Last updated 2026-07-26
TL;DR
"Camberley" refers to a town in Surrey, England, not a US state licensing region, so American assisted living or group home rules don't apply there directly. If you're opening a US facility, licensing runs through your state's health or social services department, not a UK council. This guide explains assisted living basics, how it differs from nursing homes and group homes, and how to actually start one in the US.
Is Camberley a real assisted living licensing region, and why does this search keep coming up?
Camberley is a town in Surrey, England, part of the Surrey Heath borough. It has residential care homes and retirement living schemes regulated by the Care Quality Commission (CQC), the body that inspects health and social care providers across England [1]. If you searched "assisted living residential care home Camberley" expecting US licensing information, the short answer is: there isn't a US state or county called Camberley, and the rules that govern American assisted living facilities (state health department licenses, Medicaid waiver programs, staffing ratios set by state code) don't apply to a town in Surrey. This mixup happens a lot. "Residential care home" is the standard British term for what Americans usually call assisted living or a personal care home. In England, these homes register with the CQC under the Health and Social Care Act 2008, and CQC publishes ratings (Outstanding, Good, Requires Improvement, Inadequate) for every registered location, including ones in Camberley and the wider Surrey Heath area [1]. If you're a US-based operator or aspiring operator, what you actually need is your state licensing agency, not a UK regulator. Every US state licenses assisted living type facilities under its own name and its own chapter of code (Residential Care Facility, Assisted Living Residence, Adult Foster Care Home, Personal Care Home, and so on), and the agency is almost always a state health department, department of social services, or department of aging [2]. The rest of this article covers the US side: what assisted living is, how it differs from nursing homes and group homes, and how you'd realistically start one.
What is assisted living?
Assisted living is a type of licensed residential care that helps people with daily activities like bathing, dressing, medication reminders, and meals, while letting them live in a home-like setting rather than a hospital-style facility. It sits between fully independent senior housing and a nursing home level of medical care. The federal government doesn't operate a single national definition or license for assisted living. The Centers for Medicare & Medicaid Services (CMS) confirms that "assisted living services" are regulated at the state level and states use different terms and different rules for what counts as an assisted living residence [3]. That's why the same building type is called "Residential Care Facility for the Elderly" in California, "Assisted Living Residence" in Florida, and "Adult Care Home" in North Carolina, with different staffing rules, admission criteria, and inspection cycles in each. Most states require, at minimum: a background check on staff and owners, a written policy and procedures manual, a fire and life safety inspection, staffing that's awake and available around the clock, and a plan for medication management. Beyond that floor, requirements diverge sharply by state. "Confirm with your state licensing agency" isn't a cop-out. It's the actual first step every serious operator takes.
What is a group home?
A group home is a small residential setting, usually a single-family style house, where a small number of unrelated residents live together and receive support services from paid staff. The term covers a much wider population than assisted living: group homes serve people with intellectual and developmental disabilities (IDD), mental illness, substance use recovery needs, or seniors needing help with daily living, depending on the state license type and program funding. Group homes are typically smaller than commercial assisted living buildings, often licensed for 4 to 10 residents, and are more likely to sit inside a residential zoning district. Many states treat small group homes for people with disabilities as a protected use under the Fair Housing Act, which limits how local zoning can single them out; HUD's Fair Housing Act guidance notes that zoning ordinances cannot treat group homes for people with disabilities less favorably than similarly sized groups of unrelated people living together [4]. The licensing agency, staffing ratio, and physical plant rules for a group home depend entirely on which population it serves and which state issues the license. An IDD group home in one state might be licensed by the state's developmental disabilities agency, while a mental health group home in the same state is licensed by the behavioral health department, each with its own rulebook. If you're comparing models, our guide on assisted living facilities breaks down how licensing categories split by population and building size.
What is an assisted living facility?
An assisted living facility is the licensed building or program itself, the physical location plus the state-issued license that allows it to legally provide personal care services to residents in exchange for payment. It's different from "assisted living" the general concept; the facility is the specific licensed entity your state agency approves, inspects, and can fine or shut down. A facility license typically specifies: the maximum number of residents allowed, the level of care permitted (some states cap facilities at residents who need help with activities of daily living but not skilled nursing), staff-to-resident ratios by shift, and physical plant requirements like sprinkler systems, exit widths, and bedroom square footage. States renew these licenses on a set cycle, commonly annually, and conduct both routine and complaint-driven inspections during that period. Getting the license is a multi-step process: entity formation, background checks for owners and administrators, a facility plan review (often involving the state fire marshal), a policies and procedures manual covering admission, discharge, medication, emergency response, and abuse reporting, and a pre-licensing inspection. Our assisted living facility walkthrough covers the paperwork sequence most states use.
