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Making Sense of Assisted Living Ratings
The Purpose of Assisted Living Ratings

The Ratings

It's imperative to know the history of violations and how an assisted living facility rates according to your state's regulations and reviews. Does it pass the state's most accessible and transparent websites for consumers? If it does not, you need to know why not!

The Centers for Medicare and Medicaid Services helps consumers understand the purpose of assisted living ratings and explains why it's important to gain in-depth knowledge.

The following guide, developed by CMS, is a rating system to help consumers, their families, and caregivers compare nursing homes more easily. Even though the CMS system's designed for nursing homes, there is not a website like this to access licensing and audits of each facility. The reason is, states regulate assisted living facilities.

Compare Assisted Living Ratings and Reviews

Understand Medicare Ratings

Comparing data features a quality rating system that gives each facility a rating, usually between 1 and 5. The facilities with 5 stars have above average quality over one with 1 star. According to the CMS, there is one general 5-star rating, and individual source ratings for the following three:

Health Inspections

These ratings contain data from the past 3 years of on-site inspections which contribute to standard and complaint surveys. It's obtained by individuals who perform on-site visits and follow specific protocols which determine if the facility meets Medicare's minimum quality requirements (if the facility is Medicare-approved). Over 200,000 reviews are in the national health inspection scoring system.


These ratings contain data from the number of residents given care by staff. It takes into account the level of need of care of residents in all the Medicare facilities. If a facility has residents who have more severe needs would be expected to have more staff than one with minimum needs.

Quality Measures

Rates the facility on 9 physical and clinical measures for residents: from pressure sores to changes in resident's mobility. It gives an overview about how well a facility cares for a residents' physical and clinical needs.

Factors Important to Consumers When Reviewing Residential Care

State Audits & Regulations
State Audits & Regulations

As stated above, assisted living facilities are not audited or licensed by the federal government. Senior housing, at the assisted living level, is in the hands and oversight by individual state government agencies.

The factors that influence assisted living residents' and families' satisfaction include quality of life and satisfaction, legal actions taken against a community, citations given, if it's for profit or not for profit, the facility's licensure and types of services it's allow to perform, and how current residents rate the facility and it's services. These areas affect satisfaction and is important to look for when reviewing and choosing a facility.

Check Assisted Living Inspections & Violations by the State

Check Assisted Living Licenses with State Regulating Bodies

Looking Up a Community

When researching online to learn if an assisted living community has a license and if it has any issues or regulation violations in its recent history, you'll learn that some states' websites are easy to navigate, while others fall far behind. But don't give up in your search for understanding the audits and violations because it could put your loved one's safety at risk.

Know that each of the state's regulatory websites for assisted living facilities work differently, but generally they have search forms that allow you to verify that a senior housing provider has a license and if there are concerns or issues that you want to research, verify and resolve.

  1. Visit your state's website to locate the search form. Choose "assisted living facility" as provider type and insert the name of the assisted living facility. Enter information in other fields, like the city name, to help narrow the search down further. If there's just one community in your state with that name, only one result is given.
  2. From the results page, click the name of the facility you are researching (if there are more than one facility with same name). You'll be directed to a page that opens to the specific license type for that community, the number of residents its licensed to house, access to inspections reports and any legal actions against the community and other records.

Click "inspections reports" to view all the inspection reports. If there's a legal action initiated by the state against the facility, the amount of charges/or fine will appear. This is a red flag. Click on the case number (usually colored) to read why legal action's taken. You'll learn exactly what happened.

Other information you'll learn:

  • Facility address
  • Name of the Administrator
  • Name of the Owner
  • For Profit or Not for Profit Status
  • Number of licensed beds
  • License number and effective date
  • License expiration
  • License status
  • Emergency actions
  • Inspection reports

Types of Services:

  • Medicaid services
  • Specialty license

Legal Actions

Date Imposed - Case Type - Violation - Fine Amount

Legal actions are issues for licensee of the facility at the time the case initiated. The Final Order displays the name of the licensee.

You can click on the case number and it'll list the historic actions against a facility. You'll see a document outlining the imposed fine.

Indicators of a Quality State Website for Assisted Living Facilities

When reviewing your state's licensing and rating system, the following indicators show you it's a quality site:

  • It's frequently updated
  • Easily accessible and easy to do a search (not in a downloadable PDF)
  • Records are easily accessible in one place

Details listed about the community:

  • License number and expiration date
  • Address, contact information, contact name, owner
  • History of state inspections and documented violations
  • Viewable inspections and violations
  • Easy to navigate

During the review and rating research, always read through the violation or fine should you find one. A violation is a simple concern like a dirty bathroom sink, so read through all the issues that apply to resident safety first or those that point to consistent patterns and problems of an ill-run facility or ill-trained staff.


Check Assisted Living Inspections & Violations by the State

Check Assisted Living Licenses with State Regulating Bodies

Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.