Assisted Living Index

Which states, and why

A state is here when its licensing agency publishes inspection findings per facility in a form that can be read as data — the tag, the date, the classification and the requirement — and when that publication can be refreshed on a schedule. Most states publish something; few publish that. A state that is absent does not publish usable data yet, or has not been built yet. It says nothing about the facilities in it.

Florida: what is in the record, and what is not

Where it comes from

AHCA inspection records and the FloridaHealthFinder facility locator, published by the Florida Agency for Health Care Administration (AHCA). Each facility is identified by its AHCA file number. AHCA's routine ("Standard") licensure inspection of an assisted living facility is every two years, with complaint and monitoring visits in between.

How findings are written

As AHCA survey tags, each with a class. Florida classifies each deficiency under section 429.19, Florida Statutes: Class I (imminent danger), Class II (direct threat), Class III (indirect or potential threat) and Class IV (minor, paperwork-level). Class III is by far the most common.

Not in this record

Fire and life safety. In Florida the fire safety inspection of an assisted living facility is done by the local fire authority under the Florida Fire Prevention Code, not by AHCA, and those reports are not part of this record. What AHCA does cite about the building — physical plant, emergency management and emergency power — is here.

Why a facility may be missing

The list is every facility AHCA currently licenses as an assisted living facility. A building licensed under another category — a nursing home, an adult family care home, an independent living community that needs no licence — is not here, and a facility that has closed drops off when the state’s list does. Missing is never the same as clean: a facility with nothing on file in the last 5 years is listed and says so.

1,272 of 3,013 licensed facilities in Florida have a building-related citation on file in the last 5 years. The building survey tags AHCA cites most:

• A0152 Physical Plant - Safe Living Environment / Other
• A0200 Emergency Environmental Control
• CZ830 Emergency Management Planning
• A0182 Emergency Mgmt - Plan Implementation
• ZZ830 Emergency Management Planning
• A0181 Emergency Plan Approval

Texas: what is in the record, and what is not

Where it comes from

the Long-Term Care Provider Search on HHSC's TULIP portal and HHSC's licensed assisted living directory, published by the Texas Health and Human Services Commission (HHSC). Each facility is identified by its HHSC licence number. HHSC inspects a licensed assisted living facility for renewal about every two years, with complaint investigations in between, and its Life Safety Code inspectors visit separately from the health inspectors.

How findings are written

As HHSC findings. HHSC's provider portal shows each facility's most recent comprehensive inspection and the findings from recent inspections, which in practice reaches back to about 2019. Nothing older is published per facility.

Not in this record

Scope and severity, and enforcement. HHSC rates each finding on a scope-and-severity scale but does not publish the rating per facility, and it records fines and enforcement actions separately; neither is republished here. What is here is unusual among states: HHSC inspects fire and life safety itself and publishes those findings per facility, so this record carries a real life safety section.

Why a facility may be missing

The list is every facility HHSC currently licenses as an assisted living facility. A building licensed under another category — a nursing home, an adult family care home, an independent living community that needs no licence — is not here, and a facility that has closed drops off when the state’s list does. Missing is never the same as clean: a facility with nothing on file in the last 5 years is listed and says so.

994 of 1,995 licensed facilities in Texas have a life safety or building citation on file in the last 5 years. The life safety and building findings HHSC cites most:

• Conduct required fire drills and document fire drills on the required form
• Inspect, test, and maintain fire sprinkler system components
• Provide the required emergency preparedness and response plan training and conduct drills
• Provide smoke compartmentation where required
• Review the plan at least annually to reflect changes in information, within 30 days following a disaster, within 30 days after a drill, and within 30 days after a change in rule or policy
• Have a program to inspect, test, and maintain the fire alarm system and keep records of inspection, testing, and maintenance of the fire alarm system

California: what is in the record, and what is not

Where it comes from

the Community Care Licensing facility search and its published facility evaluation and complaint investigation reports, published by the California Department of Social Services, Community Care Licensing Division (CDSS). Each facility is identified by its CDSS facility number. Community Care Licensing's routine inspection of a Residential Care Facility for the Elderly is annual, with complaint investigations and case-management visits in between.

How findings are written

As CDSS sections, each with a type. Community Care Licensing classifies each deficiency as Type A, a violation that if not corrected poses a direct and immediate risk to the health, safety or personal rights of residents, or Type B, a violation that without correction could become such a risk, a recordkeeping violation, or a violation that could affect required services.

Not in this record

Fire and life safety. A Residential Care Facility for the Elderly needs a fire clearance from the local fire authority, and that inspection is not part of the CDSS record. What CDSS does cite about the building is here: maintenance and operation of the premises, the emergency and disaster plan, and the physical environment sections of Title 22.