What is assisted living vs nursing home?
| Regulator | State licensing agency | State agency + CMS federal certification | |
|---|---|---|---|
| Medical care level | Help with ADLs, medication reminders | Skilled nursing, 24-hr clinical care | |
| Federal rules | None specific (state-defined) | 42 CFR Part 483 [5] | |
| Typical staff | Caregivers, med aides, administrator | RNs, LPNs, CNAs, therapists | |
| Medicare coverage | Not covered | Covered for limited skilled stays only | If your state uses a different name for either category, check its licensing chapter directly; our assisted living overview lists common naming patterns state by state. |
Assisted living provides help with daily living activities in a residential setting; a nursing home (also called a skilled nursing facility) provides 24-hour medical care and skilled nursing under state and federal nursing home rules, including the ones tied to Medicare and Medicaid certification. The core difference is medical intensity: nursing homes are built for people who need ongoing clinical care, IV therapy, wound care, or rehab after a hospital stay; assisted living is built for people who are largely mobile and stable but need help with tasks like bathing, dressing, or medication. Nursing homes that accept Medicare or Medicaid must meet federal Requirements of Participation under 42 CFR Part 483, which cover things like a registered nurse on duty for at least 8 consecutive hours a day, full resident assessments, and a formal survey and certification process run through CMS and the state survey agency [5]. Assisted living facilities are licensed and inspected at the state level and are not subject to these federal nursing home rules, even though many states borrow similar language for fire safety and staffing. Here's a quick side-by-side: | Feature | Assisted Living | Nursing Home |
What does assisted living provide?
Assisted living typically provides a private or semi-private room, three meals a day, help with activities of daily living (bathing, dressing, toileting, transferring, eating), medication management or reminders, housekeeping and laundry, and 24-hour staff availability for emergencies. Most states also require a written service plan for each resident that's updated on a set schedule, often every 6 to 12 months or after a significant change in condition. What's not typically included is skilled nursing care. If a resident needs IV medication, wound care beyond a simple dressing change, or ongoing physical therapy, most state rules require either bringing in outside home health services or transferring the resident to a nursing home, depending on the severity and the facility's license level. States that allow "enhanced" or "limited nursing" tiers within assisted living (some call this a Level 2 or Level 3 license) permit more, but always under specific staffing and nursing oversight rules set by that state's code. Most states also require facilities to have a written plan for emergency preparedness, including evacuation procedures, and a policy for reporting abuse, neglect, or unexplained injury to the state licensing agency or adult protective services. These aren't optional extras. They're baseline conditions of keeping the license active.
What is the difference between assisted living and nursing home?
The practical difference comes down to who's allowed to live there and what level of staff is on site. Assisted living residents are generally people who can direct their own care and just need help with daily tasks; nursing home residents often need hands-on clinical care and closer medical monitoring. States enforce this distinction through admission and retention criteria written into their assisted living codes, sometimes called "negotiated risk" or "discharge criteria" provisions. Cost structure differs too. Nursing home stays covered by Medicare are limited to specific circumstances (typically following a qualifying hospital stay, for a limited number of days, and only for skilled care), while assisted living is almost never covered by Medicare at all, a distinction covered in detail in the next section. Licensing burden also differs. Nursing homes go through federal survey and certification in addition to state licensing if they accept Medicare or Medicaid patients, adding a layer of inspection and paperwork that most assisted living facilities never touch unless they're also enrolled in a state Medicaid home and community-based services (HCBS) waiver.
Does Medicare cover assisted living facilities?
