How to check an assisted living facility

There is no Medicare star rating for assisted living, and that surprises almost everyone. Here is why, and the records that actually tell you whether a place is safe.

Why there is no Medicare rating

Medicare rates nursing homes, home health agencies, hospices, and hospitals because Medicare pays for them. When the federal government pays, it inspects, and it publishes the results as star ratings on Care Compare. Assisted living is different. It is licensed by your state, not certified by Medicare, and Medicare does not pay for it. So no federal agency rates it, and there is no national five-star score to look up. That is not a hole in one website; it is how the whole system was built.

The records that do exist: your state's inspections

Every state licenses assisted living and inspects it on a schedule. You may see it called a residential care facility, an adult care home, or a personal care home, depending on where you live. Those inspection reports, plus any complaints the state investigated, are the real equivalent of a nursing home's deficiency record.

The catch is that there is no single national place to read them. Each state runs its own system, and they are wildly uneven:

• A handful of states publish inspection results in a searchable online database.
• Many states publish nothing you can browse and require a public-records request by email or phone to see a facility's file.
• One state, Minnesota, has built a consumer report card with quality-of-life and safety ratings. It is the exception, not the rule.

To find your state's records, search "[your state] assisted living inspection reports" or "[your state] residential care facility licensing," or call your state's health or human services department and ask for a facility's inspection and complaint history. If the records are not online, you have the right to request them.

Sourced from the structure of federal and state long-term care regulation: Medicare's Care Compare covers only federally certified provider types, and assisted living licensure and inspection sit with each state's agency. Data reviewed August 2026.

The free help most families never use

Every state has a Long-Term Care Ombudsman, a free, government-funded advocate who investigates complaints in assisted living and other long-term care. They can tell you about a facility's complaint history and help you make sense of what you find. It costs nothing and there is no sales pitch. The federal Eldercare Locator connects you to yours: eldercare.acl.gov or 1-800-677-1116.

What the inspection records show, and how to read them

Like nursing home deficiencies, assisted living citations vary in seriousness, and the same three questions cut through them. Severity: was anyone actually harmed, or was it a paperwork gap? Pattern: is the same problem cited across more than one inspection? Recency: was it last month or five years ago? Medication errors, staffing shortfalls, and a resident leaving unsupervised, cited more than once, are signal. One old, low-level citation is noise.

What no record can tell you: the tour

Inspection reports cannot tell you whether staff know residents by name, whether the afternoon activity actually happens, or whether the food is edible. That is what a visit is for. Take our free tour checklist with you, and score each place while it is fresh with the tour scorecard. For what assisted living runs where your parent lives, see care costs by state.