Last updated 2026-07-24
TL;DR
A DSHS assisted living facility locator is a state database (run by a Department of Social and Health Services or equivalent agency) that lets you search licensed facilities, check license status, and pull inspection or complaint history. Washington State DSHS runs one of the best-known versions; most other states run similar tools under different agency names.
What is a DSHS assisted living facility locator?
A DSHS assisted living facility locator is a public, searchable database maintained by a state agency, typically named a Department of Social and Health Services, Department of Health, or Department of Human Services, that lists every licensed assisted living facility in the state along with its license status, capacity, and often its inspection history. Washington is the state that literally uses the name "DSHS," and its Aging and Long-Term Support Administration publishes a facility search tool covering assisted living facilities, adult family homes, and nursing homes [1]. If you searched "dshs assisted living facility locator" hoping for one national tool, there isn't one. Each state runs its own version, under its own agency name, with its own data fields and update schedule. Washington's version pulls from its Aging and Long-Term Support Administration licensing records [1]. Texas runs a similar tool through Health and Human Services (its facilities are called assisted living facilities too, licensed under Texas Health and Safety Code Chapter 247) [2]. California's version sits inside the Department of Social Services Community Care Licensing Division and covers Residential Care Facilities for the Elderly [3]. The practical function is the same everywhere: you type in a city, county, or facility name, and you get back a list of licensed facilities with addresses, phone numbers, license numbers, capacity, and (in most states) a link to the most recent inspection report or survey. For families, that's how you check whether a facility is actually licensed before moving a parent in. For operators, it's how you check what your competitors are licensed for, what capacity they're approved for, and what their inspection record looks like. One honest caveat: these locators are only as current as the state's data entry. Some states update within days of an inspection; others lag by weeks or months. If a facility's status looks stale or contradictory, call the licensing office directly. Confirm with your state licensing agency before treating any locator listing as the final word.
What is assisted living?
Assisted living is a licensed residential care setting for adults, usually seniors, who need help with daily activities like bathing, dressing, medication reminders, and meals but don't need the 24-hour skilled nursing care a nursing home provides. Centers for Medicare & Medicaid Services describes assisted living as one category within the broader "long-term care" spectrum, distinct from nursing homes and home health care [4]. Assisted living residents typically have their own room or apartment, take meals in a shared dining area, and get help with what regulators call "activities of daily living" (ADLs): bathing, dressing, toileting, transferring, and eating. Staff are present around the clock, but the staff-to-resident ratio and the scope of medical care allowed varies a lot by state license type. This is different from a nursing home (also called a skilled nursing facility), which is licensed to provide daily medical care, physical therapy, wound care, and other clinical services under a nurse's ongoing supervision. It's also different from independent living, which offers no personal care at all, just housing and amenities for seniors who don't need assistance. States use different license names for what is functionally the same idea: assisted living facility, residential care facility, personal care home, adult foster care, adult family home. If you're building a licensing plan, start with our guide to assisted living facility licensing basics, since the label your state uses changes which statute and which inspection checklist applies to you.
What is a group home?
A group home is a licensed residential setting, usually a house in a regular neighborhood, where a small number of unrelated residents live together with staff support. Unlike assisted living, which is almost always framed around seniors, group homes serve a wider range of populations: adults with intellectual or developmental disabilities (IDD), people in mental health recovery, youth in child welfare custody, or people in substance use recovery. The regulatory line between "group home" and "assisted living facility" is mostly about population and license category, not physical setup. A six-bed house licensed as an adult family home for seniors and a six-bed house licensed as an IDD group home can look identical from the curb. What differs is the licensing chapter you're operating under, the staffing qualifications required, and the plan-of-care documentation the state expects to see at inspection. Most states cap group home size somewhere between four and sixteen residents for the "community-based" license tier, with anything larger reclassified as an institutional facility subject to different fire and zoning rules. That threshold number varies by state and by population served, so confirm with your state licensing agency before you commit to a property size. If your plan is IDD, mental health, or recovery housing rather than senior care, our assisted living facilities overview walks through how those license tracks diverge from senior assisted living licensing.