No. Medicare does not cover the cost of room and board or personal care services at an assisted living facility. Medicare.gov states plainly that Medicare "doesn't cover... assisted living, adult day care, and other long-term care services and support" as a general rule, though it may cover specific medical services (like a doctor visit or physical therapy session) that happen to occur at an assisted living facility [6]. Medicare Part A does cover a limited stay in a skilled nursing facility, but only under specific conditions: the beneficiary must have had a qualifying inpatient hospital stay of at least 3 days, need daily skilled nursing or therapy, and be admitted to a Medicare-certified facility within 30 days of that hospital stay. Even then, coverage is capped, with a copay kicking in after day 20 and coverage ending entirely after 100 days per benefit period . Medicaid is a different story. Many states cover some assisted living type services through a Medicaid Home and Community-Based Services (HCBS) waiver under Section 1915(c) of the Social Security Act, though Medicaid generally still won't pay for room and board in an assisted living setting, only the personal care and supportive services layered on top . Coverage, eligibility, and waiver waitlists vary enormously by state, so anyone planning to rely on Medicaid reimbursement needs to check their specific state's waiver program before building a business plan around it. Our assisted living facilities guide has more detail on how HCBS waivers interact with state licensing categories.
How to start a group home
Starting a group home means working through five broad stages: entity setup, license selection, facility prep, staffing and policy development, and inspection. None of these steps are optional, and skipping ahead (like signing a property lease before confirming zoning) is the single most common way operators lose money before they open. 1. Form your business entity and get an EIN. Most states require the licensee to be a legal business entity, not an individual, before they'll even accept an application. 2. Identify the exact license category you need. This depends entirely on the population you plan to serve: seniors needing help with daily living, adults with IDD, people in mental health recovery, or people in substance use recovery. Each population usually maps to a different state agency and a different chapter of code, so calling your state licensing agency directly (not a general web search) is the fastest way to confirm the right category. 3. Check zoning before you sign anything. Some group homes for people with disabilities qualify for protection under the federal Fair Housing Act, meaning local governments can't apply zoning rules to them that they wouldn't apply to an ordinary family household of similar size, per HUD's Fair Housing Act guidance [4]. That protection has limits and doesn't override every local ordinance, so confirm with your local planning or zoning department before committing to a property. 4. Build your policies and procedures manual and staffing plan. States typically require written policies covering admission and discharge criteria, medication management, emergency and disaster response, resident rights, abuse reporting, staff training requirements, and background check procedures. Staffing ratios (how many staff per resident, per shift) are set by state code and vary by population served and facility size. 5. Schedule your pre-licensing inspection. This usually covers fire and life safety (sprinklers, smoke detectors, exit signage, evacuation drills), physical plant standards (bedroom size, bathroom ratios, accessibility), and a review of your policy manual against state requirements. Building this paperwork from scratch, state by state, is genuinely one of the slower parts of the process; a state-specific licensing kit like our $299 State Group Home Licensing Kit exists to give operators a starting policy manual and application checklist built around their specific state's requirements, rather than starting from a blank document. It doesn't replace confirming details with your state agency, but it saves a lot of the drafting time.
How do I start a group home? (step order and common mistakes)
The order above matters because each step gates the next one. You can't get a facility inspection scheduled without an approved policy manual in most states; you can't finalize your policy manual without knowing your exact license category; and you can't confirm your license category without knowing which population you're serving and which state agency governs it. The most expensive mistake operators make is signing a lease or purchase agreement before confirming zoning and occupancy load with the local planning department. A house that looks perfect for six residents might be zoned for a maximum occupancy that doesn't support your resident count, or might need a costly sprinkler retrofit to meet the fire code for a licensed care facility versus a private residence. Confirm zoning and building code requirements with your local building and zoning office before signing anything. The second most common mistake is underestimating staffing costs and ratios. States set minimum staff-to-resident ratios that increase depending on the acuity of residents you accept, and going below minimum staffing on any shift is one of the fastest ways to trigger a licensing complaint. Build your staffing plan against your state's actual minimum ratio requirement, not against what "seems reasonable," and pad it, because turnover in direct care roles is high across the industry.
What's the realistic timeline and cost to get licensed?
There's no single national number here because timelines and fees are set state by state, sometimes county by county for zoning approval on top of that. What's true across nearly every state: budget for application fees, background check fees, a facility inspection fee, and often a separate fire marshal inspection fee, all payable before your license is issued. Confirm exact fee amounts with your state licensing agency, since they range widely and change periodically. Timeline-wise, expect the process from entity formation to open doors to take several months at minimum, not weeks, once you factor in zoning confirmation, facility buildout or retrofit, background check processing, policy manual review, and scheduling the pre-licensing inspection. States with a waitlist for inspector availability can add extra weeks on top of the paperwork itself. None of this is optional paperwork you can shortcut. Licensing agencies exist specifically to verify life safety and resident protection standards before allowing anyone to accept vulnerable residents into a home, and a rushed or incomplete application typically gets kicked back for corrections, adding time rather than saving it.
