Last updated 2026-07-25
TL;DR
"Renewity residential assisted living" isn't a recognized licensing term or agency name; it's most likely a misspelling or a private company name someone searched for. Assisted living is licensed, non-medical residential care for adults who need help with daily activities. To open one, you apply through your state's licensing agency, meet staffing and building rules, and pass inspection before intake.
What is "renewity residential assisted living"?
There's no state licensing category, statute, or federal program called "renewity residential assisted living." If you landed here searching that phrase, you're probably looking for one of three things: a private company or franchise using "Renewity" in its name, a misspelling of "renew" or "serenity" (both common in senior living branding), or general information on how assisted living and group homes work. We can't verify a specific company by that exact name tied to a state license, so this article won't pretend to know one. What we can do is give you the real, sourced answer to the question underneath the search: what is assisted living, how is it different from a nursing home or group home, and what does it actually take to open one. Every state runs its own licensing program for residential care. There's no federal license for assisted living. The Centers for Medicare & Medicaid Services (CMS) regulates nursing homes that take Medicare or Medicaid, but assisted living licensing sits entirely with state agencies, usually the state health department or department of social/human services [1]. That's why the exact rules, fees, and even the terminology (assisted living, residential care facility, adult foster care, personal care home) shift from state to state.
What is assisted living?
Assisted living is a licensed residential setting for adults, mostly seniors, who need help with daily activities like bathing, dressing, medication reminders, and meals, but who don't need the round-the-clock skilled nursing care a nursing home provides. Residents typically live in private or semi-private apartments or rooms and get support on an as-needed basis, not continuous medical monitoring. The National Center for Health Statistics, part of the CDC, defines residential care communities as places that provide room and board with at least two meals a day, around-the-clock supervision, and help with at least two activities of daily living (ADLs) or medication administration, for people who don't require nursing home-level care [2]. As of the most recent National Study of Long-Term Care Providers, there were an estimated 31,400 residential care communities in the U.S. with about 1.2 million licensed beds [2]. Assisted living is not a medical model. Staff help residents live independently with support, but the facility isn't equipped (by license or by design) to manage complex medical needs, ventilators, or heavy nursing care. If a resident's needs progress past what the facility's license allows, most states require a move to a higher level of care, often a nursing home.
What is a group home?
A group home is a small residential setting, usually a single house, licensed to serve a limited number of people (often 4 to 10, depending on the state) who need supervision, personal care, or behavioral support. The term covers a lot of ground: adult foster care homes, homes for people with intellectual or developmental disabilities (IDD), mental health residential homes, and small assisted living homes are all commonly called "group homes" in casual conversation. The legal license name varies by state and population. In some states an IDD group home is licensed under a developmental disabilities agency, while a senior group home might be licensed under the same residential care rules as a larger assisted living building. The physical size is the main difference from a big assisted living community: a group home is often a converted single-family house in a residential neighborhood, capped at a small number of residents by fire code and zoning, not a purpose-built facility with dozens of units. Because group homes are smaller and often started by individual operators rather than corporate chains, the application process, staffing ratio, and inspection standards tend to be more approachable for a first-time licensee, but the paperwork burden per bed is often higher relative to a large facility.
What is an assisted living facility (and how is "facility" used differently by state)?
An assisted living facility is the physical building and licensed program where assisted living services happen. Some states use "facility" as the official license name (Florida's Assisted Living Facility license, for example, is governed by Chapter 429 of the Florida Statutes) [3]. Other states avoid the word entirely and license the same kind of care as a "residential care facility for the elderly" (California), "assisted living residence" (several states), or "personal care home." The term "assisted living facility" and "assisted living" get used interchangeably in everyday speech, and for most practical purposes they mean the same thing: a licensed residence providing help with ADLs, medication support, meals, and supervision, short of nursing-level medical care. When you're researching your own state's rules, search for your state health or social services department plus "assisted living license" or "residential care license" rather than assuming the exact word "facility" will appear in your state's statute. Florida's statute, for instance, defines an assisted living facility as "any building or buildings, section or distinct part of a building, private home, boarding home, home for the aged, or other residential facility... which undertakes through its ownership or management to provide housing, meals, and one or more personal services" [3].