What is an assisted living facility (and what does the license actually require)?
An assisted living facility is the specific, licensed legal entity: a building, an operator, and a set of approved services, all tied to a license number issued by the state agency. "Assisted living" describes the model of care; "assisted living facility" is the regulated business you'd actually apply to open. Most states require, at minimum: a facility license application with a fee (commonly in the low hundreds to low thousands of dollars, varying widely by state and bed count), a fire marshal or life-safety inspection, a health department or licensing agency site survey, background checks on the administrator and direct-care staff, a written policy and procedure manual covering medication management and emergency response, and proof of financial solvency. Texas, for example, licenses assisted living facilities under Health and Safety Code Chapter 247 and requires facilities to meet standards set by the Executive Commissioner of Health and Human Services [2]. The license itself typically names a maximum capacity (how many residents you're approved for), a level of care (some states split "Type A" facilities, which serve residents who can evacuate independently, from "Type B/C" facilities, which serve residents who need help evacuating or have cognitive impairment), and an expiration or renewal date. All of that data is exactly what shows up in a facility locator search. For a full state-by-state breakdown of what the application packet actually includes, see our assisted living facility licensing guide.
What is assisted living vs nursing home?
| Regulated by | State licensing agency | State agency + federal CMS Conditions of Participation [6] | |
|---|---|---|---|
| Nursing care | Limited, often via contracted or part-time nurse | 24-hour licensed nursing staff required | |
| Typical resident | Needs help with ADLs, largely mobile | Needs ongoing medical/skilled nursing care | |
| Medicare coverage | Room and board not covered | Short-term skilled stays can be covered | |
| Setting | Apartment-style, more independence | Hospital-adjacent, clinical environment | The practical upshot for an operator: if you want to run a business that provides medical care, wound care, IV therapy, or skilled rehab, you're in nursing home territory, with a much heavier regulatory and staffing lift. If you're providing housing, meals, medication reminders, and help with dressing and bathing, you're in assisted living or group home territory. |
The core difference is medical intensity. Assisted living is personal care plus housing; a nursing home (skilled nursing facility) is medical care plus housing, with a registered nurse or licensed practical nurse on duty and a physician overseeing each resident's plan of care. Medicare.gov's official comparison tool distinguishes "nursing homes," which provide skilled nursing care, from "assisted living," "board and care homes," and "continuing care retirement communities," noting that nursing homes are the right fit for people who "need a high level of care" [5]. Nursing homes are subject to federal Medicare/Medicaid Conditions of Participation under 42 CFR Part 483, which sets specific staffing, care planning, and resident rights requirements [6]. Assisted living facilities are licensed and regulated purely at the state level; there's no federal assisted living license. Here's a side-by-side on the practical differences: | Feature | Assisted living | Nursing home |
What does assisted living provide?
Assisted living provides housing, meals, help with daily activities, medication management, social activities, and 24-hour staff availability, but generally not hands-on skilled nursing care. The exact service list is defined by each state's licensing rules and by the individual resident's negotiated service plan. Common services across most state assisted living license types include: private or semi-private living space, three meals a day plus snacks, help with bathing, dressing, grooming, and toileting, medication administration or reminders (the specific rules on who can administer medication vary a lot by state), housekeeping and laundry, transportation to medical appointments, and structured social or recreational programming. What assisted living generally does not provide, at least not without add-on licensing or a waiver, is: ventilator care, IV therapy, wound care beyond basic first aid, or 24-hour skilled nursing supervision. If a resident's needs escalate past what the facility's license allows, most states require either a transfer to a higher level of care or, in some states, a documented plan showing the facility has arranged additional skilled services. Funding-wise, assisted living is paid for mostly out of pocket or through long-term care insurance. Some states run Medicaid waiver programs (home and community-based services waivers under Section 1915(c) of the Social Security Act) that help cover assisted living-type services for eligible low-income residents , but this varies enormously by state and by waiver slot availability. Medicaid.gov describes these HCBS waivers as covering services that let people "receive long-term care in the community rather than in institutional settings" .
