According to a recent report from the National Center for Assisted Living (NCAL), 15 states updated their assisted living regulations and legislation in 2024. Infection control and quality measurement were the most common focus of these efforts. This is down from 20 states that had updated their assisted living regulations, statutes, and policies in 2023, although more regulations addressed those two subject areas in that year as well.

The report, Assisted Living State Regulatory Review, found that 45 states and the District of Columbia have infection control requirements in place that affect assisted living; and 25 states have quality measurement, data collection, or quality management requirements. These two topic areas – along with emergency preparedness – were added to the report in 2023. NCAL said it is “encouraged” that the number of states with infection control and quality measure regulations is increasing. 

In a statement, NCAL Director of Policy and Regulatory Affairs Jill Schewe, said, “These reports are important because they give us better insight on how states are working with assisted living providers to promote better care delivery for residents. It is encouraging to see updates being made to adapt to the current needs of residents in each state, and we are confident this trend will continue.” NCAL Executive Director LaShuan Bethea added, “We support and are pleased to see ongoing collaboration between providers, state regulators, and key stakeholders that helps ensure accountability and innovation. Our residents deserve the best care, and we can continue to deliver that by working together.”

The report noted that 48% of assisted living communities are Medicaid-certified as home- and community-based service providers and nearly 18% of assisted living residents depend on Medicaid coverage. Requirements for communities offering housing and person-centered support and/or health care services but use a different term than ‘assisted living’ are also included in the report. These might be called residential care or personal care homes.