Last updated 2026-07-25
TL;DR
"Form 602" is not one national document. It's shorthand some states use for their assisted living license application or a related attachment (like a resident agreement or physical plant form). Always confirm the actual form number, name, and current version with your state licensing agency before you file.
What is form 602 in assisted living licensing?
There is no single federal "Form 602" for assisted living. State health and social services departments number their own forms, and several states happen to use "602" (or similar numbering) for a piece of the assisted living license application, a facility disclosure statement, or a resident admission agreement template. If you searched for this term because a state website or a consultant mentioned it, the safest move is to go straight to your state licensing agency's assisted living or residential care licensing page and search the exact form number there, because numbering schemes get renumbered when agencies update their rules. This matters more than it sounds like it should. Operators sometimes download an outdated PDF from a third-party site, fill it out, and get it bounced back by the licensing office because the agency moved to a revised version six months earlier. States that regulate assisted living, sometimes called residential care facilities, adult foster homes, or personal care homes depending on the state, typically publish their current forms only on the official.gov licensing portal. If you can't find "Form 602" listed there under your state's current forms library, assume the number changed or it belongs to a different state entirely. What you actually need is the full initial license application packet, not one isolated form. That packet usually bundles the application itself, a criminal background check authorization, a physical plant or fire marshal inspection form, staffing plan, policy and procedure manual, and financial disclosure. Treat any single numbered form as one piece of a larger file, not the whole submission.
What is assisted living?
Assisted living is a licensed residential setting for adults, usually older adults, who need help with daily activities like bathing, dressing, medication reminders, and meals but do not need the round-the-clock skilled nursing care a nursing home provides. The Centers for Medicare & Medicaid Services (CMS) describes assisted living as a type of "residential care community" that provides room and board along with supportive services, distinct from skilled nursing facilities [1]. Most states license these settings under names like assisted living facility, residential care facility, adult care home, or personal care home. Regulations, not a single federal statute, govern licensing, staffing ratios, resident rights, and physical plant standards, and they vary widely by state. That's why the actual paperwork (including whatever "Form 602" turns out to be in your state) differs from Ohio to Texas to California. A baseline national figure worth knowing: the National Center for Health Statistics reported roughly 1.2 million licensed assisted living and residential care beds nationwide as of its most recent survey years [2]. That gives you a sense of scale, but licensing rules are set state by state, not nationally, so the bed count doesn't translate into one uniform rulebook.
What is a group home?
A group home is a licensed residential setting, usually smaller than an assisted living facility, where a group of unrelated residents live together and receive support services, supervision, or care from staff. The term covers several populations: people with intellectual or developmental disabilities (IDD), adults recovering from substance use, people with serious mental illness, and in some states, seniors who need a lower level of care than assisted living requires. Group homes and assisted living facilities overlap in some states and are licensed under entirely separate rules in others. A four-bed adult foster care home in one state might fall under the same licensing chapter as a 60-bed assisted living building in another. The practical difference for an operator: group homes serving IDD or behavioral health populations often answer to a state's developmental disabilities or behavioral health agency, while senior-focused assisted living answers to the state health department or department of aging. Confirm with your state licensing agency which category your planned population and building size actually fall under before you start filling out any application, whether it's numbered 602 or something else entirely.
What is an assisted living facility?
An assisted living facility is a licensed building or set of buildings where residents live in private or semi-private rooms or apartments and receive personal care services, meals, housekeeping, and often medication management, under state oversight. It sits between independent living (no licensed care) and a nursing home (skilled, 24-hour medical care) on the continuum of senior housing. License categories inside "assisted living" often stack. Many states have tiered licenses, for example a basic personal care license and a higher "limited nursing" or "enhanced" tier that allows the facility to keep residents with greater care needs, administer more medications, or handle certain medical devices. The application forms differ by tier, and this is a common reason states use multiple numbered forms (602, 603, 604, etc.) within one licensing chapter. Before you build a staffing plan or lease a property, pin down which tier you're licensing for. A facility licensed only for basic personal care that admits a resident who needs skilled nursing-level care can get cited during inspection for admitting someone outside its scope of license, an issue surveyors flag under most states' resident admission and retention rules.
