Last updated 2026-07-26
TL;DR
Every state runs its own online license lookup for assisted living facilities, usually through the state health department or social services agency. Search the facility's legal name or license number, check the expiration date and any listed violations, and confirm with your state licensing agency if the tool doesn't cover your specific facility type (adult foster care, memory care, or IDD homes often have separate registries).
What is assisted living?
Assisted living is a residential care option for people who need help with daily activities like bathing, dressing, medication management, or meals but don't need the round-the-clock medical care a nursing home provides. Residents typically live in private or semi-private apartments or rooms and get support from staff on site, plus access to meals, housekeeping, and some level of health monitoring. The federal government doesn't license or define assisted living directly. That job falls to each state. The Centers for Medicare & Medicaid Services (CMS) has noted that "there is no federal definition of assisted living," which is why the rules, the terminology, and even the name of the license can differ wildly depending on where you are [1]. Some states call it "assisted living facility," others use "residential care facility," "personal care home," or "adult care home." This patchwork matters a lot if you're trying to verify a license. You can't just Google "assisted living license lookup" and trust the first result works everywhere. You need the specific state agency that regulates that specific type of care in that specific state.
What is a group home?
A group home is a residential setting where a small number of unrelated people live together and receive support services, usually because of a disability, behavioral health need, or age-related care requirement. Group homes are common in intellectual and developmental disability (IDD) services, mental health and recovery housing, and adult foster care, and they sometimes overlap with assisted living licensing categories depending on the state. The key difference from assisted living is scale and population. A group home is often licensed for a handful of residents (commonly 4 to 8, though this varies by state and program type) and may be regulated under a different chapter of state code than a large assisted living building with 50 or 100 units. If you're verifying a license, the first step is figuring out which regulatory bucket the home actually falls into, because a group home for adults with IDD is very likely licensed by a different agency than a senior assisted living building down the street. For a broader look at how these categories differ, see our guide on assisted living facilities.
What is an assisted living facility?
An assisted living facility (ALF) is a licensed residential building or program that provides housing, personal care assistance, and supervision to residents who need help with daily living but don't require skilled nursing care. States license ALFs under specific statutes, and each facility is assigned a license number, a license status (active, provisional, suspended, revoked), and an expiration date that the public can usually check online. Most state licensing databases let you search by facility name, license number, city, or county. Florida, for example, maintains a searchable provider database through its Agency for Health Care Administration where you can pull up license status, inspection history, and any enforcement actions for a specific ALF [2]. California runs a similar tool through the Department of Social Services Community Care Licensing Division, covering Residential Care Facilities for the Elderly. When you search, look for three things: is the license currently active, when does it expire, and is there a history of substantiated complaints or citations. A license that's "pending renewal" isn't automatically a red flag, but a lapsed or suspended license is. Always confirm the current status directly with your state licensing agency rather than relying on a cached search result, since these databases update on different schedules (some daily, some weekly).
What is assisted living facility (how do state definitions vary)?
The legal definition of "assisted living facility" is written into each state's health and safety code or administrative rules, and the specifics (minimum staffing ratios, allowable resident acuity, medication administration rules, physical plant requirements) vary enough that a facility legal in one state might not qualify for the same license type in another. For example, Texas defines and licenses assisted living facilities under its Health and Safety Code Chapter 247, administered by the Texas Health and Human Services Commission [3]. Ohio licenses "residential care facilities" under Ohio Revised Code Chapter 3721 through the Ohio Department of Health [4]. Same basic care model, different statute number, different regulator, different inspection cycle. This is why a national "one-click" verification tool doesn't really exist. You have to go state by state. If you're comparing definitions across states as part of an expansion plan, our assisted living facility guide breaks down how licensing categories map across a handful of states.
How do I verify an assisted living facility license, state by state?