Does Medicare cover assisted living facilities?
No. Medicare does not cover the cost of room and board at an assisted living facility. Medicare.gov states plainly that Medicare and Medicaid "generally don't pay for non-skilled assistance-with-daily-living care," which is exactly what assisted living provides . Medicare Part A and Part B can cover specific medical services a resident receives while living in assisted living, things like doctor visits, physical therapy ordered by a doctor, or durable medical equipment, the same way Medicare would cover those services for someone living at home. But Medicare will not pay the facility's monthly rent, care fees, or room-and-board charge. Medicaid is a different story, and it's state-specific. Some states cover assisted living-type personal care services through a Medicaid HCBS waiver, but even then, Medicaid usually still won't pay for room and board, only for the care component . Whether your state offers this, what the income and asset limits are, and how long the waiver waitlist runs all vary. Confirm with your state Medicaid agency and your state licensing agency before telling prospective families that Medicaid will cover their stay. This distinction matters enormously for operators building a pro forma. If your business plan assumes Medicare reimbursement for room and board, that assumption is wrong and will sink your numbers. Build your funding model around private pay, long-term care insurance, and (where available) state Medicaid waiver rates for the care component only.
How to start a group home (the honest step order)
Starting a group home means, in rough order: pick your population and license type, confirm your state's specific licensing agency and statute, find and secure a property that meets zoning and life-safety rules, write your policy and procedure manual, hire and background-check staff, pass your pre-licensing inspection, and get your license issued before you accept a single resident. Step one is deciding who you're serving: seniors needing assisted living-level care, adults with IDD, people in mental health recovery, or people in substance use recovery. This decision drives everything else, because each population has a different license chapter, different staffing credential requirements, and often a different funding source (private pay vs. Medicaid waiver vs. state mental health authority contract). Step two is identifying your state's actual licensing agency. It might be called Department of Social and Health Services (Washington), Health and Human Services (Texas) [2], Department of Social Services (California) [3], or something else entirely. Every state runs this under a different name and a different statute number, so this is not a step you can guess your way through. Pull the actual regulation text before you sign a lease. Step three is property. Most states require specific fire suppression, egress width, bedroom square footage per resident, and ADA-adjacent accessibility standards, on top of local zoning approval for a group living use in a residential district. This is often the single biggest reason a first-time operator's timeline blows up. See our guide on assisted living at home for how zoning treats small residential-scale operations differently from larger facilities. Step four is your written policy and procedure manual: emergency preparedness, medication management, resident rights, grievance procedures, staff training plans, and infection control. States generally require this manual submitted with your application, not written after the fact. Step five is staffing: administrator qualifications (some states require a specific certification or licensed nursing home administrator credential), direct care staff background checks (most states run these through a state criminal history repository and often the federal system too), and required training hours before a new hire can work unsupervised. Step six is the pre-licensing inspection, usually covering fire/life-safety, health/sanitation, and program compliance. Only after you pass that inspection and pay your licensing fee does the state issue your operating license, at which point you'll typically show up in that state's facility locator tool within a few weeks.
How do I start a group home if I've never run a business before?