Why a facility may be missing

The list is every facility CDSS currently licenses as an assisted living facility. A building licensed under another category — a nursing home, an adult family care home, an independent living community that needs no licence — is not here, and a facility that has closed drops off when the state’s list does. Missing is never the same as clean: a facility with nothing on file in the last 5 years is listed and says so.

1,362 of 8,587 licensed facilities in California have a building-related citation on file in the last 5 years. The building sections CDSS cites most:

• CCR-87303 Maintenance and Operation
• CCR-87307 Personal Accommodations and Services
• CCR-87309 Storage Space
• CCR-87202 Fire Clearance
• CCR-87203 Fire Safety
• CCR-87305 Alterations to Existing Building or New Facilities

Arizona: what is in the record, and what is not

Where it comes from

AZ Care Check, ADHS's public licensing database, and the statement of deficiencies it publishes for each inspection, published by the Arizona Department of Health Services, Division of Licensing (ADHS). Each facility is identified by its ADHS licence number. ADHS inspects a licensed assisted living facility for compliance about once a year, with complaint investigations and monitoring visits in between.

How findings are written

As ADHS rules. AZ Care Check shows each facility's inspections for the last three years, with the statement of deficiencies for each. Nothing older is published per facility, so this record starts three years back.

Not in this record

Fire and life safety inspection, and severity. The fire inspection of an assisted living facility is the local fire department's, and ADHS does not publish it. What ADHS does cite about safety is here, under its own emergency and safety standards: evacuation and elopement drills, the annual fire inspection report on file, smoke detectors and extinguishers. ADHS does not rate a deficiency's severity, and its enforcement actions are recorded separately and not republished.

Why a facility may be missing

The list is every facility ADHS currently licenses as an assisted living facility. A building licensed under another category — a nursing home, an adult family care home, an independent living community that needs no licence — is not here, and a facility that has closed drops off when the state’s list does. Missing is never the same as clean: a facility with nothing on file in the last 3 years is listed and says so.

1,036 of 2,219 licensed facilities in Arizona have a building-related citation on file in the last 3 years. The building rules ADHS cites most:

• R9-10-820 Environmental Standards
• R9-10-819 Emergency and Safety Standards
• ARS-36-420.04 Emergency responders; patient information; discharge planning
• R9-10-821 Physical Plant Standards

Oregon: what is in the record, and what is not

Where it comes from

the Licensed Long-Term Care Settings Search (ltclicensing.oregon.gov) and the inspection reports it publishes for each facility, published by the Oregon Department of Human Services, Aging and People with Disabilities, Safety, Oversight and Quality Unit (ODHS). Each facility is identified by its ODHS facility ID. ODHS surveys a residential care or assisted living facility for licence renewal at least once every two years, with an annual kitchen inspection and complaint investigations in between.

How findings are written

As ODHS survey tags, each with a severity level. ODHS rates each deficiency on a four-level scale, with a scope of isolated, pattern or widespread. Level 1 is no actual harm with the potential for minimal harm; Level 2 is no actual harm with the potential for more than minimal harm; Level 3 is actual harm that is not immediate jeopardy; Level 4 is immediate jeopardy to resident health or safety. Level 2 is by far the most common.

Not in this record

Fire and life safety inspection, and enforcement. The fire inspection of an Oregon assisted living or residential care facility is the State Fire Marshal's or the local fire authority's and is not published; what ODHS itself cites about the building — its fire and life safety rule, emergency and disaster planning, and the building requirements — is here. ODHS also publishes substantiated abuse and licensing complaint findings, licence conditions and civil penalties for each facility; none of that is republished. This record is the survey citations only. Adult foster homes, which Oregon licenses separately and which are mostly licensed to an individual, are not included.

Why a facility may be missing

The list is every facility ODHS currently licenses as a residential care or assisted living facility. A building licensed under another category — a nursing home, an adult family care home, an independent living community that needs no licence — is not here, and a facility that has closed drops off when the state’s list does. Missing is never the same as clean: a facility with nothing on file in the last 5 years is listed and says so.

498 of 572 licensed facilities in Oregon have a building-related citation on file in the last 5 years. The building survey tags ODHS cites most:

• C0420 Fire and Life Safety: Safety
• C0422 Fire and Life Safety: Training For Residents
• C0513 Doors, Walls, Elevators, Odors
• C0613 General Building: Doors-Walls, Cleanable
• C0510 General Building Exterior
• C0610 General Building Exterior

Georgia: what is in the record, and what is not

Where it comes from

the HFRD inspection report search (its Laserfiche repository of statements of deficiencies) and the GaMap2Care facility finder, published by the Georgia Department of Community Health, Healthcare Facility Regulation Division (HFRD). Each facility is identified by its HFRD facility ID. HFRD inspects a licensed assisted living community or personal care home on a routine periodic schedule, with complaint investigations and follow-up inspections in between.

