Best Assisted Living Facilities

Our guide covers key information to keep in mind when evaluating and selecting assisted living facilities. First, we cover the average cost and fees of assisted living facilities, which can vary by state and facility. We also spell out what factors to look for in an assisted living facility (depending on individual needs), including accommodations, medical attention, location and more. These factors further include the variety of services, activities and entertainment that may be available.

In the United States, the median assisted living cost is $5,350 per month or $64,200 per year, according to the 2023 Genworth Cost of Care Survey. Keep in mind that assisted living costs often include housing, care and meals, which is why the prices may cause some sticker shock at first.

The median assisted living cost was $5,350 per month in 2023.

Where you live plays a significant role in how much you pay for assisted living, though. According to Genworth’s survey, the most expensive state for assisted living in 2020 was Delaware, with an average of just over $80,000 per year. The cheapest state for assisted living was Alabama, which came in at just under $38,000 per year on average.

Prices also depend on the level of care the resident in question needs. Someone who only needs limited assistance may not be charged as much as someone who requires 24/7 care. Realistically assess your or your loved one’s needs and abilities before comparing prices or selecting a facility.

Some other fees to watch out for include:

• Entrance fees: Some facilities charge an entrance fee when a new resident moves in. This fee is typically placed in reserve to pay for future medical expenses. Residents can decide if they want the unused portion of this fee returned to them or a beneficiary after they leave the facility. A resident’s monthly rate may depend on whether they have the fee returned and how much of the fee is returned.
• Service fees: Some facilities charge a flat-rate fee that doesn’t change, regardless of the amenities you use or the level of care you need. Others may offer a few package levels or services to select from. As you evaluate facilities, inquire about exactly which services are included and which incur added expenses.

To ease the burden of assisted living costs, experts suggest investing in long-term care insurance early, when premiums are less expensive.

How much does Medicaid pay for assisted living?

In most cases, Medicaid does not cover the cost of room and board in assisted living communities. However, certain medical assisted living services may be covered, such as nursing, prescription drugs and therapy. Those who are eligible can also request enrollment in Medicaid waiver programs, (typically known as Home and Community-Based Services (HCBS) waivers). These 300 nationwide waiver programs differ by state but can help cover assisted living costs.

Choosing an assisted living facility is a major decision and never something to be done lightly. Careful consideration of your options can help you or a loved one live a safe, happy life in a caring environment.

Coping with a loss of independence is never easy, but most assisted living facilities provide private apartments or otherwise private housing so residents can live independently when they don’t need assistance. Here are a few things to look for in an assisted living facility.

• Services: Assisted living facility residents have a wide variety of needs. See if the facility offers the services you need, whether that's memory care, a specialized diet, exercise programs or something else. If you anticipate needing more advanced services in the future, look for a facility that also offers skilled nursing or specific services. Likewise, consider whether amenities, like in-house hair salons, theaters and pools, are important to you. To help refine your options, create a list of "needs" and a list of "wants" that are nice to have but not necessary. The right community will check off all of your needs and many of your wants.
• Cost: As an early step in your research, plan out your budget and how you intend to pay. Facilities may require upfront payment, monthly rent or payments for individual services. Some may accept Medicaid, but they might limit the number of Medicaid residents they accept or the length of time services are covered. If you're paying from your personal income, set a monthly budget for yourself and only compare facilities that fall within that price range.
• Location: A good location helps assisted living residents stay connected to their greater communities. Close proximity to friends and loved ones is important, especially if your mobility or travel capabilities are limited. There are also state regulations to consider, especially when it comes to medical assistance provided by the facility. If you require significant medical care, check to make sure it’s available at assisted living facilities in your state.
• Accommodations: The style, size and quality of a living space goes a long way toward the resident's comfort. Assisted living communities may offer semiprivate rooms, private rooms or full apartments. Try to browse pictures of a facility’s living areas online or schedule a tour to see the rooms in person. This should help you get a feel for both the privacy and comfort level there.
• Community: Assisted living facilities offer a strong sense of community and culture for residents through social engagements with other residents and wellness activities or events. To get a vibe for the community, check out its activity schedule, clubs, or facilities dedicated to arts, exercise and other pursuits. Potential residents are often encouraged to visit, take in a meal, walk the grounds and engage with current residents to see if a community is a good fit.
• Medical attention: Most assisted living facilities should have registered nurses on call 24/7. They might also have medical aides, attendants and other medical staff, including certified nursing assistants, licensed practical nurses and medical directors.

You will have access to help with ADLs regardless of the assisted living facility you choose, but other amenities and services vary by facility.

Standard services

Facilities offer a variety of services for their residents’ convenience. Some of the most common include:

• Housekeeping: Those living in independent or assisted living communities often receive once-a-week housekeeping service. Housekeepers typically perform only light cleaning tasks.
• Laundry: At some locations, the housekeepers will do a load of personal laundry and supply fresh linens when they perform their other cleaning tasks. Residents typically have access to free on-site washers and dryers.
• Activities: Most facilities offer activities and classes that are free to all residents. These programs help residents build a community and remain mentally and physically engaged.
• Dining: Those in skilled nursing facilities receive all of their meals from the facility's dining room. Residents who live in an assisted living or residential community, where the residences often have kitchens, can usually select how many meals a day they wish to eat at the on-site dining facility. Dining service may be buffet-style or have table service.
• Salon/barber: Assisted and independent living communities often have a salon and/or barbershop on-site so residents don't have to leave the property to get a haircut.

On-site entertainment

Entertainment and activity types vary by facility. Admittance to these areas may have additional fees associated with them.

• Common areas: Common rooms provide residents a place to gather for community activities or host a larger number of guests than can comfortably fit in their room or apartment.
• Pool: Facilities may have pools for physical therapy, fitness and/or recreation. Individuals who suffer from joint pain may be especially interested in a facility with an indoor pool for year-round fitness activities.
• Fitness center: A full fitness center with equipment designed for seniors or those with physical challenges helps residents maintain or improve their physical abilities.
• Library: Well-stocked libraries offer residents a mentally engaging activity that doesn't require physical strength or leaving the property.
• Computer lab: Residents who like to communicate with friends and family through email or social media will enjoy having access to a computer, and on-site labs usually have staff who can help residents with any technical problems.

As Amiyah, a ConsumerAffairs reviewer from Pennsylvania, whose loved one moved into an assisted living facility, said: “They can skate. They can have lunch in the park. They have a bowling night, and they can dance with each other. They can go to the movies and do much much, more. It's a lot.”