You start the same way, just slower and with more outside help: pick your population, read your state's actual statute and licensing manual cover to cover, and budget real time (often four to twelve months, depending on the state and property readiness) between your first application submission and your license being issued. The biggest first-timer mistakes are predictable: buying or leasing a property before confirming zoning allows a group living use, underestimating the cost and time of life-safety upgrades (sprinkler retrofits alone can run into tens of thousands of dollars depending on square footage and local fire code), and writing a policy manual that's copied from a template with no connection to the actual daily operations of the house. If you have zero background in healthcare licensing, plan on either hiring a consultant who specializes in your state's specific license type, or building in real time to read the primary source regulation yourself rather than relying on secondhand blog summaries (including this one; always confirm against the actual statute). This is where a structured document kit earns its cost versus a from-scratch approach. GroupHomePath's $299 one-time State Group Home Licensing Kit gives you a state-specific starting framework for the application checklist, policy manual sections, and staffing plan template, so you're not building from a blank page. It doesn't replace reading your state's actual regulation or working with your licensing office directly, and it doesn't guarantee approval, no product legitimately can, but it does save you the weeks of scattered research most first-time operators lose before they even submit an application. Start at /licensing-kit-builder.
How do the state facility locator tools actually help operators (more than families)?
For an operator, a state facility locator is a free competitive intelligence tool: you can see every licensed facility in your target county, their approved capacity, and often a link to their most recent inspection or complaint history. That's market research most consultants would charge you for. Pull the locator data for your target service area and look at three things: how many licensed beds already exist in your population category, how full or empty the market looks based on capacity versus the number of facilities, and how the existing facilities' inspection records read. A county packed with facilities carrying repeat citations might mean genuine oversupply, or it might mean an opportunity to compete on quality and pass inspections cleanly. Washington's DSHS locator, for instance, lets you filter by facility type (assisted living facility, adult family home, nursing home) and pulls from live Aging and Long-Term Support Administration licensing data [1]. California's Community Care Licensing Division runs a similar public search for Residential Care Facilities for the Elderly, including complaint and citation history [3]. Texas HHS runs one for its assisted living facilities licensed under Chapter 247 [2]. Before you lease a property or file an application, spend an afternoon in your state's locator. It's free, it's primary-source, and it'll tell you things a real estate agent or an over-eager consultant won't.
What's the real difference between assisted living, group homes, and adult foster care licenses?
The differences are population served, facility size, and which state agency and statute governs the license, not the day-to-day caregiving itself. All three models provide housing plus help with daily living activities; the license category determines the paperwork, staffing rules, and inspection standard you're held to. Assisted living facilities are generally the largest of the three, licensed under a dedicated assisted living statute, and built around senior residents needing help with ADLs but not skilled nursing. Group homes typically serve IDD, mental health, or recovery populations in smaller settings, often four to sixteen residents, licensed under a separate disability-services or behavioral-health statute rather than an aging-services statute. Adult foster care (also called adult family homes in some states) is usually the smallest scale, often capped at two to six residents in a single-family home, with the home operator frequently living on-site. None of these labels are consistent across state lines. A facility that would be called "adult foster care" in one state might be licensed as a small assisted living facility in another. This is exactly why a facility locator search only makes sense within one state's system; you can't cross-reference license types state to state without checking each state's actual statute definitions. For more on how these categories diverge, see our overview on senior assisted living facilities near me, which walks through how search tools and license categories interact for families and operators alike.
Frequently asked questions
What is assisted living?
Assisted living is a licensed residential care model for adults, usually seniors, who need help with daily activities like bathing, dressing, and medication but don't need 24-hour skilled nursing care. It combines housing, meals, and personal care support, and is regulated entirely at the state level, with no single federal assisted living license or standard.
What is a group home?
A group home is a licensed residential setting, typically a house in a regular neighborhood, where a small number of unrelated residents live with staff support. Group homes commonly serve adults with intellectual or developmental disabilities, people in mental health recovery, or people in substance use recovery, under license categories separate from senior assisted living.
What is an assisted living facility?
An assisted living facility is the specific licensed business entity: a building, an operator, and an approved set of services tied to a state-issued license number and capacity limit. It's the regulated legal form of the broader "assisted living" care model, and it's what shows up as a searchable listing in a state facility locator tool.
What is the difference between assisted living and nursing home?
