Assisted living in the United States: cost, licenses, and how to choose
Assisted living is housing plus help with daily activities — bathing, dressing, medications, meals — for someone who does not need round-the-clock skilled nursing. It is licensed by states, not scored by CMS. Explore communities, compare available records, and prepare for tours with Haven’s free family tools.
Local metros differ. Medicare does not pay this room-and-board bill.
What assisted living is — and is not
Seniors who need help with some activities of daily living (ADLs) but do not require round-the-clock skilled medical care. Communities typically include a private or shared apartment, meals, housekeeping, activities, and scheduled help. They are not hospitals and not skilled nursing facilities. If your parent needs 24/7 licensed nursing, look at skilled nursing and CMS Care Compare — not an assisted-living brochure.
How to pay (and why Medicare will not)
Most families pay privately: savings, proceeds from a home sale, or long-term care insurance. Some states offer Medicaid waivers that cover the careportion for people who qualify; many communities do not accept them. Wartime veterans may qualify for VA Aid & Attendance. Medicare still does not pay assisted-living room and board.
State licenses vs CMS nursing-home stars
CMS stars, staffing hours, and federal health-inspection ratings apply to Medicare-certified nursing homes. Assisted living has no equivalent federal score. Use the state license, the latest state survey, complaint history, and what you observe during visits. Available reports vary by state; each community page links to the sources we have.
How to compare your options
- Prepare for a care conversation with the free 2-minute assessment.
- Read state licenses and inspection reports — not CMS stars, and not a Haven score.
- Tour at least three communities; go back once unannounced.
- Compare all-in monthly cost, not the base rate.
- Read the contract before any deposit. The 5-step guide walks the tour, price, and paperwork.
Find communities and prepare for visits
Search communities near your family, explore care options, or print the free family guide to keep your questions and comparisons together.
Common questions
How much does assisted living cost?
Assisted living typically costs $4,700–$7,400 per month nationally (a broad planning range, not a measured national price range). Metro pages show modeled planning estimates, not community quotes. The advertised base rate is rarely the all-in price — care levels, medication management, and community fees add on.
Does Medicare pay for assisted living?
No. Medicare does not pay room and board in assisted living. It may cover certain medical services a resident receives, and short rehab in a skilled nursing facility after a qualifying hospital stay. Families typically use savings, a home sale, long-term care insurance, a state Medicaid waiver if eligible, or VA Aid & Attendance.
How do I check assisted living inspections?
Assisted living is licensed and surveyed by each state, not CMS. There are no federal star ratings. Ask every community for its last two inspection reports and any substantiated complaints, and look up the license on the state site when it is public. Use CMS Care Compare only for nursing homes.
How many assisted living communities should we tour?
Tour at least three so you have a real comparison. Visit each finalist twice: the scheduled weekday tour, then an unannounced visit at a meal or on a weekend. Get an itemized all-in quote in writing before you write a deposit check.
What is the difference between a state AL license and a CMS nursing-home rating?
A state license means the community is allowed to operate assisted living under that state's rules. A CMS star rating is a federal score for Medicare-certified nursing homes. Haven does not convert one into the other or invent an assisted-living star.