How to choose assisted living
What the state licence records on our assisted living pages mean, what to ask on a visit, warning signs, who pays and how to complain about an assisted living home.
Who this guide is for
For older adults and people with disabilities who can no longer live safely alone and need help with daily activities (bathing, dressing, medicines, meals), but do not need 24-hour nursing care. People who need nursing care around the clock may need a nursing home.
What the official data on our pages means
- Licence type
- Each state licenses these homes under its own names (assisted living facility, residential care facility, personal care home, adult care home and others) and its own rules. We show the state’s own name.
- Licence status and number
- Whether the licence is active on the state’s list on the date we retrieved it. A licence means the home met the state’s minimum rules; it is not a rating.
- Capacity
- The number of residents or beds the licence allows.
- State inspection record
- Where the state publishes inspections or complaints, we link to the home’s record. Read it before you visit, and ask how any problems were fixed.
What to ask when you visit
A general checklist for any assisted living or residential care home. It is not medical or legal advice.
- Is the licence current? Can I see the latest state inspection report and how any problems were fixed?
- What does the monthly fee include, and what costs extra (levels of care, help with medicines, laundry, transport)?
- How and how often are fees raised, and with how much notice?
- What help with daily activities is offered (bathing, dressing, medicines), and who gives it?
- How many staff are on duty during the day and at night? Is a nurse on site or on call?
- What happens if care needs increase? When would a resident have to move out?
- Is there a memory-care area for people with dementia, and is the home licensed for it?
- Does the home accept Medicaid (or a state waiver program), long-term care insurance or veterans’ benefits?
- How are medical emergencies handled, and which hospital is usually used?
- Can I talk with residents and families, share a meal, and visit at different times of day?
- What does the contract say about moving out, discharge and refunds? Ask for a copy to read at home.
Read the state record before you visit: state licence search.
Free official help: the Eldercare Locator (U.S. Administration for Community Living), 1‑800‑677‑1116, eldercare.acl.gov, can connect you with your area agency on aging and your state’s Long-Term Care Ombudsman, who helps residents and families with concerns about a home.
Warning signs
- The licence is not active, or the home is not on the state’s list at all.
- The home will not show you the contract, the full list of fees or the latest inspection report.
- Few staff at night, residents who look unwashed or left alone, or medicines handled by untrained staff.
- A memory-care unit that the state has not licensed for people with dementia, or doors that are not secure.
Costs and who pays
Medicare does not pay for room, board or personal care in assisted living. It still covers doctor visits, hospital care and other covered services while you live there.
Medicaid may pay for some services in assisted living in many states, often through a home and community-based services (waiver) program, usually not for room and board. Programs and waiting lists differ by state.
Most residents pay privately; long-term care insurance and veterans’ benefits may help. Ask what the monthly fee includes, what costs extra and how fees go up.
In general terms only. Deductibles, coinsurance and other amounts change every year, and Medicaid rules differ by state: check Medicare.gov, call 1-800-MEDICARE or your state Medicaid agency, and ask your plan.
How to complain or get help
- State licensing agency: the agency that licenses the home takes complaints and inspects. Each state’s agency is listed under Official state sources.
- The Long-Term Care Ombudsman in your state is free and independent: ombudsmen help residents of nursing homes, assisted living and other care homes (and their families) with complaints and with residents’ rights. Find yours through the Eldercare Locator, 1-800-677-1116.
- If you think someone is being abused, neglected or exploited and is in danger, call 911. You can also report it to the state agency and to Adult Protective Services (the Eldercare Locator can give you the number).
Find care on US Patient Guide
Common questions
What is the difference between assisted living and a nursing home?
Assisted living offers housing, meals and help with daily activities, and is licensed by the state. A nursing home gives 24-hour nursing care, and most are certified and inspected for Medicare and Medicaid.
Does Medicare pay for assisted living?
No. Medicare does not pay for room, board or personal care in assisted living. Medicaid may pay for some services in some states.
Why is there no star rating for assisted living?
There is no federal rating or federal list of assisted living: each state licenses and inspects these homes under its own rules. We show the state’s licence record instead.
Sources
- Residential facilities, assisted living, and nursing homes (National Institute on Aging)
- Long-term care: what Medicare covers (Medicare.gov)
- Long-term services and supports (Medicaid.gov)
- Long-term care: planning and paying (U.S. Administration for Community Living)
- Long-Term Care Ombudsman Program (U.S. Administration for Community Living)
- Eldercare Locator (U.S. Administration for Community Living), 1-800-677-1116
- National Institute on Aging in Spanish
Written in plain language by US Patient Guide from the official sources above, November 2, 2026. The facts on each provider page come from the official data shown on that page, with its date. Not medical advice.