State-by-State Guide to Assisted Living

Regulatory Agency

Regulatory Overview

Alabama licenses two types of assisted living facilities: standard and specialty care (for residents with dementia or Alzheimer's). Each type is categorized by size: Family (2-3 residents), Group (3-16 residents), and Congregate (17+ residents). Specialty care facilities must meet additional requirements.

What Facilities Are Called

Assisted Living Facilities and Specialty Care Assisted Living Facilities

Legal Definition

An assisted living facility provides residence, health supervision, and personal care to three or more individuals who need help with activities of daily living. Specialty care facilities are additionally licensed to care for residents with cognitive impairments.

Regulatory Agency

Regulatory Overview

Alaska's Division of Health Care Services licenses assisted living homes. Providers determine the level of care and services they offer but must register their service list with the state.

What Facilities Are Called

Assisted Living Homes

Legal Definition

An assisted living home provides care in a homelike environment for elderly persons and persons with disabilities who need help with activities of daily living. The facility must serve three or more unrelated adults and provide housing, food, and personal assistance.

Regulatory Agency

Regulatory Overview

Arizona's Bureau of Residential Facilities Licensing licenses assisted living facilities, sub-classified by size and level of services. All facilities must comply with resident rights, food service, abuse reporting, and resident agreement requirements.

What Facilities Are Called

Assisted Living Facilities

Legal Definition

An assisted living facility is a residential care institution, including adult foster care, that provides supervisory care, personal care, or directed care services on a continuing basis.

Regulatory Agency

Regulatory Overview

Arkansas licenses assisted living facilities at two levels. Level II facilities must employ a registered nurse, while Level I facilities do not have this requirement. Both levels share the same general licensing requirements unless otherwise noted.

What Facilities Are Called

Assisted Living Facilities (Level I and Level II)

Legal Definition

An assisted living facility provides housing, meals, personal services, and limited nursing services for more than three adult residents for periods exceeding 24 hours. Services may be provided directly or through contractual arrangements.

Regulatory Agency

Regulatory Overview

California's Community Care Licensing Division licenses Residential Care Facilities for the Elderly (RCFEs), which may also be known as assisted living facilities, retirement homes, or board and care homes.

What Facilities Are Called

Residential Care Facilities for the Elderly (RCFE)

Legal Definition

An RCFE is a housing arrangement where at least 75% of residents are 60 or older, providing varying levels of care and supervision. Facilities range from small homes to large communities.

Regulatory Agency

Regulatory Overview

Colorado licenses assisted living residences (ALRs). Facilities that provide a secure environment or receive Medicaid reimbursement must meet additional requirements. Reduced licensing fees are available for facilities with significant Medicaid enrollment.

What Facilities Are Called

Assisted Living Residences

Legal Definition

An ALR provides room, board, personal services, protective oversight, social care, and 24-hour supervision to three or more unrelated adults who cannot live fully independently but do not require round-the-clock medical or nursing care.

Regulatory Agency

Regulatory Overview

Connecticut licenses assisted living services agencies that serve residents of managed residential communities. The agencies must be licensed while the communities themselves register with the Department of Public Health. Alzheimer's special care programs have separate licensure requirements.

What Facilities Are Called

Assisted Living Services Agencies in Managed Residential Communities

Legal Definition

Assisted living services agencies provide nursing services and help with daily living activities. A managed residential community offers private residential units in a group living environment, primarily for residents age 55 and older.

Regulatory Agency

Regulatory Overview

Delaware's Division of Health Care Quality licenses assisted living facilities for medically stable persons who do not require skilled nursing services and supervision.

What Facilities Are Called

Assisted Living Facilities

Legal Definition

Assisted living is a combination of housing, supportive services, supervision, personalized assistance, and health care designed to help those who need assistance with activities of daily living.

Regulatory Agency

Regulatory Overview

D.C. licenses two types of residential care: Community Residence Facilities (CRFs) and Assisted Living Residences (ALRs). ALRs can provide a higher level of care than CRFs.

What Facilities Are Called

Community Residence Facilities (CRF) and Assisted Living Residences (ALR)

Legal Definition

A CRF provides sheltered living for ambulatory adults who can perform daily activities with minimal help. An ALR combines housing, health services, and personalized assistance through individually developed service plans.

