Questions
If something here is unclear, that is our fault. Tell us and we will rewrite it.
It is the difference between help and clinical care, and it decides almost everything else. Assisted living is a residential setting with help for daily life: medication reminders, bathing, dressing, meals, transport. It is licensed by the state, not the federal government. A nursing facility, often called a skilled nursing facility or a nursing home, provides 24-hour clinical care under nursing supervision, is certified by Medicare and Medicaid, and is inspected federally. Most people need assisted living. Nursing facilities cost roughly twice as much and are the right answer when the clinical need is genuine.
Every certified nursing facility in the country carries a federal rating from one to five stars, made up of three parts: health inspection results, nurse staffing levels, and clinical quality measures. We show all four figures rather than only the headline. Trust them as a starting point, not a verdict. The inspection score is the most reliable of the three because it is based on unannounced visits by state surveyors. The quality measures are partly self-reported by the facility. A five-star home can still be wrong for your person, and a three-star home twenty minutes closer, that your family will actually visit, is often better. Assisted living has no equivalent rating anywhere in the country, because there is no federal inspection of it at all.
It is the total nursing time available divided by the number of residents. It is the single most predictive number on a nursing facility's record, and it is the one worth reading before the star rating. Around 3.0 hours is common; above 4.0 is genuinely good; below 2.5 is a warning. We also show weekend registered nurse hours, because staffing frequently drops at the weekend and that is when families notice the difference. And we show annual staff turnover: a facility replacing most of its nursing staff every year cannot offer continuity of care no matter what its rating says.
Both are federal warnings and we show them prominently. Special Focus means the facility has a persistent record of serious inspection problems and has been placed under additional federal scrutiny. Roughly 88 facilities nationally carry it, with about 440 more listed as candidates. The abuse flag marks facilities cited for abuse in recent inspections. Neither is a small matter, and a site funded by placement commissions has every reason not to mention them.
Because the advertised figure is room and board, and the care is billed separately. Most assisted living communities assess the resident at move-in and assign a level-of-care tier that adds several hundred to well over a thousand dollars a month, and the tier is reassessed as needs change. There may also be a one-off community or entry fee. The single most useful question you can ask on a tour is not what it costs. It is: what does the level-of-care fee add for someone with these exact needs, and what has your annual increase been for the last three years?
For assisted living, no. Medicare does not pay for room, board or long-term personal care in an assisted living facility anywhere in the United States, and any site implying otherwise is misleading you. For a nursing facility, only briefly: after a qualifying hospital stay, Medicare covers up to 100 days of skilled care, fully for the first 20 and with a substantial daily co-payment after that. It is rehabilitation cover, not long-term cover.
Yes, and yes. Medicaid is the largest payer for long-term nursing facility care in the country, though eligibility rules, income limits and asset rules are set state by state. For assisted living it is far more limited: most states cover some assisted living services through a Home and Community Based Services waiver, but the waiver usually pays only for the care, never for room and board, and most states run a waiting list. Ask any facility two questions: do you accept Medicaid at all, and do you accept it from day one or only after a period of private payment.
If the person served during a wartime period, or is their surviving spouse, Aid and Attendance is an addition to a VA pension that can contribute meaningfully toward assisted living or in-home care. It is a national programme and it is widely under-claimed. Applications take months, so start early. Your county veterans service officer will help at no charge, and you should never pay anyone a fee to file this for you.
Memory care means a secured setting with staff trained in dementia, designed so that someone who wanders cannot leave unsupervised. The certification requirements differ in every state, and in most states a facility may not lawfully operate or advertise a secured dementia unit without a specific additional certification, with its own staff training and building standards. If the person wanders or tries to leave, this is not a preference. It is a legal requirement, and it is why we ask about it before we show you anything.
Today we can confirm this for Texas only. The certification is published in each state's own assisted living register, and the federal nursing home record does not carry it at all. In every other state we show you the facilities we do hold and mark clearly that we cannot confirm a secured unit, rather than hiding them. Ask each facility directly, and make it your first question.
Visit unannounced, at a mealtime, ideally at the weekend. Look at the staff rather than the building: are they unhurried, do they use residents' names, how many are on the floor. Ask what the staff turnover has been in the last year and what the level-of-care fee would be for your person specifically. Ask to see the most recent inspection report, which every facility must make available. Then visit a second time, at a different hour.
Because one is federal and the other is not. Nursing facilities are certified by Medicare and Medicaid, so a single federal record covers all fifty states, and we hold all of it. Assisted living has no national register at all. Each state licenses it separately, publishes it separately, and calls it something different. We pull each state's own register and check it before publishing, which is slower than scraping and is the reason the data can be trusted. Texas is complete. The rest are in progress, and the coverage page shows exactly where each one stands.
