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An assisted living facility is a residential facility.  In addition to a place to live, assisted living facilities generally provide housekeeping, meals, transportation to doctors and treatments, activities and personal assistance. While assisted living homes are primarily for the elderly, they accept any residents who need assistance with living - so long as the assistance is not the kind of nursing requirements which are provided in a Nursing Home. Some retirement communities offer a assisted living by providing a place to live, meals and nursing care as needed.

Currently there is no federal oversight over the industry. Each state sets its own definition and decides what oversight and inspections are required.

There are no objective standards developed to assess assisted living homes.  If licensing is required in your state, restrict your search to licensed homes if there are any in your area. In addition to the protection of licensing, you can and should read the governing agency’s inspection report. You can ask the facility for a copy of inspection reports. (To learn about requirements in your state, through the Eldercare Locator: offsite link, Tel: 800.677.1116

It is advisable to visit and inspect the premises at least once, and preferably at least one other time. It would be helpful if one of the visits was not expected by the personnel at the home so you have a chance of seeing what life is really like there.


  • Medicare: As a general matter, Medicare does not pay for care in assisted living facilities unless certified skilled care is delivered. Most skilled living facilities are not certified. 
  • Medicaid: Medicaid pays for care in an assisted living facility in some states depending on amount of income and assets,  
  • Private health insurance: Most private health insurance plans do not cover assisted living facilities. However,  you can try to negotiate with the insurer for coverage based on the argument that staying in an assisted living facility is less expensive than going into a hospital.

Contracts: It is advisable to read the contract carefully - or have an attorney do it for you. The contract should include all the matters you care about, including a move to a nursing home or hospital and your right to be involved in the process.

NOTE:  Ideally, an assisted living facility would be linked to a nursing home in case there is a need to move to a higher level of care. If both faclities were in the same building(s) you would be able to move smoothly into the nursing home and back to the assisted living facility when and as appropriate.

For  additional information see

Factors To Consider When Deciding Whether To Enter An Assisted Living Facility:

Before entering an assisted living facility, consider whether you can continue to live at home or whether you need an assisted living facility. Consider the following factors.

If you need help making the decision, consider consulting a professional known as a "geriatric care manager".  In addition to exploring what is best for you, geriatric care managers can also provide information about the facilities in your area. (For information about geriatric care managers including how to locate and vet one, click here.) 

  • Can the services you need be provided at home? 
    • More and more services can be provided at home.
    • If the service can be provided at home, is it covered by your health plan? 
  • If the services you need cannot be provided at home, do you need a nursing home instead of an assisted living facility? If you will need ongoing medical care, a nursing home is the proper venue, not an assisted living facility. (For more information, see the document in "To Learn More.")
  • The cost and means available for paying your stay.
    • Will your insurance cover a stay in an assisted living facility?
    • If your insurance or a government program will pay, will the home accept the payment in full?
    • If you have no health coverage, does Medicaid in your state pay for care in an assisted living facility? If so, can you qualify for Medicaid? (See: Transfer Of Income And/Or Assets To Qualify For Medicaid)

How To Maximize A Stay In An Assisted Living Facility

In order to maximize your stay in an assisted living facility:

  • Personalize your room to the extent that you can to make yourself feel comfortable and at home.
  • If you have a roommate and the two of you don't get along, request a change.
  • Be an active participant in your care. 
    • Speak up about your needs and when you think you are not being treated well. 
    • Choose a family member or friend to act as a patient advocate to talk with the facility administration on your behalf when you aren't feeling well or if you are not up for speaking up for yourself. Remind that person that being courteous and friendly works better than anger - at least in most instances. Hopefully the person will know when it is necessary to push harder.
  • Keep in mind that federal and state laws give all residents of an assisted living facility the right to dignity, choice, quality services and activities and to self-determination. 
  • Try to resolve problems through discussion. Since there is strength in numbers:
    • It may help to get other residents of the assisted living facility to approach the facility administrator together to request a change. 
    • Consider joining together to create a Resident Council. You can find information about Resident Councils at offsite link, click on Residents. 
  • If there are problems that are not resolved through discussion:
    • Contact your state's Ombudsman. 
      • Part of his or her job is to help people in assisted living facilities.
      • You can locate your state's Ombudsman through offsite link or the Eldercare Locator at www.EldercareLocator.go offsite linkv or by calling 800.677.1116.
      • Contact other state agencies which help people in a skilled nursing facility. You can locate the agencies through  offsite linkClick on Resident, then Assisted Living, , then Getting Help
    • If there is abuse, neglect or exploitation, contact your county's Adult Protective Services office.
If problems are not resolved, and if the subjects are important to you, consider moving to another assisted living facility.