Regulatory Agency

Regulatory Overview

Florida licenses assisted living facilities ranging from one resident to several hundred. Facilities can obtain specialty licenses for limited nursing services, extended congregate care, and limited mental health services, allowing residents to age in place.

What Facilities Are Called

Assisted Living Facilities

Legal Definition

An assisted living facility provides personal care services in a homelike environment. It offers housing, meals, and one or more personal services for periods exceeding 24 hours to adults who are not relatives of the owner or administrator.

Regulatory Agency

Regulatory Overview

Georgia licenses two types of residential care: Personal Care Homes (PCHs) and Assisted Living Communities (ALCs). ALCs have more stringent standards than PCHs regarding services, staffing, training, and physical plant requirements. Facilities offering memory care must meet additional requirements.

What Facilities Are Called

Personal Care Homes (PCH) and Assisted Living Communities (ALC)

Legal Definition

A PCH provides housing, food, and personal services for two or more unrelated adults. An ALC is a personal care home serving 25+ residents that provides specialized assisted living care including medication administration by certified aides.

Regulatory Agency

Regulatory Overview

Hawaii's Office of Health Care Assurance licenses assisted living facilities.

What Facilities Are Called

Assisted Living Facilities

Legal Definition

An assisted living facility consists of a building complex offering dwelling units to individuals, along with services to help residents maintain an independent assisted living lifestyle.

Regulatory Agency

Regulatory Overview

Idaho licenses residential assisted living facilities with the purpose of providing choice, dignity, and independence to individuals needing help with daily activities. Licensing rules establish standards for maintaining a safe and healthy environment.

What Facilities Are Called

Residential Assisted Living Facilities

Legal Definition

A residential assisted living facility provides supervision, personal assistance, meals, and lodging to three or more adults not related to the owner.

Regulatory Agency

Regulatory Overview

Illinois regulates assisted living and shared housing establishments under one set of rules. Assisted living requires private apartment units, while shared housing does not. Supportive living facilities that accept Medicaid are a separate category.

What Facilities Are Called

Assisted Living Establishments and Shared Housing Establishments

Legal Definition

An assisted living establishment provides community-based residential care for at least three unrelated adults (at least 80% age 55+) who need help with daily activities. Services include personal, supportive, and health-related care available 24 hours per day.

Regulatory Agency

Regulatory Overview

Two Indiana agencies oversee assisted living: the Department of Health (IDOH) licenses residential care facilities, while the Family and Social Services Administration maintains a registry for Housing with Services Establishments. Facilities providing medication administration or nursing care must be licensed.

What Facilities Are Called

Residential Care Facilities

Legal Definition

A residential care facility provides residential nursing care, which may include identifying health conditions, deriving nursing diagnoses, and executing care regimens as prescribed by healthcare professionals.

Regulatory Agency

Regulatory Overview

Iowa's DIAL certifies assisted living programs (ALPs), which is the functional equivalent of licensure. Programs can also obtain dementia care certification by meeting additional staffing and safety requirements.

What Facilities Are Called

Assisted Living Programs and Dementia-Specific Assisted Living Programs

Legal Definition

Assisted living provides housing with health-related care, personal care, and help with daily activities for three or more tenants in a homelike environment. Programs must have 24-hour response staff and encourage family involvement, self-direction, and independence.

Regulatory Agency

Regulatory Overview

Kansas licenses three types of residential care settings: assisted living facilities, residential health care facilities, and Home Plus residences. Each type has different capacity and service requirements.

What Facilities Are Called

Assisted Living Facilities, Residential Health Care Facilities, and Home Plus

Legal Definition

An assisted living facility cares for six or more individuals who may need personal care and supervised nursing assistance. Facilities provide apartments and coordinate services available 24/7 to support resident independence.

Regulatory Agency

Regulatory Overview

Kentucky's Office of Inspector General licenses assisted living communities. These are private business entities with no public funding available for their services. Three licensure options exist: Social Model, Basic Health Services, and Dementia Care.

What Facilities Are Called

Assisted Living Communities (Social Model, Basic Health Services, or Dementia Care)

Legal Definition

An assisted living community provides sleeping accommodations and assisted living services to five or more adult persons not related to the owner or manager.