Frequently asked questions
What is assisted living?
Assisted living is a licensed residential care option that helps residents with daily activities like bathing, dressing, and medication reminders while they live in a home-like setting. It's regulated at the state level, not federally, so definitions and rules vary by state [3].
What is a group home?
A group home is a small residential setting where a limited number of unrelated residents live together with paid staff support. It can serve seniors, people with intellectual or developmental disabilities, mental health populations, or people in recovery, depending on the license type and state.
What is an assisted living facility?
An assisted living facility is the specific licensed building and program approved by a state agency to provide personal care services for pay. The license sets resident capacity, staffing ratios, and physical plant requirements, and is subject to renewal and inspection.
What is assisted living vs nursing home?
Assisted living helps with daily living tasks in a residential setting; a nursing home provides 24-hour skilled nursing and medical care under federal Requirements of Participation (42 CFR Part 483) in addition to state licensing [5]. Nursing homes serve higher-acuity, more medically complex residents.
What does assisted living provide?
Typically a room, meals, help with bathing, dressing, and medication, housekeeping, and 24-hour staff availability. It generally does not include skilled nursing care like IV therapy or wound care beyond basic dressing changes, which usually requires a nursing home or outside home health support.
How to start a group home?
Form a business entity, identify the exact license category for your target population, confirm zoning before signing a lease, build a state-compliant policy manual and staffing plan, and schedule your pre-licensing inspection. Each step gates the next, so order matters.
What is the difference between assisted living and nursing home?
Assisted living residents generally direct their own care and need help with daily tasks; nursing home residents need ongoing skilled nursing care and closer medical monitoring. Nursing homes also face federal certification rules under 42 CFR Part 483 that assisted living facilities don't [5].
Does Medicare cover assisted living facilities?
No. Medicare does not cover room, board, or personal care at an assisted living facility, per Medicare.gov guidance [6]. Medicare Part A may cover a limited skilled nursing facility stay under specific conditions, but that's a different setting entirely [7].
How do I start a group home?
Confirm your license category and governing state agency first, then check local zoning before signing any lease, then build your policy manual, staffing plan, and background checks, and finally schedule your pre-licensing inspection. Skipping zoning confirmation is the most common costly mistake.
Is Camberley a US state or licensing region for assisted living?
No. Camberley is a town in Surrey, England, regulated by the Care Quality Commission, not a US state licensing jurisdiction. US operators need their own state's health or social services licensing agency, which uses entirely different rules and terminology.
Does Medicaid pay for assisted living?
Some states cover certain assisted living support services (not room and board) through Medicaid Home and Community-Based Services waivers under Section 1915(c) of the Social Security Act [8]. Coverage, eligibility, and waitlists vary enormously by state, so check your specific state's waiver program directly.
What's the difference between a group home and an assisted living facility?
Group homes are typically smaller (often 4 to 10 residents) and can serve a wider range of populations including IDD, mental health, or recovery residents, more than seniors. Assisted living facilities are usually larger, senior-focused, and licensed under a state's aging or health services agency.
Sources
- Medicaid.gov, Home & Community-Based Services: US assisted living and residential care licensing is handled at the state level
- CMS.gov, Nursing Home Reform / Long-Term Care overview: Assisted living services are regulated at the state level, with definitions varying by state
- eCFR, 42 CFR Part 483 Requirements for States and Long Term Care Facilities: Nursing homes must meet federal Requirements of Participation including nursing staff and assessment rules
- Medicare.gov, Long-Term Care: Medicare does not cover assisted living, adult day care, and other long-term care services and support
- Medicare.gov, Skilled Nursing Facility Care Coverage: Medicare Part A covers a limited skilled nursing facility stay only after a qualifying 3-day hospital stay, with a copay after day 20 and coverage ending after day 100
- Social Security Administration, Section 1915(c) Home and Community-Based Services Waivers: States may cover home and community-based services, including some assisted living supports, through 1915(c) Medicaid waivers