Residential Care Laws

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Senior Housing Licensure, Regulatory Review and Violation Resources

Senior housing facilities, such as assisted living communities and nursing homes, are regulated at both the state and federal level, although the majority of the burden for governing the laws and regulations falls to the state where the facility is based.

Senior living residents are protected by numerous state licensure and regulatory requirements from the size of the rooms and resident capacity to security and patient-staff ratios. When looking to place your loved one in a senior living environment, it is important to know not only about the care and services they provide but also that their facility is appropriately licensed and without serious violations or reviews. Due to the fact that there are many different types of facilities with a variety of services, it can be difficult to navigate the necessary documentation needed to ensure that the senior care facility is in compliance with state licensure and regulations and not in violation of state law.

Senior Housing Types

When beginning your search for an elder care facility, it is important to understand that there are different types of senior care environments. The following are some of the types and the different referenced names that they might fall under.

Independent Living Communities - Also referred to as:

  • Senior Housing
  • Retirement Communities
  • Retirement Villages
  • 55+ Communities
  • Senior Apartments
  • Congregate Care
  • Continuing Care Retirement Community


Assisted Living – Also referred to as:

  • Board and Care
  • Boarding Homes
  • Adult Foster Care
  • Adult Family Homes
  • Assisted Care Communities
  • Assisted Living Facilities
  • Personal Care Facilities
  • Residential Care Homes
  • Senior Group Homes


Nursing Homes – Also referred to as:

  • Long-term Care Facility
  • Skilled Nursing Facility
  • Convalescent Home
  • Rest Home


Respite Care - Also referred to as:

  • Short-Term Accommodation Program
  • Adult Day Care
  • Temporary Adult Care


Home Care – Also referred to as:

  • Home Health Care
  • Home Care Aide
  • In-Home Care


Senior care and housing facilities have different guidelines, requirements and procedures for classification of the different senior living facilities. Even though there are many resemblances amongst the states as to various licensure and regulatory requirements, there are still as many as different sets of directives as there are states. Regulatory guidelines include, but are not limited to:

  • Administrative Requirements
  • Medication Administration and Management
  • Staffing Certification and Ratio Requirements
  • Medicare Coverage/Medicaid Waivers
  • Memory Care Staff and Patient Requirements
  • Building and Security Requirements


Searching for information about senior care and housing facility citations, violations, reviews and inspection reports can be frustrating and time consuming if you are unsure of where to look for those resources.

Learning about facility health and safety records can differ some from state to state, since each state has their own elder care and housing laws. However, with a little snooping, and with the help of your state's Department of Health...or just a good search engine, you can almost always obtain this important information.

In addition, it is also recommend investigating the Consumer Health Ratings to find links to State-Level Inspection Reports and Quality Review Ratings of senior care facilities.

How to Look Up Senior Living Facility Licenses, Violations, Reviews and Inspection Reports

Senior care facilities are regulated in all 50 states. The facility’s license should be easily available for you to locate in the building, if not, ask staff or the administrator to see it. Also, all state laws provide for a Resident Bill of Rights, which should be posted. Elder living communities are inspected by the state’s regulatory agency in which you can request a copy of the most recent survey report for that community. Adult living communities also must comply with health and safety codes, fire safety regulations, local building codes and other requirements.

In addition, many facilities are professionally managed and provide some type of company quality assurance review program to evaluate and continuously improve upon the services they offer, as well as family and resident boards to address complaints or questions in a timely manner.

Consider the following when choosing a senior home:

  • Does the facility conduct criminal background checks on all staff members?
  • Does the community educate and train staff on elder neglect and abuse?
  • Is there a specific procedure for reporting suspected abuse?
  • What are the reasons why a resident may be asked to leave the community?
  • Is the state inspection report on hand for review?
  • Are the employees compassionate and focused on the residents' individual needs?
  • What provisions or supervision is provided for safety and security? 
  • Is the care facility kept clean and accessible?
  • Is the care facility’s other residents and staff respectful of residents' privacy and dignity?


At least once a year, a state inspector visits adult family homes and inspects their environment, the staff, the financial accounting and the residents to ensure they are in compliance with state regulations.  If an inspection of a community results in noncompliance of specific criteria, it is issued a deficiency citation. The federal government may intercede and impose stricter penalties on the facility for serious deficiencies or for deficiencies that the community failed to correct. In addition, state governments may also impose their own penalties on the facility as well.

If the senior housing facility accepts and offers services with Medicare or Medicaid, the community is required to display the results of its last full inspection for the public to review. 

For the most current information on nursing homes, or to find out more about inspections, contact your Long Term Care Ombudsman's office or the State Survey Agency in your area.

It is critical to the health and safety of your loved one to research and investigate any residential care facility before making a commitment and moving in. It is also important to visit and tour several homes before you make your final decision. Before deciding on a residential care home, make sure all of your questions are answered in a clear and concise manner and you feel comfortable before moving in.