Assisted Living Regulations Changed in 29 States In Last Year

More than half of all U.S. states — 29, to be exact — tweaked regulations, statutes and policies for assisted living providers between June 2017 and June 2018, according to the 2018 edition of the “Assisted Living State Regulatory Review” from the National Center for Assisted Living (NCAL).

The most common changes to state regulations were related to staffing, and ran the gamut from additional training requirements to expanded background check requirements, according to this year’s report.

In particular, Colorado, Florida, Louisiana, New Hampshire, North Carolina, Ohio, Oklahoma, Oregon and Texas all made changes that affect training or qualifications for assisted living workers.


The new regulations took many forms. For instance, Florida, New Hampshire and North Carolina all tweaked administrator qualifications or training, while Louisiana added a requirement mandating orientation for direct care staff to include an evaluation for competence in providing assistance with activities of daily living (ADLs). Oklahoma, meanwhile, passed legislation requiring in-service training on Alzheimer’s and dementia-related care for medical and direct care workers.

While 21 states and Washington, D.C. reported no legislative or regulatory changes that affect assisted living communities, more regulations are likely on the way.

Last year, 25 states and Washington, D.C. reported they planned to propose, formally review or consider such changes over the next year, according to the report. Possible changes coming down the pike include a review of licensure requirements, implementation of new legislation and potential changes to Medicaid requirements for participating assisted living communities.


“The potential changes range from a complete review of the licensure requirements to targeted regulatory updates to implementation of new legislation, as well as changes to Medicaid requirements for participating assisted living communities,” stated Lilly Hummel, NCAL’s senior policy director and the report’s author, in a press release.

Written by Tim Regan

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