Regulatory Agency

Regulatory Overview

Louisiana licenses four levels of adult residential care based on facility size, setting type, and services provided. These range from small home-like settings (Level 1, 2-8 residents) to large communities with independent apartments (Levels 3 and 4, 17+ residents).

What Facilities Are Called

Adult Residential Care Providers (Levels 1-4)

Legal Definition

An adult residential care provider offers housing, meals, assistance with daily living activities, and lodging to two or more unrelated adults. Levels vary by capacity and whether units include independent apartments with kitchenettes.

Regulatory Agency

Regulatory Overview

Maine licenses several types of facilities under the umbrella term "assisted housing programs," including assisted living programs (which offer private apartments) and residential care facilities (which offer private or semi-private bedrooms). Some facilities receiving Medicaid must comply with additional rules.

What Facilities Are Called

Assisted Housing Programs, Assisted Living Programs, and Residential Care Facilities

Legal Definition

Assisted housing services include providing personal care, meals, medication management, lodging, and supervision. Assisted living programs specifically offer services in private apartments, while residential care facilities use private or semi-private bedrooms.

Regulatory Agency

Regulatory Overview

Maryland's Office of Health Care Quality licenses assisted living programs based on three levels of care. There is no minimum number of residents required for licensure. Facilities adding Alzheimer's special care units must notify the state.

What Facilities Are Called

Assisted Living Programs

Legal Definition

An assisted living program provides housing, supportive services, supervision, personalized assistance, and health-related services to residents who need help with daily living activities, promoting optimum dignity and independence.

Regulatory Agency

Regulatory Overview

Massachusetts certifies assisted living residences through the Executive Office of Elder Affairs. These residences offer housing, meals, and personal care on a rental basis in a residential, non-institutional environment. Special care residences can be certified for enhanced dementia-related services.

What Facilities Are Called

Assisted Living Residences

Legal Definition

An assisted living residence provides room, board, and personal care services for three or more unrelated adults. Residents pay for assistance with daily living activities in a non-medical residential setting with 24-hour support available.

Regulatory Agency

Regulatory Overview

Michigan licenses two types of residential care: Homes for the Aged (for persons 55+) and Adult Foster Care (for any adult needing care). The term "assisted living" is commonly used but is not formally recognized in Michigan's statutes or rules.

What Facilities Are Called

Homes for the Aged and Adult Foster Care

Legal Definition

A Home for the Aged provides room, board, and supervised personal care to 21 or more unrelated persons age 55 and older. Adult Foster Care provides personal care, supervision, and protection for 3 to 20 unrelated persons in a residential setting.

Regulatory Agency

Regulatory Overview

Minnesota's Department of Health licenses assisted living facilities (ALFs) and assisted living facilities with dementia care (ALFDCs). The state provides distinct regulatory frameworks for each type.

What Facilities Are Called

Assisted Living Facilities (ALF) and Assisted Living Facilities with Dementia Care (ALFDC)

Legal Definition

An assisted living facility provides sleeping accommodations and assisted living services to one or more adults. ALFDCs meet additional requirements for residents with dementia. The definition excludes nursing homes, hospitals, and other settings licensed under separate state programs.

Regulatory Agency

Regulatory Overview

Mississippi licenses two types of personal care homes: assisted living and residential living. The primary difference is that residential living communities may not admit or retain individuals who cannot walk independently. Facilities may also establish Alzheimer's/dementia care units.

What Facilities Are Called

Personal Care Homes (Residential Living and Assisted Living)

Legal Definition

Personal care homes help residents with daily living activities such as bathing, walking, feeding, grooming, and dressing. Assisted living personal care homes provide additional medical services, medication administration, and emergency response services.

Regulatory Agency

Regulatory Overview

Missouri licenses both assisted living facilities (ALFs) and residential care facilities (RCFs). ALFs may admit residents who need more help evacuating the building, must follow a social model of care, and must have physician oversight. RCF residents must be able to evacuate without assistance.

What Facilities Are Called

Assisted Living Facilities and Residential Care Facilities

Legal Definition

An ALF provides 24-hour care, assistance with daily living activities, medication management, and health care supervision under a social model of care for three or more residents. An RCF provides shelter, board, and protective oversight for three or more residents who can self-evacuate.