Assisted living provides housing and help with daily activities like bathing and dressing; a nursing home provides that plus 24-hour skilled nursing care under a physician's ongoing supervision. Nursing homes fall under federal Medicare/Medicaid Conditions of Participation (42 CFR Part 483) in addition to state licensing; assisted living is state-licensed only.
Does Medicare cover assisted living facilities?
No. Medicare does not pay for room and board at an assisted living facility. Medicare.gov states that Medicare and Medicaid generally don't pay for non-skilled personal care assistance, which is what assisted living provides. Medicare can cover separate medical services (doctor visits, therapy) a resident receives while living there, just not the facility's care or housing fees.
How do I start a group home?
Pick your population and license type, confirm your state's specific licensing agency and statute, secure a property that passes zoning and fire/life-safety review, write your required policy and procedure manual, background-check and train staff, and pass your pre-licensing inspection before accepting any residents. The exact sequence and requirements vary significantly by state.
How do I find a DSHS assisted living facility locator for my state?
Search your state's health or social services agency website directly; Washington's is run by the Department of Social and Health Services, but most other states run the same kind of tool under a different agency name (Health and Human Services, Department of Public Health, Department of Social Services). Confirm with your state licensing agency for the correct current link.
What does assisted living provide that a group home doesn't, or vice versa?
They largely overlap: both provide housing, meals, and help with daily activities. The real difference is population and license category, not services. Assisted living is built around senior care licensing; group homes are typically licensed under separate IDD, mental health, or recovery-focused statutes with different staffing and training requirements.
Is an assisted living facility the same as a nursing home?
No. An assisted living facility provides personal care and housing without the 24-hour skilled nursing staff and physician oversight required in a nursing home. Nursing homes are also subject to federal Conditions of Participation under 42 CFR Part 483 in addition to state licensing, while assisted living facilities are state-licensed only.
Can I check a facility's inspection history before choosing one?
Yes, in most states. State facility locator tools typically link to the most recent inspection or survey report, and many also show complaint history and any citations. California's Community Care Licensing Division, for example, publishes complaint and citation records for its licensed facilities alongside the basic listing.
How much does it cost to license a group home or assisted living facility?
Costs vary enormously by state, license type, and facility size, ranging from a few hundred to several thousand dollars for the application fee alone, before counting property upgrades, staff training, and inspection prep costs. There is no single national fee; confirm the exact figure with your specific state licensing agency.
Does Medicaid cover assisted living or group home costs?
Sometimes, through state-specific Medicaid Home and Community-Based Services (HCBS) waivers authorized under Section 1915(c) of the Social Security Act, but coverage, eligibility, and waitlists vary widely by state, and room-and-board costs are typically still excluded even when the waiver covers care services.
How long does it take to get an assisted living or group home license approved?
Timelines vary by state, license type, and how prepared your application and property are, but a realistic range for most first-time applicants runs from several months to about a year between initial application and license issuance. No agency guarantees a specific timeline or approval outcome.
Sources
- Texas Health and Safety Code, Chapter 247 (Assisted Living Facilities): Texas licenses assisted living facilities under Health and Safety Code Chapter 247, with standards set by the Executive Commissioner of Health and Human Services
- California Department of Social Services, Community Care Licensing Division: California licenses Residential Care Facilities for the Elderly through its Community Care Licensing Division
- Medicare.gov, Nursing Home Care comparison: Medicare.gov distinguishes nursing homes, which provide skilled care, from assisted living, board and care homes, and CCRCs
- Code of Federal Regulations, 42 CFR Part 483: Nursing homes are subject to federal Medicare/Medicaid Conditions of Participation under 42 CFR Part 483
- Medicare.gov, Long-Term Care coverage information: Medicare and Medicaid generally don't pay for non-skilled assistance with daily living, which is what assisted living provides
- Medicaid.gov, Home & Community-Based Services 1915(c): Section 1915(c) HCBS waivers let states cover long-term care services in the community rather than institutional settings