NCAL Report: States Continue Strengthening Assisted Living Regulations

More than half of states updated assisted living requirements

Survey and Certification; Regulations

WASHINGTON, D.C. – Assisted living regulations, statutes, and policies in 27 states were updated between June 2018 and June 2019, according to the National Center for Assisted Living’s (NCAL) 2019 edition of the “Assisted Living State Regulatory Review.” The association released the latest edition of its annual review today.

“Once again, states are demonstrating their ability to respond to the evolving assisted living environment to foster quality improvement, provider transparency, and resident safeguards,” said Scott Tittle, NCAL Executive Director. “NCAL supports ongoing collaborative efforts between assisted living providers, state regulators, and other stakeholders to find the proper balance of oversight while still honoring the specific needs and desires of each resident.”

The report found that the most common changes to state regulations aimed to enhance resident protections. The most frequent change over the past year was regarding resident disclosure and notification requirements. Four states (Colorado, Minnesota, Oregon, and Virginia) and the District of Columbia passed laws requiring new types of notification either to the resident or to the state. Three other states (Alabama, California, and Utah) finalized small regulatory revisions affecting required resident notifications.

The 2019 Regulatory Review indicates a potential trend in the profession, as more than half of states reported changes to their assisted living requirements for the second year in a row. Since 2015, 84 percent of states have reported changes that affect assisted living.

“Changes each year can vary from big to small, but it is evident that state regulations are increasing in assisted living,” said Lilly Hummel, NCAL’s senior policy director and the report’s author. “Each state is determining how to enhance assisted living for their specific resident population, and we anticipate this trend to continue.”

The “Assisted Living State Regulatory Review” summarizes key selected state requirements for assisted living licensure or certification. It includes information on 20 categories, including which state agency licenses assisted living as well as recent legislative and regulatory activity. Additional categories cover requirements for resident agreements, admission and discharge policies, scope of care, life safety, among others.

The full report along with summaries for each state are available at