Regulatory Agency

Regulatory Overview

Montana licenses assisted living facilities to provide supportive health services in a setting that promotes resident independence, individuality, privacy, and dignity.

What Facilities Are Called

Assisted Living Facilities (Categories A through D)

Legal Definition

An assisted living facility is a congregate residential setting that provides personal care, 24-hour supervision and assistance, activities, and health-related services. Four categories (A-D) provide different levels of care based on resident needs.

Regulatory Agency

Regulatory Overview

Nebraska's Licensure Unit licenses assisted living facilities within the Department of Health and Human Services.

What Facilities Are Called

Assisted Living Facilities

Legal Definition

An assisted living facility is a residential setting that provides assisted-living services for compensation to four or more unrelated persons. It does not include homes where casual care is provided at irregular intervals.

Regulatory Agency

Regulatory Overview

Nevada's Bureau of Health Care Quality and Compliance licenses residential facilities for groups, which generally serve elderly persons or persons with physical or intellectual disabilities. Facilities must apply for special endorsements to their license.

What Facilities Are Called

Residential Facilities for Groups

Legal Definition

A residential facility for groups provides food, shelter, assistance, and limited supervision on a 24-hour basis to persons who are elderly, have an intellectual or physical disability, or are infirm. The term includes assisted living facilities.

Regulatory Agency

Regulatory Overview

New Hampshire licenses two categories of assisted living residences: Supported Residential Health Care Facilities (which may provide limited health services) and Residential Care facilities (which provide a lower level of care). Requirements are generally the same for both.

What Facilities Are Called

Assisted Living Residence-Residential Care and Supported Residential Health Care Facilities

Legal Definition

Supported Residential Health Care Facilities provide social or health services as needed but do not require 24-hour nursing supervision. Residential Care facilities provide a minimum of assistance in personal and social activities with minimal supervision or health care in a home-like setting.

Regulatory Agency

Regulatory Overview

New Jersey licenses three types of assisted living services: assisted living residences (new construction with apartments), comprehensive personal care homes (converted from residential health care facilities), and assisted living programs (serving publicly subsidized housing tenants). A certificate of need is required.

What Facilities Are Called

Assisted Living Residences, Comprehensive Personal Care Homes, and Assisted Living Programs

Legal Definition

Assisted living provides coordinated personal and health services available 24 hours per day, promoting resident self-direction, independence, and dignity. Assisted living residences offer private apartments with kitchenettes. Comprehensive personal care homes house no more than two residents per unit.

Regulatory Agency

Regulatory Overview

New Mexico's Division of Health Improvement licenses and regulates assisted living facilities through its Health Facility Licensing and Certification Bureau.

What Facilities Are Called

Assisted Living Facilities

Legal Definition

An ALF provides programmatic services, room, board, and/or assistance with one or more daily living activities to two or more unrelated individuals.

Regulatory Agency

Regulatory Overview

New York licenses and regulates Adult Care Facilities, which provide non-medical residential services to adults who cannot live independently. Three types exist: Adult Homes, Enriched Housing Programs (primarily for those 65+), and Residences for Adults. Assisted Living Residences are a distinct program with enhanced services.

What Facilities Are Called

Adult Care Facilities (Adult Homes, Enriched Housing Programs) and Assisted Living Residences

Legal Definition

Adult care facilities provide temporary or long-term residential care, room, board, housekeeping, personal care, and supervision to five or more unrelated adults who are substantially unable to live independently.

Regulatory Agency

Regulatory Overview

North Carolina's assisted living residences include Adult Care Homes (licensed, categorized by size) and Multi-unit Assisted Housing with Services facilities (registered but not licensed). Family care homes serve 2-6 residents; adult care homes serve 7 or more.

What Facilities Are Called

Assisted Living Residences, Adult Care Homes, and Multi-unit Assisted Housing with Services

Legal Definition

Assisted living residences provide group housing with meals, housekeeping, and personal care services. Adult care homes provide 24-hour scheduled and unscheduled personal care directly or through agreements with licensed home care or hospice agencies.

Regulatory Agency

Regulatory Overview

North Dakota licenses both basic care facilities and assisted living facilities. An assisted living facility must contain at least five living units and serve five or more unrelated individuals, providing individualized support services to maintain residents' independence.

