Assisted Living Facilities
Assisted living facilities provide a residential alternative to in-home care and nursing homes for people who need assistance with activities of daily living such as eating, bathing, and toileting. Assisted living facilities provide room and board, which includes housing, utilities, and meals, and typically provide access to round-the-clock staff. In contrast to nursing homes, assisted living facilities generally do not provide 24-hour skilled nursing services or rehabilitative services on an ongoing basis. Unlike nursing homes, which are subject to extensive federal regulations, assisted living facilities are regulated at the state level.
According to a nationwide study, in 2022, facilities ranged in size from a few beds to fifty or more, with 41 beds on average. The majority of facilities—57 percent—were chain-affiliated, while others were independently owned. About 82 percent of facilities were for-profit while 17 percent were nonprofit.
While most assisted living facility residents pay for their care using their own personal resources, federal programs cover certain services provided in assisted living facilities for those who are eligible. For example, Medicaid programs can opt to cover assisted living services for certain program enrollees. Medicaid programs are not allowed to cover the costs associated with room and board for beneficiaries receiving assisted living services. Medicaid may also cover other health care services provided in assisted living facilities, such as physical therapy.
Medicare generally does not cover assisted living services or room and board but may cover other health care services provided in these facilities, such as hospice services. Residents of assisted living facilities may also leverage other federal programs to finance costs associated with assisted living. For example, residents eligible for federal disability benefits may use these benefits to pay for room and board costs.
The GAO issued its report on June 2, 2026 entitled “ASSISTED LIVING FACILITIES: Information on Federal Spending and Medicaid Coverage” in which it reported that federal Medicaid and Medicare spending for services provided in assisted living facilities totaled at least $12 billion in 2024. This amount is likely an undercount because of data limitations. For example, assisted living facilities are not a uniformly defined provider type and thus not consistently identified in the data.
· Federal Medicaid spending. GAO identified at least $3.5 billion in federal Medicaid spending for services provided in assisted living facilities in 2024. State Medicaid programs may cover assisted living services—that is, assistance with activities of daily living and other supportive services provided in assisted living facilities—as well as other services such as physical therapy.
· Medicare spending. GAO identified $8.5 billion in traditional Medicare spending for services provided in assisted living facilities in 2024. Medicare generally does not cover assisted living services but may cover other health care services such as hospice in assisted living facilities.
Other federal programs, such as Department of Housing and Urban Development and Department of Veterans Affairs programs, may be used by beneficiaries to help cover the costs of certain services, such as room and board, in assisted living facilities. The amount of spending by these programs for such services is unknown.
Forty-four states’ Medicaid programs covered assisted living services for older adults and people with disabilities as of March 2025. More than half of states—29 of the 44—covered these services under Medicaid home- and community-based services waivers. These waivers give states the flexibility to target enrollment to specific populations and to limit the number of participants.
If you or a loved one suffered injuries (or worse) while a resident of an assisted living facility in the United States due to an assisted living fall, assisted living neglect, assisted living negligence, assisted living abuse, assisted living under-staffing, or an assisted living facility failing to properly care for a vulnerable adult, you should promptly find an assisted living claim lawyer in your state who may investigate your assisted living claim for you and file an assisted living claim on your behalf or on behalf of your loved one, if appropriate.
Visit our website to be connected with assisted living attorneys in your U.S. state who may assist you with your claim, or call us toll-free in the United States at 800-295-3959.
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