What is assisted living facility (same term, different framing)
If you're seeing "what is assisted living facility" phrased without the article "an," it's usually someone searching from a state licensing document or form title, since state statutes and rule chapters often drop the article in section headers (for example, "Assisted Living Facility Licensing Requirements" as a chapter title). The substance is identical to the definition above: a licensed residential setting providing personal care and supportive services short of skilled nursing care. One practical note: when you're reading a state's actual licensing statute or rule chapter (the kind of document that eventually produces a form numbered something like 602), the definitions section at the start of the chapter is the one place you should always read word for word. States define terms like "personal care," "resident," "assisted living facility," and "administrator" with specific legal meaning that controls what your license permits and what your inspector checks against. Don't rely on a summary article, including this one, as a substitute for that definitions section in your state's actual code.
What is the difference between assisted living and nursing home?
| Staffing | Personal care aides, part-time or on-call nurse | Licensed nurses on-site 24/7 | |
|---|---|---|---|
| Medical acuity | Low to moderate, stable conditions | Moderate to high, often post-hospital | |
| Typical setting | Apartment-style or private room | Hospital-like room, shared or private | |
| Medicare coverage | Not covered | Short-term skilled stays covered under conditions [3] | |
| Regulator | State health/aging department, varies | State health department, plus federal CMS certification | The regulatory difference matters as much as the clinical one. Nursing homes that accept Medicare or Medicaid must be certified by CMS and meet federal Conditions of Participation under 42 CFR Part 483 [4]. Assisted living facilities are licensed purely at the state level; there is no federal assisted living certification program. |
The core difference is level of medical care and staffing. Assisted living provides help with daily living activities and some health monitoring, staffed mainly by personal care aides and often a part-time or on-call nurse. A nursing home (also called a skilled nursing facility, or SNF) provides 24-hour skilled nursing care, staffed by licensed nurses around the clock, and is built to handle residents recovering from surgery, managing complex medical conditions, or needing rehabilitation therapy. CMS draws this distinction directly in its nursing home guidance, describing skilled nursing facilities as providing "skilled nursing care and related services for residents who require medical or nursing care" and rehabilitation services, a higher acuity threshold than assisted living is licensed to meet [3]. | Feature | Assisted living | Nursing home (SNF) |
What does assisted living provide?
At minimum, licensed assisted living provides a private or semi-private living space, three meals a day, help with activities of daily living (bathing, dressing, toileting, transferring, eating), housekeeping, laundry, medication management or reminders, and 24-hour staff availability for safety and emergencies. Most facilities also provide social and recreational activities and transportation to medical appointments. What's not typically included: skilled nursing procedures like wound care beyond basic first aid, IV therapy, ventilator care, or rehabilitation therapy at a hospital-level intensity. States define the specific list of permitted and prohibited services in their assisted living rule chapters, and this list is exactly what your license application and inspection checklist will test you against. A facility that wants to offer a broader scope of nursing-adjacent services usually needs a higher license tier, sometimes with its own separate form. Medication administration rules deserve their own callout because they trip up new operators constantly. Many states distinguish between "medication reminders" (any staff member can do this), "medication assistance" (may require a certified med aide), and "medication administration" (often restricted to licensed nurses). Get this distinction from your state's specific rule chapter, not from a general checklist, because the line moves state to state and the wrong assumption here is one of the most common citation-generating errors on first inspections.
Does Medicare cover assisted living facilities?
No. Medicare does not cover the cost of room and board or personal care services in an assisted living facility. Medicare.gov states plainly that "Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home)" and separately clarifies that long-term custodial care, which is what assisted living primarily provides, is excluded from Medicare coverage [1]. What Medicare will cover, even for a resident living in assisted living, is medically necessary services delivered there: doctor visits, physical therapy ordered by a physician, durable medical equipment, and hospice care services (though not the room and board portion of hospice). Medicaid is the more relevant program for long-term assisted living costs, but coverage there is inconsistent. Some states cover assisted living-type services through a Medicaid Home and Community-Based Services (HCBS) waiver under section 1915(c) of the Social Security Act, which allows states to cover services in community settings as an alternative to nursing home placement [5]. Coverage, waiting lists, and eligibility rules differ enormously by state, so operators should confirm with their state Medicaid agency whether their facility type qualifies as an HCBS waiver provider before assuming any Medicaid revenue stream exists. For family members shopping for care, this Medicare gap is the single most common source of financial shock, and if you're marketing your facility, be direct with prospective families about this rather than letting the Medicare question linger unanswered during a tour.
