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How Assisted Living and Senior Housing Are Regulated

When selecting an assisted living facility or senior housing, a number of factors can help narrow your search: price, location, activities, even the food. Arguably the most important factor, however, is whether or not the facility had violations or citations when last inspected under senior housing regulations.

While you could do a quick online search and read reviews of assisted living facilities, these third-party sites aren’t in charge of inspections. That duty is usually the responsibility of the government.

For example, the Centers for Medicare and Medicaid Services launched Nursing Home Compare in 2008 as a web-based report card. Using a five-star rating, the agency assesses the quality of care of CMS-certified nursing homes.

While an excellent resource, Nursing Home Compare doesn’t evaluate assisted living or senior housing options not funded by Medicare. For that, you have to turn to other federal and state agencies for senior housing regulations.

Woman with clipboard and older woman, to illustrate post on senior housing regulations.

Defining Assisted Living

Before comparing housing options for seniors, you should understand the difference between independent living communities and assisted living facilities.

Independent living communities – sometimes also known as retirement communities, senior apartments or 55+ communities – cater to people who require little to no assistance. These are seniors who are independent and have few medical concerns.

These homes are paid for privately and include options like meal packages and social activities. Because these homes are private, there isn’t much government funding except, for some, under Section 202 of the Supportive Housing for the Elderly Program. This U.S. Housing and Urban Development program finances housing for “very low-income elderly persons, including the frail elderly,” and provides rent subsidies.

Assisted living communities are specifically designed for people who can no longer live on their own but do not need the high-level care of nursing homes. Assisted living facilities help residents with daily routines like eating and taking medications. These facilities also provide social activities, provide transportation and have staff available 24 hours a day.

Assisted living facilities are mostly paid for privately, but some do accept Medicaid.

Nursing homes, in contrast, provide 24/7 care for severe medical conditions. They can be paid for privately or with Medicare or Medicaid.

Regulations folder, to illustrate post on senior housing regulations.

Regulating Assisted Living

If a nursing home is receiving funds from Medicare or Medicaid, it must comply with federal regulations established in the 1987 Nursing Home Reform Act.

In general, assisted living facilities and senior housing are regulated by the states. Each state issues a license to a facility after an inspection, typically conducted annually or semiannually. This process is overseen by a state’s department of health, department of social services or, in some instances, a combination of these departments.

Inspection teams typically comprise nurses, social workers, sanitarians and public health officials. The teams survey staff, residents and family members; examine facility records, and make observations. These surveys are then used to identify compliance and quality improvement issues.

Most state regulations address essential services that a senior living facility must provide. These services include assistance with activities of daily living (help with dressing, eating, etc.), meals, housekeeping and resident assessments. Some states have additional regulations for services such as money management, making medical appointments and taking residents shopping.

Keep in mind that many senior housing communities that provide only housing, housekeeping and meals are not required to be licensed by the states.

For information on the regulations in your state, offers a list of state agencies responsible for assisted living licenses and regulations.

Learn all about assisted living in’s Assisted Living Guide.

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  • Mark Edelen

    About :

    Welcome to the Retirement Living Blog. I direct and edit the blog for the best senior-housing and senior-living insight and advice, while also conducting search-engine optimization for the site as a whole. Follow me on Twitter @MarkEdelen.


    1. Hi Mark, I’m vey impressed with your knowledge and willingness to help this who have many different concerns and questions about elderly housing and care giving. My name is Nate Moe.
      My wife and I, are embarking on a new phase of our lives together. We have come to a point in life where we have become much more self sufficient in our finances etc. We however, do not feel satisfied with where we’re going. So we’ve had many discussions and have come down to a couple of things we want to invest our time and money into that will bring success to all involved.
      A residential assisted living facility is looking like a pretty good plan for us.
      Would you please give us some sights to go over And learn about, to see wether this would be a good venture for us?
      Thank you so much Mark
      Nate Moe

    2. Becky Porter says:

      Does any Agency regulate independent living facilities for seniors? What if a senior is mistreated there?

    3. Renita Payne says:

      Hello,can you please tell me how to go about having some placed in a different assisted living ? We are not pleased with the up keep or treatment

    4. Julie Rojas says:

      Who regulates assisted living facilities when the new owner is doing things that are not ethical perhaps even fraudulent?

    5. Hi Mark,
      my husband and I are looking to purchase
      affordable house in senior housing community in Tampa Florida.
      Can you direct us to a right path?

    6. Ridley Fitzgerald says:

      I like how you talked about the difference between assisted living and independent living. For my parents, I think assisted living would be the best choice. Like you said, it is for people that need help, but nothing too high-level. Thanks for the clarification.

    7. Adolfo Goncalves says:

      Hi Mark, I’m looking for an appartment for my brother (62), his wife (45) and 2 kids ( 9 and 11). Is there any 55+ in south Miami ? Thanks

    8. Susanne Hambrick says:

      I need help to find an subsidized Apartment in Seminole, Fl.

      • Hello, Susanne. Thanks for your comment. does not list senior apartments in Seminole itself, but we offer 25 choices in the Tampa Bay area.

        Nine of the apartments classify themselves as affordable. I would suggest starting with those. Pinellas Heights Senior Apartments also offers rent based on income. Click “Check Availability” next to each apartment to contact them for more information.

        I hope that helps.


    10. Linda Rose Stahl says:

      I am looking for a two flat or duplex in chgo.northern suburbs.can you help?

    11. Hello, Linda. Thanks for your message.

      You will find all our listings for senior housing in the Chicago metro area here:

      I hope this helps.


    1. […] general, assisted living facilities and senior housing are regulated by the states, not by the federal government. For information on assisted living regulations in your state, […]

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