To verify a license, start with the state agency that regulates assisted living in that state, not a general web search. Most states publish a free, public-facing license verification or provider search tool. Here's the general process: 1. Identify the correct regulating agency for that state and facility type (health department, social services department, or a dedicated licensing division). 2. Search by the facility's legal business name and address, since a marketing name ("Sunny Meadows") often differs from the licensed entity name. 3. Confirm the license status, issue date, and expiration date. 4. Check for a public inspection or survey report and any complaint history, if the state publishes one. 5. Call the agency directly if anything is ambiguous. Most licensing divisions have a phone line for exactly this purpose. Some examples of what these tools look like in practice: Florida's AHCA Florida Health Finder database lets consumers search licensed ALFs and view inspection reports [2]. California's Community Care Licensing Division provides a facility search tool covering RCFEs, including citation history. Texas HHS maintains a provider search covering assisted living facilities licensed under Chapter 247 [3]. Because every state names its tool something different and updates on a different cycle, the honest answer is: confirm directly with your state licensing agency every time, especially before signing a lease, placing a family member, or representing a license as active in any marketing material.
What does assisted living provide?
Assisted living typically provides a private or semi-private living space, three meals a day, help with activities of daily living (bathing, dressing, grooming, toileting, mobility), medication management or reminders, housekeeping and laundry, social and recreational activities, and 24-hour staff availability for basic needs and emergencies. What it does not typically provide is skilled nursing care, ongoing IV therapy, ventilator support, or the intensive medical monitoring found in a nursing home. States set specific rules about what level of care an ALF can legally provide before a resident must be discharged or transferred to a higher level of care. These are usually called "admission and retention" or "negotiated risk" standards, and they vary significantly by state. Medication administration is a good example of how granular these rules get. Some states allow only "assistance with self-administration," meaning staff can remind and hand over medication but the resident must physically take it themselves, while other states permit licensed or certified staff to administer medication directly. This single rule difference changes what kind of staff you need to hire and how you write your medication policy. For help building compliant policy documents, see our page on assisted living.
What is the difference between assisted living and nursing home?
| Regulator | State licensing agency only | State licensing + federal CMS certification | |
|---|---|---|---|
| Care level | Help with daily activities | 24-hour skilled nursing | |
| Staffing | Direct care aides, medication aides | RNs, LPNs, therapists on staff | |
| Medicare coverage | Generally not covered | Short-term skilled care may be covered | |
| Public federal database | No, state-only | Yes, CMS Care Compare | If you're deciding which license type fits your business model, our facility assisted living guide walks through how states classify care levels. |
The core difference is the level of medical care. Assisted living is for people who need help with daily activities but are medically stable and don't need continuous skilled nursing. A nursing home (also called a skilled nursing facility or SNF) provides 24-hour skilled nursing care, rehabilitation services, and is built to handle residents with significant medical needs, including those recovering from surgery, managing complex chronic conditions, or requiring end-of-life care. Regulatory oversight differs too. Nursing homes are certified under federal Medicare and Medicaid rules in addition to state licensing, and they're subject to federal survey standards enforced by CMS [1]. Assisted living facilities are licensed purely at the state level with no federal certification requirement, which is part of why federal oversight and public reporting on ALFs is much thinner than what exists for nursing homes through the CMS Care Compare tool. | Feature | Assisted living facility | Nursing home (SNF) |
Does Medicare cover assisted living facilities?
No. Medicare does not cover the cost of room and board in an assisted living facility. CMS states plainly that "Medicare doesn't cover long-term care (also called custodial care)" if that's the only care a person needs, and assisted living room and board falls squarely into that custodial category [1]. Medicare Part A may cover short-term skilled nursing care in a certified SNF after a qualifying hospital stay, and Medicare Part B may cover specific medical services a resident receives while living in an ALF (like doctor visits or physical therapy), but it does not pay the facility's monthly rent or personal care fees. Medicaid is a different story, though still limited. Many states offer Medicaid Home and Community-Based Services (HCBS) waivers that can help cover personal care services within an assisted living setting, but Medicaid generally still does not pay for room and board itself. The federal HCBS waiver authority sits under Section 1915(c) of the Social Security Act, and Medicaid.gov confirms that states can use these waivers to fund home and community-based services as an alternative to institutional care [5]. Coverage details, waiting lists, and whether room and board is separately billed to the resident all vary by state, so confirm with your state Medicaid agency and licensing agency together before assuming a facility accepts Medicaid waiver residents.
