Assisted-Living Regulation Issues: A Business Case for Action or Creative Destruction

Linda Christiansen, Joanie Sompayrac


This paper examine whether state law regulating assisted-living facilities in United State is sufficient or underdeveloped and inconsistent. As the U.S. population ages, legislatures and courts need to address the growing need to develop comprehensive and consistent law in this area, and the industry must be fast to anticipate threats and changes from all directions. The paper’s methodology includes reviewing the statistics that indicate the growing demand for assisted-living facilities and researches and reports variations of regulation regarding assisted-living facilities across the United States. Findings include extensive inconsistencies in regulation exists across the states; and there is a great need for either more uniform industry standards, or for federal regulation if the industry is not willing or able to self-regulate. We also find that regardless of regulation or self‑regulation, increasingly demanding and better-informed consumers who have greater access to more information will push the industry to change. The assisted-living industry must find a proper balance between offering a good product and doing so at a reasonable cost – a necessary goal for most businesses.


Assisted living, elder care, elder law, regulation.

Full Text:



Protection of Aged or Disabled Adults, Alabama Code § 38-9-7 and 8,

Assisted Living Facilities, Alabama State Board of Health, Administrative Code, Chapter 420-5-4,

Allen, K. G. (1999, June). From Official Report…Assisted Living: Information, Quality Concerns. Consumers’ Research Magazine, 82:6, 20+.

Assisted Living Federation of America (ALFA), Assisted Living Regulations and Licensing; Federal Statutes that Impact Assisted Living,

Benson, W. Assisted Living Industry Under Scrutiny by U.S. Congress., May 11, 2001.

Bruce, P. A. (2006). NOTE: The Ascendency of Assisted Living: The Case for Federal Regulation, 14 Elder L.J. 61 (2006).

Public Health and Well-Being: Managed Residential Communities, CT Gen Stat § 19a-693 (2013).

Dignity, D.C. Code § 44-105.03 (2000).

Edelman, Toby S. (2007, March 27). Is It Time for Federal Regulation of the Assisted Living Industry? Center for Medicare Advocacy Weekly Alert.

Elder Justice Act, Public Act 111-148, Patient Protection and Affordable Care Act, Title VI, Subtitle H,

Illinois Elder Abuse and Neglect Act/Adult Protective Service Act, 320 ILCS 20,

Assisted Living Programs, Iowa Code § 231C.

Jennings, M. (2006). How Ethics Trump Market Inefficiencies and Thwart the Need for Regulation, Corporate Finance Review 10(5), 36-41.

Lewin-VHI, Inc. (1996, February). U.S. Department of Health and Human Services National Study of Assisted Living for the Frail Elderly: Literature Review Update. Retrieved from

Marek, Carol, Individual Service Plans (ISPs): An Assisted Living Care Plan Defines a Resident’s Needs & Services, Assisted Living Facilities.Org. Retrieved from

The 2012 MetLife Market Survey of Long-Term Care Costs, 2013, MetLife Mature Market Institute. Retrieved from

Mollica, RL, Trends in State Regulation of Assisted Living, Generations, Fall 2008, 32 (3): 67-70 (2008).

National Committee for the Prevention of Elder Abuse (NCPEA). Retrieved from

Licensing of adult care homes for the aged and disabled, North Carolina General Statute § 131D-2, (2005).

Older Americans Act of 1965 (as amended 2006), Public Law 109-365, and

Patient Protection and Affordable Care Act (as amended through May 1, 2010), Retrieved from

Programs for Older Americans, 42 U.S. Code Chapter 35,,

Polzer, K. (2013). Assisted Living State Regulatory Review 2013, National Center for Assisted Living. Retrieved from

Quality Living, Inc., and Leonore Cooper v. State Department of Public Health, 711 So. 2d 1021 (Ala. Civ. App. 1997).

Retsinas, J (2005 May). Assisted Living: A Regulation Dilemma, State Legislatures, vol. 31 (5), 26-7.

Schneider, S., & Nordheim, G. (2014, Jun/Jul). Individual service plans: Assisted living’s key to quality care, Long-Term Living: For the Continuing Care Professional, vol. 63 issue 5, 26-28.

Shapiro, J. P. (2001, March 21). The Assisted Living Dilemma, U.S. News and World Report, vol. 130, issue 20, 64.

Welfare: Programs and Services for Abused Persons, Tenn. Code Ann. § 71, Chapter 6 (2014).

U.S. Department of Health & Human Services. (2003). Administration on Aging, Older Americans Act: A Layman’s Guide,

U.S. Department of Health & Human Services. Administration on Aging (2014). Profile of Older Americans: 2014,

U.S. Department of Health & Human Services, Agency of Healthcare Research and Quality, Residential Care and Assisted Living: State Oversight Practices and State Information Available to Consumers,

U.S. Department of Housing and Urban Development, Section 202 Supportive Housing for the Elderly Program. Retrieved from

U.S. Department of Justice, Civil Rights Division (2009, July). A Guide to Disability Rights Laws. Retrieved from

United States Department of Labor, Futurework – Trends and Challenges for Work in the 21st Century. Retrieved from

Health Care Facility Licensing and Inspection Act, Utah Code Annotated § 26-21-2.

Va. Code Ann. § 63.2-100, 2006 Code of Virginia.

Walters, J. (2012). Uncertainty, Isomorphism, and the Birth of a New Industry Regulatory Policy Development in a New Health Services Sector, 1994-2004, Administration & Society, Vol. 44 Issue 4, 458-486.

Wayne, Karen. (2001, March) A New Era for Regulation, Nursing Homes Long Term Care Management, 64.



  • There are currently no refbacks.

Copyright (c) 2015 International Journal of Business and Social Research


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


If you find difficulties in submitting manuscript please forward your doc file to Our support team will assist you in submission process and other technical matters.

In order to get notifications on inbox please add  this domain in your email safe list.

International journal of business and social research (Print)
ISSN 2164-2540

International journal of business and social research (Online)
ISSN 2164-2559

[International Journal of Business and Social Research (IJBSR) previously published by MIR Center for Socio-Economic Research, MD, USA. From February 2018 this journal is published by the LAR Center Press, OR, USA]