What Facilities Are Called

Basic Care Facilities and Assisted Living Facilities

Legal Definition

A basic care facility provides room, board, and health, social, and personal care to help residents attain or maintain their highest level of functioning. Assisted living facilities provide coordinated individualized support services in a series of living units.

Regulatory Agency

Regulatory Overview

Ohio licenses residential care facilities, with "assisted living" used interchangeably with "residential care." Facilities may apply for special care unit designation for residents with cognitive impairments, increased emotional needs, or serious mental illness.

What Facilities Are Called

Residential Care Facilities

Legal Definition

A residential care facility provides accommodations for 17 or more unrelated individuals with supervision and personal care for at least three who are dependent on others due to age or impairment, or for three or more individuals including at least one receiving skilled nursing care.

Regulatory Agency

Regulatory Overview

Oklahoma licenses assisted living centers and residential care facilities. Assisted living centers can provide medical care, while residential care homes cannot. Residential care home residents must be ambulatory and capable of managing their own affairs.

What Facilities Are Called

Assisted Living Centers

Legal Definition

An assisted living center serves two or more persons who need help with personal care or nursing supervision, and may need intermittent or unscheduled nursing care, medication assistance, and help with transfers or ambulation.

Regulatory Agency

Regulatory Overview

Oregon licenses two types of facilities: Assisted Living Facilities (which must offer private apartments with kitchenettes) and Residential Care Facilities (which may have shared rooms). Memory Care Communities require additional endorsement and must meet specific dementia care standards.

What Facilities Are Called

Assisted Living Facilities and Residential Care Facilities

Legal Definition

An assisted living facility consists of fully self-contained individual living units for six or more adults, offering 24-hour coordinated supportive services including personal care, health services, and social activities using a person-centered approach.

Regulatory Agency

Regulatory Overview

Pennsylvania licenses two types of residential care: Personal Care Homes (for residents who don't need 24-hour nursing care) and Assisted Living Residences (which may serve residents requiring nursing home level of care). The two differ in concept, unit type, and level of care.

What Facilities Are Called

Personal Care Homes and Assisted Living Residences

Legal Definition

A personal care home provides food, shelter, and personal assistance for four or more unrelated adults who need help with daily living but not long-term nursing care. An assisted living residence provides food, shelter, assisted living services, and supplemental health care for four or more adults.

Regulatory Agency

Regulatory Overview

Rhode Island licenses assisted living residences for individuals who do not require nursing home care but need room, board, personal assistance, and possibly medication administration. Additional licenses are available for dementia care and limited health services.

What Facilities Are Called

Assisted Living Residences (with optional Dementia Care and Limited Health Services licenses)

Legal Definition

An assisted living residence serves six or more unrelated adults, providing personal assistance, limited health services, lodging, and meals. Residences are licensed based on fire code levels (self-preservation ability) and medication classifications.

Regulatory Agency

Regulatory Overview

South Carolina licenses community residential care facilities, which include settings that may be referred to as "assisted living."

What Facilities Are Called

Community Residential Care Facilities

Legal Definition

A community residential care facility provides room, board, and personal assistance for two or more adults age 18+ for periods exceeding 24 hours. Facilities are designed to maximize residents' dignity, autonomy, privacy, independence, and safety.

Regulatory Agency

Regulatory Overview

South Dakota's Department of Health regulates assisted living centers.

What Facilities Are Called

Assisted Living Centers

Legal Definition

An assisted living center is any facility that provides personal care and services beyond basic food, shelter, and laundry. Secured units are available for residents with cognitive deficits who may be at risk of elopement.

Regulatory Agency

Regulatory Overview

Tennessee licenses two types of facilities: Assisted-Care Living Facilities (ACLFs), which may provide medical services, and Residential Homes for the Aged (RHAs). Both serve older persons needing help with personal care. Licensing rules specify dementia care requirements for both settings.

What Facilities Are Called

Assisted-Care Living Facilities and Residential Homes for the Aged

Legal Definition

An ACLF provides residential care and services in a homelike environment, promoting personal individuality, respect, independence, and privacy for elderly and disabled adults. A Home for the Aged provides room, board, and personal services to four or more unrelated elderly persons.

