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Assisted Living State Regulatory Review

NCAL's 2009 Assisted Living State Regulatory Review

Published in March 2009, this 233-page report offers a state-by-state summary of assisted living regulations covering 21 categories; provides contact information for state agencies that oversee assisted living activities; and includes each agency’s Web site address.  In 2008, with the federal election and a deepening national economic recession as a backdrop, state assisted living regulations continued evolving in dynamic ways, though at a somewhat slower pace than the previous year. NCAL members can download a summary of regulatory changes in 2008 and state-by-state highlights.

  • At least 18 states made regulatory changes impacting assisted living/residential care facilities in 2008 with at least six of these states making major modifications.  More than 10 states are working on significant or major changes in 2009.
  • As in previous years, states continued developing standards to accommodate residents with higher health care needs.
  • Maryland overhauled its regulations.  Tennessee made major changes allowing facilities to care for residents with greater health care needs.  New York promulgated regulations establishing assisted living licensure under a 2004 statute and New Hampshire adopted rules governing one of its two levels of licensure.
  • Several states made changes to regulations relating to emergency/disaster preparedness; fire safety; staff training; medication management; disclosure; and background checks.
  • In some states, increased fiscal pressure on state Medicaid programs precipitated debates over payment rates and move-out policies.

Click on a link below to download the 2009 edition or past editions of the report. To obtain a printed copy of the 2009 edition, call (202) 898-2855, or send an e-mail to Be sure to include your name, address, and phone number.


 Assisted Living State Regulatory Reviews