How to start a group home
Starting a group home involves choosing a population to serve, picking a business and licensing structure, meeting your state's physical plant and zoning requirements, hiring qualified staff, and passing a pre-licensing inspection before you can accept your first resident. The exact sequence and paperwork differ by state and by program type (IDD, mental health, adult foster care, or assisted living for seniors). A realistic sequence looks something like this: 1. Decide which population and license category you're pursuing (this determines your regulating agency). 2. Research your state's specific licensing statute and administrative code for that category. 3. Confirm local zoning allows a group home use at your chosen property, including any occupancy or fire code requirements. 4. Write required policy and procedure manuals (medication management, emergency preparedness, resident rights, staffing plans, grievance procedures). 5. Hire and train staff to meet state-required ratios and background check requirements. 6. Submit your license application with required fees, which range widely by state. 7. Pass a pre-licensure health and safety or fire marshal inspection. 8. Receive your license and complete any post-licensure orientation requirements. None of this is fast. Depending on the state, expect the process from initial application to opening day to take several months at minimum, and longer if your property needs renovation to meet fire and life-safety code. Nobody has solid national data on average approval timelines because every state processes and reports this differently; the honest answer is to ask your state licensing agency directly what their current processing time looks like. Building every required document from scratch (policy manuals, staffing plans, emergency procedures, intake forms) is the single biggest time sink for first-time operators. This is the exact gap the $299 State Group Home Licensing Kit is built to close: a starting set of state-specific policy templates and application checklists so you're editing instead of drafting from a blank page. It doesn't replace your state's application or guarantee approval, but it can save real weeks of writing time.
How do I start a group home (what's the realistic cost and timeline)?
There is no single national number for group home startup costs because licensing fees, property costs, staffing requirements, and renovation needs vary enormously by state, population served, and facility size. What's true everywhere is that you'll pay a state licensing application fee (often a few hundred dollars, though some states charge per-bed fees or scale by capacity), cover the cost of any required property modifications to meet fire and accessibility code, and budget for staff wages and required training before you generate any revenue. Because this figure changes so much by state and program type, confirm current fee schedules directly with your state licensing agency rather than relying on any single published number. A mental health group home licensed for 6 residents in a converted single-family home has a very different cost profile than an assisted living building licensed for 40 units. The timeline question has the same answer: it depends heavily on how quickly your local fire marshal and building inspector can schedule inspections, whether your property needs renovation, and how backlogged your state's licensing office currently is. Ask directly and get it in writing if you can, since verbal estimates from front-line staff sometimes don't match actual processing queues.
How can I check if my own facility's license is displayed correctly?
Search your facility exactly as it appears in your state's public license database, using both your legal entity name and your DBA or marketing name, and confirm the address, license number, and expiration date match your actual license certificate. Discrepancies happen more often than you'd think, especially after a change of ownership, an address correction, or a license renewal that hasn't been processed into the online system yet. If you find an error, most states have a specific licensing division contact (not a general phone tree) for correcting database records. Keep a copy of your current license certificate on hand, because you may need to fax, email, or upload it as proof when requesting a correction. This matters beyond administrative tidiness. Families and referral sources (hospital discharge planners, case managers, disability service coordinators) increasingly check these public databases before making a placement decision. A facility that shows as "expired" or "not found" online, even if the paperwork is actually fine on your end, can cost you a referral. Check your listing at least once a quarter.
What should I do if a facility's license doesn't show up at all?
If a facility doesn't appear in your state's licensing database at all, it may be unlicensed, licensed under a different legal name, licensed under a different category than you searched, or simply not yet entered into a database that lags behind actual licensing actions. Don't assume the worst immediately, but don't ignore it either. The right next step is to call the state licensing agency directly and ask them to search their internal records by address rather than name, since address-based searches often surface a facility that a name search misses. If the agency confirms no license exists for that address and that type of care, that's a serious finding, particularly for family members researching a placement or for operators doing due diligence on a facility acquisition. For operators buying an existing facility, this check should happen before closing, not after. An unlicensed or improperly licensed facility can mean unwinding a purchase, facing back fees, or in some states, facing civil penalties tied to operating without proper authority.
Frequently asked questions
What is assisted living?
Assisted living is residential care for people who need help with daily activities like bathing, dressing, and medication management but don't need 24-hour skilled nursing care. Residents live in private or shared units and receive meals, housekeeping, and staff support on site. States, not the federal government, define and license assisted living, so rules and terminology vary widely from state to state.
What is a group home?