How to start a group home
Starting a group home (or an assisted living facility) means working through five stages that every state licensing agency structures roughly the same way, even though the specific forms and fees differ: 1. Pick your population and license type. IDD, mental health, recovery, adult foster care, and senior assisted living are usually licensed under different chapters, sometimes different state agencies entirely. This decision drives every form you'll file after it. 2. Check zoning and property requirements first, before you sign a lease. Group homes serving people with disabilities are generally protected under the Fair Housing Act's reasonable accommodation provisions, but zoning classification, occupancy limits, fire code, and building type still apply and vary by municipality [6]. Related reading: assisted living covers how state license categories interact with local zoning. 3. Build your policy and procedure manual, staffing plan, and emergency plan. Most states require these as attachments to the initial license application, not as separate approvals you can add later. 4. Submit the full license application packet to your state agency, including background checks for owners and staff, fire and health inspections, and any facility-specific forms like the "Form 602" style document this article started with. Expect application review timelines that range from a few weeks to several months depending on the state and how complete your first submission is; confirm with your state licensing agency for its current published timeline. 5. Pass your pre-licensure inspection. Health, fire, and sometimes building inspectors will walk the physical space against a checklist tied to your specific license type before the agency issues the license. If you want a structured starting point instead of assembling this from scratch, GroupHomePath's $299 State Group Home Licensing Kit organizes the application checklist, policy manual template, and staffing plan format by state, so you're not guessing which forms your state actually requires.
How do I start a group home (state-by-state considerations)
The mechanics above hold everywhere, but three things differ enough state to state that they deserve separate confirmation before you spend money: License category and agency. In many states the department of health licenses assisted living and adult care homes, while a separate department of human services, developmental disabilities, or behavioral health licenses IDD, mental health, and recovery group homes. Filing with the wrong agency wastes weeks. Capacity thresholds. Some states set a low resident cap (commonly around 3 to 8 residents) for the lightest-touch licensing tier, above which stricter fire and building codes apply. These thresholds are set in each state's own code, not nationally, so don't assume a number from one state applies to yours. Fire and life-safety code. Most states adopt some edition of the National Fire Protection Association's Life Safety Code (NFPA 101) for residential care occupancies, but the specific edition adopted and how it applies to small group homes versus larger facilities is set by each state fire marshal's office . Confirm the adopted edition and occupancy classification with your state fire marshal, not with a general contractor's assumption. For state-specific licensing detail, see assisted living facility and assisted living facilities, which walk through how these categories are typically structured.
What should be in your license application packet besides the numbered forms
Whatever your state calls its core application (Form 602 or otherwise), the agency almost always wants a packet, not a single document. Expect to assemble: - A completed license application with owner and administrator information
- Criminal background check authorization and results for owners, administrators, and direct care staff
- Proof of financial capacity to operate (some states require a specific cash reserve or bond)
- A staffing plan showing coverage ratios by shift
- A policy and procedure manual covering admission/discharge criteria, medication management, emergency preparedness, resident rights, and incident reporting
- Fire marshal inspection approval and health department inspection approval
- Proof of zoning compliance or a certificate of occupancy for the intended use Missing one document is the single most common reason initial applications get sent back for revision rather than denied outright. Building the full packet before your first submission, rather than filing piecemeal as the agency asks for each piece, generally shortens your overall time to licensure, though exact review timelines are set by each state and you should confirm current processing times with your state licensing agency directly.
How does assisted living compare to home-based care options
Some families and even some operators consider a hybrid model: personal care delivered in a private home rather than a licensed facility. This is sometimes marketed as assisted living at home, but it is a fundamentally different licensing category from a residential facility license. If personal care staff are coming into a private residence rather than residents moving into a licensed facility, most states require a home care agency license instead of (or in addition to) a residential facility license, and the two license types have almost no form overlap. If you're weighing that model, read assisted living at home before assuming your facility license work transfers over, because it generally doesn't. Families searching for options nearby, often typed as "senior assisted living facilities near me," are typically comparing licensed facilities in their local area on cost, level of care, and availability; that consumer-side search behavior is a different question from the operator-side licensing question this article covers, but see senior assisted living facilities near me if you're building a facility's public-facing information and want to understand how prospective residents actually search.
