Assisted living residence

An assisted living residence is a licensed setting where adults who need help with daily activities live and receive that help from staff. The care is the same category of care an assisted living facility provides. The word choice is the difference, and it was deliberate: the states that picked “residence” over “facility” were signaling that these are places people live, not places people are placed.

What the license actually regulates

State rules for an assisted living residence cover the same ground everywhere the term is used. Staff must be trained to a set number of hours. Medication handling has to follow a written protocol. There are minimum staffing levels, fire safety requirements, resident rights provisions, and periodic unannounced inspections.

What varies is how the state handles rising care needs. Some states license a single category and let each residence decide how much care it will take on. Others layer endorsements on top: a dementia endorsement, an enhanced care level, a nursing services designation. The endorsement, when a state uses one, is the most reliable evidence that a home is equipped for a particular need. It is checkable in the state database, unlike a marketing claim.

Residence does not mean small

A licensed assisted living residence can be a high-rise or a house. Colorado, Massachusetts, New Jersey, Rhode Island, Vermont, West Virginia, and the District of Columbia all use the term across the full size range.

Size is the variable families usually care about most, and it is not in the license name. It is in the licensed capacity, which the state records for every home. A residence licensed for six is a fundamentally different daily experience from one licensed for 120, even when the license category is identical.

How to search when this is your state’s term

Search the state database by license type rather than by the phrase you would use in conversation. A search for “board and care” in Colorado returns nothing, because that phrase has no legal meaning there. A search for assisted living residence returns everything, at which point capacity is the filter that finds the small ones.

Pennsylvania and New Hampshire use assisted living residence as a secondary category alongside a different main term, so a home in either state may hold one license or the other. Check both.

Our state directories below already filter for small licensed homes, so you can start from the list rather than from the database.