cost.
Primarily, older persons or their families pay the cost of assisted living. Some health and long term care insurance policies may cover some of the costs associated with assisted living. In addition, some residences have their own financial assistance programs.
The federal Medicare program does not cover the costs of assisted living facilities or the care they provide. In some states, Medicaid may pay for the service component of assisted living. Medicaid is the joint federal and state program that helps older people and those with disabilities pay for health care when they are not able to afford the expenses themselves. Additional information on financing can be obtained from the resources listed below.
Where can I learn more about assisted living?
Older persons who want to find out more about the assisted living option can start by contacting their local area agency on aging (AAA). Contact the U.S. Administration on Aging’s Eldercare Locator at 1-800-677-1116 or visit to find the AAA office closest to you.
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