Almost no state calls it that in its own regulations, which is why searching for it usually fails. Here is what the largest states actually use:
| California | Residential Care Facility for the Elderly (RCFE) |
| Texas | Assisted Living Facility, Type A, B or C |
| Florida | Assisted Living Facility, four licence classes |
| New York | Adult Care Facility / Assisted Living Residence |
| Pennsylvania | Personal Care Home / Assisted Living Residence |
| Ohio | Residential Care Facility |
| Illinois | Assisted Living / Shared Housing Establishment |
| North Carolina | Adult Care Home |
| Michigan | Adult Foster Care Home / Home for the Aged |
| Wisconsin | CBRF, RCAC or Adult Family Home |
| Missouri | Residential Care Facility / Assisted Living Facility |
| Tennessee | Assisted Care Living Facility |
| Georgia | Personal Care Home / Assisted Living Community |
| Colorado | Assisted Living Residence |
| Arizona | Assisted Living Home or Center |
| Oregon | Assisted Living / Residential Care Facility |
| Washington | Assisted Living Facility |
| Minnesota | Assisted Living Facility, licensed since 2021 |
| Indiana | Residential Care Facility |
| Virginia | Assisted Living Facility |
If your state is not listed, try the phrases residential care, personal care home, adult care home, board and care or domiciliary care alongside your state's health or human services department.
More than most families expect. Staffing minimums, what a facility may lawfully accept, whether a nurse must be on site overnight, medication handling, how dementia units are certified and how often facilities are inspected are all set at state level for assisted living. Two facilities with identical marketing on either side of a state border can be permitted to accept quite different residents. It is the main reason we filter on licence type before anything else.
It is the most important licensing distinction in Texas and almost nobody explains it. A Type A facility may only serve residents who can evacuate the building without staff assistance and can follow directions in an emergency. A Type B facility may serve residents who need help to evacuate, who cannot reliably follow directions, or who need attention during the night. If the person you are placing cannot leave a building unaided during a fire alarm, a Type A facility cannot lawfully accept them. 339 of the 1,998 licensed assisted living facilities in Texas are Type A.
A Texas facility that operates or markets a secured unit for residents with dementia must hold a separate Alzheimer's certification on top of its licence, with specific staff training, environmental standards and programming. 731 of the 1,998 licensed Texas assisted living facilities hold it.
Every certified nursing facility in your state is already here, with its full federal inspection and staffing record, and that data is as good as it gets anywhere. For assisted living, tell us your state on the coverage page. We prioritise by how many families ask, so it genuinely moves the order.
Facilities can pay us for a premium listing at $4 per licensed bed a month. That is the whole of it today. We are building an optional introduction service where a facility pays a flat fee when a family asks to be contacted, but it is not switched on. We never take a placement commission, so we have no financial interest in where anyone moves in.
No. Ranking is computed only from how well a facility matches what you told us. When paid introductions launch, a paying facility will be listed first only where two facilities score within three points of each other, and we will say so on the page. Facilities that pay us nothing appear on exactly the same terms.
Because a list of advertisers is not information. Every licensed facility appears here, from the official record, with its phone number, whether or not it ever pays us a cent. If we only showed you the ones that pay, you would have no way of knowing what you were not being shown.
No. The whole search runs inside your own browser. Nothing you tell us about your family member is sent to us or stored anywhere. You can search everything and call any facility yourself using the number we publish, and we will never know you were here. We learn your name only if you specifically ask us to introduce you to a facility.
Only what they need in order to tell you yes or no: the level of care needed, whether the person can evacuate unassisted, whether a secured unit is required, and any specific clinical needs such as insulin or a two-person transfer. Plus your name and how you asked to be contacted. We would not send your budget, your notes, or your family's circumstances.
If you never asked for an introduction there is nothing to delete, because we never had it. If you did, email us and we will delete it within 15 days.
Nursing facilities come from the federal CMS Provider Information release, republished monthly. Assisted living comes from each state's own licensing register: for Texas, the Health and Human Services Commission directories dated 10 August 2026. Licence type, capacity, certifications, ownership, ratings and staffing figures are exactly as published. We correct obvious data errors, such as a city recorded in the county field, and we log every correction we make.
Use the claim link on the facility's page. We verify against the contact details already published in the licensing record, so nobody can claim a facility they do not operate. Claiming is free and stays free. If the error is in the underlying state or federal record we will show you that, because we do not silently overwrite the official data. We will help you correct it at the source.