How findings are written

As HFRD survey tags, each with a scope and severity. HFRD prints a scope-and-severity letter beside each citation, on the grid the federal nursing home survey uses: A to C is a deficiency with no actual harm and the potential for minimal harm, D to F no actual harm with the potential for more than minimal harm, G to I actual harm that is not immediate jeopardy, and J to L immediate jeopardy; within each band the letter rises from isolated to pattern to widespread. D is by far the most common.

Not in this record

Fire and life safety inspection, licence dates, and enforcement. The fire inspection of a Georgia assisted living community or personal care home is the State Fire Marshal's or the local fire authority's and is not published; what HFRD itself cites about the building — its safety precautions, emergency preparedness and design rules — is here. HFRD's file gives the date of the current permit, not the date the facility first opened, for most facilities, so the newly licensed list is partial. Fines, licence suspensions and revocations are recorded separately and not republished. Community living arrangements and adult day centers, which Georgia licenses under other rules, are not included.

Why a facility may be missing

The list is every facility HFRD currently licenses as an assisted living community or personal care home. A building licensed under another category — a nursing home, an adult family care home, an independent living community that needs no licence — is not here, and a facility that has closed drops off when the state’s list does. Missing is never the same as clean: a facility with nothing on file in the last 5 years is listed and says so.

328 of 1,867 licensed facilities in Georgia have a building-related citation on file in the last 5 years. The building survey tags HFRD cites most:

• 111-8-62-1314 Physical Plant Health and Safety Standards
• 111-8-62-1301 Physical Plant Health and Safety Standards
• 111-8-62-1308 Physical Plant Health and Safety Standards
• 111-8-62-1320 Physical Plant Health and Safety Standards
• 111-8-62-1318 Physical Plant Health and Safety Standards
• 111-8-62-1315 Physical Plant Health and Safety Standards

Virginia: what is in the record, and what is not

Where it comes from

the VDSS assisted living facility search and the inspection pages it publishes for each facility, published by the Virginia Department of Social Services, Division of Licensing (VDSS). Each facility is identified by its VDSS licence ID. VDSS issues an assisted living facility a licence for one, two or three years according to its compliance history, inspects it for renewal before each term ends, and makes monitoring inspections and complaint investigations in between.

How findings are written

As VDSS standards. VDSS's search shows each facility's inspections since about 2021, posted within five business days of the facility receiving its findings; these pages use the last five years, which is the whole of the record.

Not in this record

Fire and life safety inspection, severity, and enforcement. The fire inspection of a Virginia assisted living facility is the State Fire Marshal's or the local fire official's and is not published; what VDSS itself cites about the building — its buildings-and-grounds, fire safety and emergency preparedness standards — is here. VDSS assigns no severity to a violation, and the facility's plan of correction is not republished. Sanctions, civil penalties and licence actions are recorded separately and not republished. VDSS publishes no first-licence date; a facility appears on the newly licensed page by the date of its initial inspection where the record shows one. Adult day centers and children's facilities are other licence types and are not included.

Why a facility may be missing

The list is every facility VDSS currently licenses as an assisted living facility. A building licensed under another category — a nursing home, an adult family care home, an independent living community that needs no licence — is not here, and a facility that has closed drops off when the state’s list does. Missing is never the same as clean: a facility with nothing on file in the last 5 years is listed and says so.

442 of 575 licensed facilities in Virginia have a building-related citation on file in the last 5 years. The building standards VDSS cites most:

• 22VAC40-73-870 Maintenance of buildings and grounds
• 22VAC40-73-860 General requirements
• 22VAC40-73-950 Emergency preparedness and response plan
• 22VAC40-73-980 Emergency equipment and supplies
• 22VAC40-73-970 Fire and emergency evacuation drills
• 22VAC40-73-990 Plan for resident emergencies and practice exercise

Iowa: what is in the record, and what is not

Where it comes from

the DIAL Health Facilities Database, its public entity report and the visit and rule records it publishes for each program, published by the Iowa Department of Inspections, Appeals, and Licensing, Health Facilities Division (DIAL). Each facility is identified by its DIAL record ID. DIAL recertifies an assisted living program every two years, with complaint and incident investigations in between.

How findings are written

As DIAL rules. DIAL's database lists every visit to a program since 2004, with the rules cited at each; these pages use the last five years and count the rest.

Not in this record

Fire and life safety inspection, severity, the survey report, and enforcement. The fire safety inspection of an Iowa assisted living program is the State Fire Marshal's and is not published; what DIAL itself cites about the building — its structural requirements, the dwelling-unit rules for dementia-specific programs and the fire and safety standards of the Code — is here. DIAL assigns no severity to a citation, and the survey report itself is published only as a scanned image, which is not read. Fines, conditional certifications and other enforcement actions are recorded separately and not republished. Elder group homes and adult day services are other certification types and are not included.