A group home is a residential setting, usually for a small number of residents, where people with disabilities, mental health needs, or age-related care needs live together and receive support services. Group homes are common in IDD, mental health, recovery, and adult foster care programs, and are often licensed under different state statutes than large assisted living buildings.
What is an assisted living facility?
An assisted living facility is a licensed residential building that provides housing, personal care assistance, and supervision for residents who need help with daily living but don't require skilled nursing. Each state issues its own license, assigns a license number and expiration date, and typically publishes a public search tool so you can verify a facility's current status.
What is assisted living vs nursing home?
Assisted living serves residents who need help with daily activities but are medically stable; nursing homes provide 24-hour skilled nursing for people with significant medical needs. Nursing homes carry federal Medicare/Medicaid certification and appear on CMS Care Compare, while assisted living facilities are licensed only at the state level with no equivalent federal database.
What does assisted living provide?
Assisted living typically provides a living space, meals, help with bathing, dressing, and mobility, medication management or reminders, housekeeping, social activities, and staff available 24 hours a day for basic needs. It does not provide skilled nursing care, IV therapy, or the intensive medical monitoring found in a nursing home.
How do I verify an assisted living facility's license online?
Go to the specific state agency that licenses assisted living (health department or social services department, depending on the state) and use its public license search tool. Search by the facility's legal name and address, check the license status and expiration date, and call the agency directly if the result is unclear or missing.
Does Medicare cover assisted living facilities?
No. Medicare does not cover room and board or custodial care in assisted living. It may cover short-term skilled nursing after a hospital stay or specific medical services delivered to a resident living in an ALF, but it never pays the facility's monthly personal care or housing costs directly.
Does Medicaid pay for assisted living?
Sometimes, through state Medicaid Home and Community-Based Services (HCBS) waivers, which can help cover personal care services in an assisted living setting. Medicaid generally still does not cover room and board itself, and waiver availability, waiting lists, and covered services vary significantly by state, so confirm directly with your state Medicaid office.
How do I start a group home?
Choose the population you'll serve, identify the correct state licensing category and agency, confirm local zoning allows the use, write required policy manuals, hire qualified staff, submit your license application with required fees, and pass a pre-licensure inspection. The exact steps, fees, and timeline differ by state and by program type.
What is the difference between assisted living and a nursing home in terms of licensing?
Assisted living facilities are licensed only at the state level, with no federal certification requirement. Nursing homes must meet both state licensing rules and federal Medicare/Medicaid certification standards enforced through CMS surveys, which is why nursing homes appear in the federal Care Compare database and assisted living facilities generally do not.
How much does it cost to start a group home?
There's no single national figure because licensing fees, property costs, and staffing requirements vary by state and population served. Costs include a state application fee, any required property renovations for fire and life-safety code, and staff wages and training before opening. Confirm current fee schedules directly with your state licensing agency.
How long does it take to get an assisted living or group home license approved?
There's no reliable national average because every state reports and processes applications differently. Expect the process from application to opening to take several months at minimum, longer if the property needs renovation or the state licensing office has a backlog. Ask your state agency directly for their current processing timeline.
Can I check a facility's inspection history along with its license status?
Many states publish inspection or survey reports alongside license status in the same public database. Florida's AHCA Florida Health Finder and California's Community Care Licensing Division search tools both include citation and inspection history for licensed facilities, though the level of detail and update frequency varies by state.
What's the difference between a group home and an assisted living facility?
Group homes are typically smaller, often licensed for a handful of residents, and commonly serve IDD, mental health, or adult foster care populations under a distinct state statute. Assisted living facilities are usually larger, senior-focused, and licensed under separate aging or elder-care rules, though some states blend these categories, so check your specific state's definitions.
Sources
- CMS, Nursing Home Care vs. Assisted Living: Medicare does not cover long-term custodial care, and there is no federal definition of assisted living
- Florida Agency for Health Care Administration, Florida Health Finder: Florida's public database lets consumers search licensed ALFs and view inspection reports
- Texas Health and Safety Code, Chapter 247: Texas licenses assisted living facilities under Health and Safety Code Chapter 247
- Ohio Revised Code, Chapter 3721: Ohio licenses residential care facilities under Revised Code Chapter 3721
- Medicaid.gov, Home & Community-Based Services 1915(c): States can use 1915(c) HCBS waivers to fund home and community-based services as an alternative to institutional care