Just The Facts: Assisted Living Is A Safe, High-Quality Long Term Care Option For America’s Seniors

Families & Residents Highly Satisfied With Quality Of Care As Communities Maintain Highest Level Of Safety & Security

Assisted Living; Quality; Research and Data
​Washington, D.C. – The National Center for Assisted Living (NCAL), a part of the American Health Care Association (AHCA), released today a fact check about assisted living. There are more than 30,000 assisted living communities in the United States that care for nearly one million residents daily. Assisted living residents typically need help with everyday activities and some health care services but do not require 24-hour skilled nursing care services. These communities offer a unique mix of companionship, independence, privacy, and security in a home-like setting. 
FACT: Assisted living residents and their families are consistently happy with the care they receive.
  • According to CoreQ, nearly 80 percent of assisted living residents and their families are satisfied with their care.
  • Other studies confirm that the vast majority of residents and families love their assisted living communities.

FACT: Assisted living residents receive life-affirming care, and providers are committed to continuously improving and adapting to meet the needs of their residents.
  • Data shows that assisted living communities help reduce residents’ frailty after moving in.
  • The profession has also developed rigorous quality improvement programs that have resulted in better resident outcomes, such as the AHCA/NCAL National Quality Award Program. A recent Brown University analysis found that Silver and Gold-level recipients in assisted living have better outcomes compared to non-recipients. These award recipients had lower hospitalizations, ambulatory care sensitive hospitalizations, emergency department visits, injury-related emergency department visits, and long-term nursing home transitions than non-recipients. 

FACT: Safety and security are—and always will be—the utmost priority, especially for residents living with dementia. 
  • Surveys find that 99 percent of residents feel safe in their communities, and 91 percent say they feel safer than living on their own. 
  • Eighteen percent of assisted living communities have a dementia care unit, wing or designated floor. Eleven percent exclusively serve individuals with dementia.
  • More than 4 in 10 assisted living residents are living with Alzheimer’s disease or some form of dementia.
  • Six in 10 people living with dementia will wander at least once; many do so repeatedly.

FACT: Assisted living is a more affordable long term care option. However, how long term care is financed in the United States is broken, and assisted living is out of reach for too many seniors.
  • The value of assisted living care is clear: assisted living provides essential services such as housing, transportation, and meals, as well as social activities and some health care. Its average monthly costs are less than hiring homemaker services or a home health aide.
  • Medicare does not cover long term care, and therefore, assisted living services.
  • Eighteen percent of assisted living residents rely on Medicaid to pay for daily services, typically through a Medicaid home- and community-based waiver program, but these programs do not cover room and board.
  • NCAL published a white paper in 2023 advocating for a public-private partnership to identify opportunities that expand affordable assisted living options for low- to moderate-income older adults.

FACT: State-based regulation of assisted living is strong—it is more dynamic, encourages more localized care models, and promotes innovation. 
  • NCAL’s “Assisted Living State Regulatory Review,” which summarizes key selected state requirements for assisted living licensure or certification, found that two-thirds of states reported changes between 2020-2022, and another 31 percent between 2022-2023