WASHINGTON, D.C. – Assisted living regulations in 18 states, including the District of Columbia, were updated between January 1, 2025, and December 31, 2025, according to the National Center for Assisted Living’s (NCAL) 2025 edition of the Assisted Living State Regulatory Review released this week.
“States continually demonstrate their ability to respond to the changing needs of residents and providers within assisted living,” said LaShuan Bethea, NCAL Executive Director. “This effort fosters quality improvement, supports consumer transparency, and ensures residents and families have peace of mind that the proper safeguards are in place. NCAL supports ongoing collaboration between assisted living providers and state regulators to maintain balance of oversight while continuing to meet residents’ unique needs across the country.”
NCAL identified emerging trends in regulatory changes within the specific topics of the Regulatory Review for all 50 states and the District of Columbia. The top areas for regulatory changes in 2025 included:
- Direct Care Staff Education and Training Requirements – 10 states (20 percent)
- Administrator/Director Education and Training Requirements – Nine states (18 percent)
- Staff Scheduling Requirements – Seven states (14 percent)
“Similar to past years, this report highlights how states are working with assisted living providers to safeguard high-quality care for residents, and this year we are seeing a reinforced commitment to updating training and staffing requirements,” said Jill Schewe, NCAL’s Director of Policy and Regulatory Affairs and the report’s author. “We expect state regulations to continue to change and adapt to more effectively meet the needs of both current and future residents.”
The Assisted Living State Regulatory Review summarizes key selected state requirements for assisted living licensure or certification. It provides information for every state and the District of Columbia on topics such as which state agency licenses assisted living, recent legislative and regulatory updates affecting assisted living, scope of care, limitations of services, staffing, and training, among others.
The report also includes requirements for communities that offer seniors and people with disabilities housing and person-centered supportive and/or health care services , but may use a different term than assisted living, such as residential care and personal care homes.
The 2025 overview and executive summary, along with summaries for each state, is available on the NCAL website.