Frequently asked questions
What is assisted living?
Assisted living is a licensed residential setting, usually for older adults, that provides help with daily activities like bathing, dressing, and medication reminders, plus meals and housekeeping, without the 24-hour skilled nursing care a nursing home provides. States license and regulate assisted living individually; there's no single federal licensing standard for it.
What is a group home?
A group home is a licensed residential setting where several unrelated residents live together and receive support or supervision from staff. It can serve seniors, people with intellectual or developmental disabilities, people in mental health or substance use recovery, or other populations, depending on the state's licensing category and the home's specific license.
What is an assisted living facility?
An assisted living facility is the licensed building where assisted living services are delivered: private or semi-private rooms, meals, personal care help, and staff availability around the clock, all under a state-issued license. It sits between independent senior housing and a nursing home on the continuum of care.
What is the difference between assisted living and a nursing home?
Assisted living provides help with daily activities and is staffed mainly by personal care aides. A nursing home provides 24-hour skilled nursing care for residents with higher medical needs, staffed by licensed nurses around the clock and federally certified under CMS Conditions of Participation if it accepts Medicare or Medicaid.
Does Medicare cover assisted living facilities?
No. Medicare does not cover room, board, or custodial personal care in assisted living. It may cover medically necessary services delivered to a resident there, like physician visits or physical therapy. Medicaid, through state Home and Community-Based Services waivers in some states, is the more relevant coverage source, but availability varies by state.
How do I start a group home?
Pick your population and license category, confirm zoning and fire code requirements before signing a lease, build your staffing plan and policy manual, submit a complete license application packet to the correct state agency, and pass your pre-licensure health and fire inspections. Timelines and specific forms vary by state; confirm both with your state licensing agency.
What is Form 602 for assisted living licensing?
There's no single national "Form 602." Some states use that number for a piece of their assisted living or residential care license application, such as a facility disclosure or resident agreement form. Confirm the exact form name, number, and current version on your specific state licensing agency's official forms page before filing.
What does assisted living provide that home care doesn't?
Assisted living provides a licensed living space plus staff on-site around the clock, meals, and built-in supervision. Home care sends an aide into a private residence for scheduled hours without on-site staff coverage overnight or a licensed facility structure. The two are licensed under different categories in most states.
Can a group home serve both seniors and people with disabilities?
It depends on the state's licensing rules. Some states allow mixed-population homes under one license category; others require separate licenses tied to the specific population served (aging, IDD, mental health, or recovery), each with its own agency and forms. Confirm with your state licensing agency before planning a mixed-population home.
How long does it take to get an assisted living license approved?
Timelines vary widely by state and depend heavily on how complete your first submission is. Some states process straightforward applications in a matter of weeks; others take several months, especially if inspections or corrections are needed. Confirm current published processing timelines with your specific state licensing agency.
What's the difference between a personal care license and an assisted living license?
In states that use both terms, personal care licenses often cover a lower level of service (help with daily activities, no medication administration) while assisted living licenses allow a broader scope, sometimes including medication administration or limited nursing tasks. The exact line between them is set by each state's own rule chapter.
Do group homes have to follow the Fair Housing Act?
Group homes serving people with disabilities are generally protected under the Fair Housing Act's reasonable accommodation provisions for zoning, but the home still must meet applicable building, fire, and occupancy codes. HUD's guidance on reasonable accommodations explains how this protection interacts with local zoning restrictions.
Sources
- CMS, Nursing Home Care and Related Facility Types: Medicare distinguishes assisted living/residential care from skilled nursing facilities and excludes long-term custodial care from coverage
- CDC/NCHS, Long-Term Care Providers and Services Users in the United States: National count of licensed residential care/assisted living beds
- Medicare.gov, Skilled Nursing Facility Care: Definition and distinction of skilled nursing facility care under Medicare
- eCFR, 42 CFR Part 483: Federal Conditions of Participation govern Medicare/Medicaid-certified nursing homes
- Medicaid.gov, Home & Community-Based Services 1915(c): States may cover assisted living-type services through Section 1915(c) HCBS waivers
- NFPA 101, Life Safety Code: States commonly adopt an edition of NFPA 101 for residential care occupancy fire and life-safety requirements