Specialized Information for:

Nursing HomesAssisted Living/Board & Care Home and Community Based Services


NORC Resources

Ombudsman Advocacy in Assisted Living Board and Care (November 2013)

Federal Resources

GAO Report - Medicaid Assisted Living Services: Improved Federal Oversight of Beneficiary Health and Welfare is Needed (February 2018)
The U.S. Government Accountability Office (GAO) issued a report finding large gaps in the regulation of assisted living facilities.  The report found that states are spending more than $10 billion a year in federal and state funds for assisted living services for more than 330,000 Medicaid beneficiaries.  But, very little federal and state standards regulate the industry. The GAO report found that the federal government does not have basic information about the assisted living services being provided.  More than half of states were unable to provide information on the number and nature of cases involving the abuse, neglect exploitation or unexplained death of Medicaid beneficiaries in assisted living facilities.  Only 22 states were able to provide information on "critical incidents - cases of potential or actual harm," and in one year the states reported more than 22,900 incidents. Read the full GAO report, and find more information in the New York Times article.

National Study of Long-Term Care Providers (May 2016)
​The biennial National Study of Long-Term Care Providers (NSLTCP) monitors trends in the supply, provision, and use of the major sectors of paid, regulated long-term care services. NSLTCP uses survey data on the residential care community and adult day services sectors, and administrative data on the home health, nursing home, and hospice sectors. The vision for NSLTCP is to offer reliable, accurate, relevant and timely national and state statistical information to support and inform long-term care services policy, research and practice.

FastStats for Residential Care Communities (2016)
These stats were compiled by the Centers for Disease Control and Prevention.

Many assisted living residents are Medicaid-dependent, government report says (Dec 2011)
U.S. Department of Health and Human Services (HHS), Centers for Disease Control and Prevention, National Center for Health Statistics. 

Compendium of Residential Care and Assisted Living Regulations and Policy: 2015 Edition
The compendium was prepared for the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) and summarizes and compares states' residential care setting regulations.

Additional Resources

View Ombudsman program examples here

Assisted Living State Regulatory Review (2022)

Toolkit for Person-Centeredness in Assisted Living – An Informational Guide and Questionnaires of Person-Centered Practices in Assisted Living (PC-PAL)
Initially released for use in June 2014, the Toolkit for Person-Centeredness in Assisted Living was developed through a close partnership between the University of North Carolina at Chapel Hill and the national Center for Excellence in Assisted Living (CEAL), along with assisted living providers, residents, family members, and organizational representatives. Available for free download, the Toolkit includes questionnaires to be completed by assisted living residents and staff, and simple, easy-to-follow instructions for scoring and interpreting the results. The questionnaires measure Person-Centered Practices in Assisted Living, and are called the PC-PAL. Unlike earlier tools, the PC-PAL questionnaires are based on research evidence and have been rigorously tested for ease of use and statistical validity. Click here to access the PC-PAL. Read the entire press release on the CEAL website or on the UNC website.


View archive here

Assisted Living State Regulatory Review (2018)
This report summarizes key selected state requirements for assisted living licensure or certification. For every state and the District of Columbia, this report includes information on topics such as which state agency licenses assisted living, recent legislative and regulatory updates affecting assisted living, and requirements for resident agreements, admission and discharge, units serving people with Alzheimer’s or other dementias, staffing, and training. This report was developed by the National Center for Assisted Living.

Assisted Living Facility Inspections Guidelines by State (February 2014)
This chart gives state by state information on inspection guidelines for assisted living facilities.  Information contained includes what agency/entity within each state conducts the inspections, whether or not a facility receives advance notice of an inspection, where the public can access inspection reports and whether or not the agency investigates complaints.

Ombudsman Advocacy Challenges in Assisted Living: Outreach and Discharge (March 2001)
This technical assistance paper is presented in two sections. It begins by describing challenges programs face in doing assisted living outreach and practical steps they might take to more effectively reach assisted living consumers and providers. It continues with a focus on Ombudsman intervention in discharge cases.

Quality in Medicaid Waiver Assisted Living: The Ombudsman Program's Role and Perspective (December 2005)
This paper presents highlights of a teleconference for State Ombudsmen discussing their role and perspectives on quality in Medicaid waiver assisted living. The conference was convened by The National Association of State Units on Aging (NASUA) on April 26, 2005. Thirteen state ombudsmen and program staff from 10 states (Alaska, Arkansas, Arizona, Georgia, Illinois, Louisiana, Ohio, Pennsylvania, Virginia, Wisconsin) and the District of Columbia, participated.

Thinking of Moving to an Assisted Living Residence? Fostering Autonomy & Independence, 2003
Developed by the Long-term Care Community Coalition (formerly the Nursing Home Community Coalition of New York State). This guidebook to help people choose an assisted living residence with a special focus on finding a residence that promotes choice and independence.

Policy Principles for Assisted Living, 2003
A report resulting from the Assisted Living Workgroup. Signed by Consumer Voice (formerly the National Citizens’ Coalition for Nursing Home Reform), the National Association of State Ombudsman Programs (NASOP), and the National Association of Local Long-Term Care Ombudsman Programs (NALLTCO), this document outlines problems and proposed solutions that will guarantee a reasonable level of quality for residents of assisted living facilities.


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