Why a facility may be missing

The list is every facility DIAL currently licenses as an assisted living program. A building licensed under another category — a nursing home, an adult family care home, an independent living community that needs no licence — is not here, and a facility that has closed drops off when the state’s list does. Missing is never the same as clean: a facility with nothing on file in the last 5 years is listed and says so.

62 of 437 licensed facilities in Iowa have a building-related citation on file in the last 5 years. The building rules DIAL cites most:

• 481-69.32-2 An operating alarm system shall be connected to each exit door in a dementia-specific program
• 481-69.35-1 Structural requirements
• 481-69.29-2 In lieu of providing access to a personal emergency response system, a program serving one or more tenants…
• 481-69.29-1 Each tenant shall have access to a 24-hour personal emergency response system that automatically…
• 481-67.9-2 Emergency procedures
• 481-67.4-2 Program notification to the department when damage to the program is caused by a natural or other disaster

Utah: what is in the record, and what is not

Where it comes from

the Office of Licensing's public facility search (ccl.utah.gov) and the inspection record it publishes for each facility, published by the Utah Department of Health and Human Services, Office of Licensing (Division of Licensing and Background Checks) (DLBC). Each facility is identified by its DLBC facility ID. The Office of Licensing inspects an assisted living facility unannounced about once a year, with follow-up, complaint and investigation inspections in between.

How findings are written

As DLBC rules, each with a noncompliance level. The Office of Licensing rates each finding Low, Moderate, High or Extreme by the risk it poses to residents, and a finding cited again at a later inspection is marked as a repeat. Low is the most common; High and Extreme together are about a third.

Not in this record

Fire and life safety inspection, fines, and the licensor's narrative. The fire inspection of a Utah assisted living facility is the State Fire Marshal's or the local fire authority's and is not published; what the Office of Licensing itself cites about the building — its physical environment, maintenance, secure-unit and emergency and disaster rules — is here. Civil money penalties, appeals, and the licensor's statements of what was found and how it was corrected are in the state's record and are not republished. A technical-assistance note is not a citation and is not counted. Type I and Type II facilities are both here; other licence types are not.

Why a facility may be missing

The list is every facility DLBC currently licenses as an assisted living facility, Type I or Type II. A building licensed under another category — a nursing home, an adult family care home, an independent living community that needs no licence — is not here, and a facility that has closed drops off when the state’s list does. Missing is never the same as clean: a facility with nothing on file in the last 3 years is listed and says so.

55 of 228 licensed facilities in Utah have a building-related citation on file in the last 3 years. The building rules DLBC cites most:

• R432-270-25-5 Hot water temperatures
• R432-270-24-5 Hot water temperatures
• R432-270-25-1 Written schedule for maintenance
• R432-270-26-6 Emergency and Disaster Response Plan
• R432-270-23-5 Material stored in locked area
• R432-270-24-1 Written schedule for maintenance

West Virginia: what is in the record, and what is not

Where it comes from

OHFLAC's facility lookup, its facility search and the survey record it publishes for each residence, published by the West Virginia Office of Health Facility Licensure and Certification (OHFLAC). Each facility is identified by its OHFLAC facility ID. OHFLAC surveys an assisted living residence for licence renewal every year, with follow-up visits and complaint surveys in between, and its own life safety code survey alongside.

How findings are written

As OHFLAC deficiencies. OHFLAC's facility page shows the last three years of surveys with their deficiencies; the full history back to 2012 is on the site as documents and is not read, so this record starts three years back.

Not in this record

Severity, the regulation text, the surveyor's narrative, and enforcement. OHFLAC rates no deficiency's severity and records no correction date. The rule text on its site is served in an obfuscated typeface and is not read, and the statement of deficiency and the plan of correction are the surveyor's and the facility's own text and are not republished. What is here is unusual among states: OHFLAC surveys fire and life safety itself and publishes those findings per residence, so this record carries a real life safety section. Fines, licence actions and administrators' names are in the state's record and are not republished.

Why a facility may be missing

The list is every facility OHFLAC currently licenses as an assisted living residence. A building licensed under another category — a nursing home, an adult family care home, an independent living community that needs no licence — is not here, and a facility that has closed drops off when the state’s list does. Missing is never the same as clean: a facility with nothing on file in the last 3 years is listed and says so.

55 of 82 licensed facilities in West Virginia have a life safety or building citation on file in the last 3 years. The life safety and building deficiencies OHFLAC cites most:

• Physical Facilities
• Fire Safety, Disaster and Emergency Preparedness
• Laundry
• Bedrooms
• Water Supply and Sewage
• Physical Environment

How to read these pages

Every comparison is within the facility’s own state, because a citation in one state’s system is not the same thing as a citation in another’s, and there is no national figure to compare to. No grades, no rankings, no fines and no named people. The definitions are on the methodology page.