Regulatory Agency

Regulatory Overview

Texas licenses two types of assisted living facilities: Type A (for residents who can self-evacuate) and Type B (for residents who may need evacuation assistance). Facilities are further classified as small (4-16 residents) or large (17+ residents). Facilities advertising Alzheimer's or dementia care must have Type B certification.

What Facilities Are Called

Assisted Living Facilities (Type A and Type B)

Legal Definition

An ALF provides food and shelter to four or more unrelated persons along with personal care services and/or medication administration. Type A residents must be able to evacuate independently; Type B residents may require staff assistance with evacuation.

Regulatory Agency

Regulatory Overview

Utah licenses two types of assisted living facilities based on the level of care. Type I facilities serve residents who can exit without assistance, while Type II facilities provide full assistance including general nursing care. Both types are classified by size: large (17+), small (6-16), and limited capacity (2-5).

What Facilities Are Called

Type I and Type II Assisted Living Facilities

Legal Definition

A Type I facility provides daily living assistance and social care to residents who can exit independently. A Type II facility is homelike and provides 24-hour coordinated personal and health care services, including full daily living assistance and general nursing care.

Regulatory Agency

Regulatory Overview

Vermont licenses two settings for adults who cannot live independently but don't require nursing home care: Assisted Living Residences (which require private apartments) and Residential Care Homes (Level III and Level IV). Through Medicaid waiver programs, many residential care homes also serve residents who need nursing home level of care.

What Facilities Are Called

Assisted Living Residences and Residential Care Homes

Legal Definition

An assisted living residence combines housing, health, and supportive services in a homelike setting with private apartments, promoting resident self-direction and independence. Residential care homes provide room, board, personal care, supervision, and medication management.

Regulatory Agency

Regulatory Overview

Virginia licenses assisted living facilities at two service levels: residential living care (minimal assistance) and assisted living care (at least moderate assistance). Facilities may be licensed for one or both levels.

What Facilities Are Called

Assisted Living Facilities (Residential Living Care and Assisted Living Care)

Legal Definition

An assisted living facility provides or coordinates personal and health care services, 24-hour supervision, and assistance for four or more adults who are aged, infirm, or disabled in a primarily residential setting.

Regulatory Agency

Regulatory Overview

Washington licenses assisted living facilities that provide room, board, and help with daily activities to seven or more residents. Facilities may contract with the state to provide Medicaid-funded services including specialized dementia care, behavioral health supports, and intermittent nursing.

What Facilities Are Called

Assisted Living Facilities

Legal Definition

An ALF is any home or institution that provides housing, basic services, and general responsibility for the safety and well-being of seven or more residents. It does not include independent senior housing, independent living units in continuing care communities, or similar settings.

Regulatory Agency

Regulatory Overview

West Virginia licenses two types of residential care: Assisted Living Residences (ALRs) and Residential Care Communities (RCCs). The key difference is that RCC residents must be capable of self-preservation in an emergency. Separate licensure is required for Alzheimer's/dementia special care units.

What Facilities Are Called

Assisted Living Residences (ALR) and Residential Care Communities (RCC)

Legal Definition

An ALR provides personal assistance, supervision, or both to four or more residents who are dependent on others due to physical or mental impairment and may require limited, intermittent nursing care.

Regulatory Agency

Regulatory Overview

Wisconsin licenses three types of assisted living providers: Community-Based Residential Facilities (CBRFs), Residential Care Apartment Complexes (RCACs), and Adult Family Homes (AFHs). All are designed to enhance independence in the least restrictive, most homelike environment possible.

What Facilities Are Called

Community-Based Residential Facilities, Residential Care Apartment Complexes, and Adult Family Homes

Legal Definition

A CBRF provides care and services to five or more unrelated adults who need supportive or protective services. An RCAC provides independent apartments with personal, supportive, and nursing services. An AFH provides care in a smaller home-like setting.

Regulatory Agency

Regulatory Overview

Wyoming licenses assisted living facilities at two levels: Level 1 (without a secure unit) and Level 2 (with a secure unit requiring special staffing and education). There is no minimum resident count to trigger licensure.

What Facilities Are Called

Assisted Living Facilities (Level 1 and Level 2)

Legal Definition

An assisted living facility provides limited nursing care, personal care, and boarding home care to persons not related to the facility owner. Habilitative care is not included.