Facilities News Overview

Assisted Living

Assisted Living has become a popular option for older adults. These facilities are not Nursing Homes, have few requirements and protections for residents, vary significantly from one another and can be expensive. The information and links below may help to demystify Assisted Living.

The New York Times published “What to Know about Assisted Living” by Jordan Rau on November 11, 2023. This article is not specific to Massachusetts, but provides a good overview as well as important insights into the benefits and costs of Assisted Living.

The Washington Post (free article) published Understaffed and neglected: How real estate investors reshaped assisted living on December 17, 2023 which provides a look at the evolution of Assisted Living. The Dignity Digest editor chose this article as the December 19 Spotlight.

In the News


Download the Assisted Living in Massachusetts: A Consumer Guide from the Massachusetts Executive Office of Elder Affairs.

Elder Affairs has compiled a comprehensive Assisted Living webpage.

Residency Agreement

The lists below are from Residency Agreements between a MA Assisted Living Residence (ALR) and a Resident that all residents (or residents’ legal representative) must sign before moving in.


  • An Assisted Living Residence (ALR) is not a nursing home.
  • Nurses are not required to be on duty and in the building 24 hours per day/7 days per week. Inquire with the ALR how often and when nurses are in the building.
  • Resident’s cannot receive skilled nursing care from ALR employees.
  • You may be required to provide and pay for additional private care if the ALR determines that your care needs exceed the level of care available at the ALR


  • A signed residency agreement is a contract between you and the ALR; read it carefully before signing. Note: If additional services are subsequently required, your monthly costs may increase.
  • Eviction from an ALR must comply with the provisions of landlord/tenant law, M.G.L. c. 186 or c. 239, and include all notices required by law.
  • The ALR cannot prevent you from returning to the ALR after a hospital or rehab stay; however, if your care needs exceed the ALR’s capacity for services you may be required to hire private care staff to meet your care needs.
  • Your resident agreement may allow the ALR to terminate your residency if it determines that you are no longer suitable to live there; if this is the case, the Residence must provide a ____ day notice prior to requiring you to leave.
  • Signing a residency agreement that includes an arbitration clause or signing a separate arbitration agreement may prohibit use of the court system to resolve disputes and instead require you to present your case to an mediator


  • You should assess your finances to determine how long you can afford to stay at the ALR before making a commitment.
  • If you deplete your assets (run out of money) and are unable to afford the cost of the ALR in the future, the ALR may require you to move.
  • The ALR can change your monthly fees with ___ days’ notice.
  • Your service plan can change based on the ALR’s reassessment of your needs. Changes to your service plan may change your monthly costs.
  • If you fail to provide notice of termination of Residency in accordance with the terms of the Residency Agreement, you may incur additional charges.

Problem Resolution

As part of the state of MA Ombudsman program, the Assisted Living Ombudsman is an advocate and may act as mediator in an attempt to resolve problems that arise between an assisted living facility and one or more of its residents. Anyone can bring a complaint before the ombudsman. The complaint can be on behalf of a specific resident or on behalf of residents as a group. The ombudsman can provide you with information and concerns that have been filed against a residence.

Residents may file a complaint at any time with the Assisted Living Residence Ombudsman or the Assisted Living Residence Certification Unit at Executive Office of Elder Affairs by calling (617) 727-7750 or 1-800-AGE-INFO (1-800-243-4636).

Unless you give the Ombudsman permission to share your concerns, matters are kept confidential.