Assisted Living Facility

What is an Assisted Living Facility?

An Assisted Living Facility (ALF) is a housing option for people who require more assistance than Home Health Care may provide but less assistance than a Nursing Home provides. ALF’s may provide an entire apartment, a single room or a shared room.

The Assisted Living Facility may require you to sign a rental agreement that includes the cost of your rent, what health services are included and the added cost for additional care services.  The rental agreement may specify when you are no longer medically eligible to remain in the ALF. You may be required to provide 30 days notice before moving out or risk paying a penalty.


Costs range between $25,000 to $50,000 per year, however, additional health care services may be billed separately. Most Assisted Living Facility residents pay privately. Not all Long Term Care Insurance plans cover the cost of living in an Assisted Living Facility. Some states do provide Medicaid coverage for residents of Assisted Living Facilities however not all ALF’s accept Medicaid.

Some types of  health care services that may be provided:

  • 3 Meals a day plus snacks
  • Housekeeping and laundry
  • Staff member available 24/7
  • Help with bathing, dressing, and eating
  • Help with medications (reminders or administering)
  • Recreational activities

Choosing an Assisted Living Facility

Two major concerns you may have when considering assisted living is the cost of the care. First, can you afford it and what happens if you run out of money? Consider all of your financial resources-sale of your home, retirement accounts, savings, pensions, VA benefits long term care insurance. When visiting facilities to determine if they will meet your care needs ask what the policy and practice is for residents who outlive their financial resources. Does the facility offer a reduced rate if you are willing to share a room? Does the ALF accept Medicaid? Is preference given current residents when a Medicaid bed becomes available?

Second, what is the quality of the care you will receive? This may take a bit more research because ALF’s are a housing provider first and health care provider second. ALF’s are licensed and regulated by the state they are located in. Contact your state’s Long Term Care Ombudsman to learn if there have been any complaints against the facility.

Long Term Care Ombudsman are advocates for residents of nursing homes, board and care homes and assisted living facilities.Under the federal Older Americans Act, every state is required to have an Ombudsman Program that addresses complaints and advocates for improvements in the long-term care system. Ombudsmen provide information about how to find a facility and what to do to get quality care.

Once you locate an ALF near you:

  • Schedule a visit to tour the facility and eat a meal
  • Talk with the Staff, Residents and Families
  • Use your 6 senses
    • What do you see? Is it clean, do residents appear well cared for, is it a decor you like, are staff easily identifiable & available
    • What do you hear? Are staff polite to each other, how do they address residents, are there call lights ringing unanswered, are residents yelling for assistance
    • What do you smell? Do you smell body odors, or a port-a-potty on a hot summer day, staff perfume/cologne, strong cleaning chemicals-bleach/ammonia/air freshners,
    • What do you feel? Is the floor tacky, are salt & pepper shakers sticky, handrails smooth and in reach
    • What do you taste? Is the food good, does the menu have variety and appealing alternatives
    • What does your gut tell you? would you fit in with other residents, do you like the overall environment
  • Make an unscheduled visit at another time such as an evening or weekend


To have an idea of what it is like to transition into an ALF long term care facility watch “The Thin Edge of Dignity by Dick Weinman”

Why Should I Care?

You may appreciate the security of having 24/7 staff available to you

while still retaining a great deal of your independence.