What is assisted living vs nursing home?
| Licensing authority | State only | State + federal (CMS) |
|---|---|---|
| Medical care level | Non-medical, ADL support | 24-hour skilled nursing |
| Nurse on site | Not usually required 24/7 | RN required 8 hrs/day min, licensed nurse 24/7 [4] |
| Typical setting | Apartment, room, or house | Hospital-like rooms, shared or private |
| Medicare coverage | Does not cover room and board | Covers up to 100 days post-hospital stay under conditions [5] |
The core difference is the level of medical care and the licensing framework behind it. Assisted living is non-medical, supportive housing; nursing homes (also called skilled nursing facilities) provide 24-hour licensed nursing care for people with significant medical needs, post-surgical recovery, or conditions that require constant clinical monitoring. Nursing homes that accept Medicare or Medicaid must meet federal requirements under 42 CFR Part 483 and are certified by CMS, on top of state licensing [4]. Assisted living facilities are licensed only at the state level; there is no federal certification for assisted living, and Medicare does not certify or rate assisted living facilities the way it rates nursing homes on Medicare's Care Compare tool. Staffing is the clearest practical difference. Nursing homes are required to have a registered nurse on site for at least 8 consecutive hours a day, 7 days a week, and licensed nursing staff (RN or LPN) on duty 24 hours a day, under federal nursing home requirements [4]. Assisted living staffing rules are set state by state and are typically far lighter: many states require only a "awake, direct care staff" ratio and don't mandate a nurse on site at all, though medication aides or licensed nurses may be required to handle medication administration depending on state rules. | Feature | Assisted living | Nursing home |
What does assisted living provide?
Assisted living typically provides a private or semi-private room or apartment, meals (usually 2 to 3 a day), housekeeping, laundry, help with activities of daily living (bathing, dressing, toileting, transferring, eating), medication management or reminders, 24-hour staff availability for supervision, and social or recreational activities. Many facilities also arrange transportation to medical appointments. What's not typically included: skilled nursing care, physical therapy, or complex medical treatment. If a resident needs wound care, IV therapy, or continuous monitoring, that usually falls outside what a standard assisted living license allows, and the facility has to either bring in outside home health services or the resident has to move to a higher level of care. The exact list of required services is set by each state's licensing rules, and it varies quite a bit. Some states allow assisted living facilities to administer medications only through a licensed nurse or certified medication aide; others allow more delegation. If you're comparing facilities for a family member, ask for the state's specific list of "included services" under the facility's license type, more than the marketing brochure.
Does Medicare cover assisted living facilities?
No. Medicare does not cover the cost of room and board in assisted living facilities. Medicare.gov states plainly that Medicare does not cover "long-term care (also called custodial care)" if that's the only care a person needs, and specifically excludes non-medical assisted living costs [5]. Medicare may cover specific medical services a resident receives while living in assisted living, like doctor visits, some home health services, or durable medical equipment, but it does not pay for the housing, meals, or personal care costs of assisted living itself. That's a common point of confusion for families budgeting for a parent's care. Medicaid is different. Many states offer a Medicaid Home and Community-Based Services (HCBS) waiver that can help cover the personal care and service costs (not room and board) in an assisted living or residential care setting, for people who qualify financially and medically. Coverage, eligibility, and which services are included vary enormously by state, so check your state Medicaid agency's HCBS waiver page directly [6]. Medicaid.gov's home and community-based services page is the right starting point to understand the waiver structure [6].
How to start a group home (the real process)
Starting a group home means working through your state's specific licensing process, and no two states use identical steps, but the general shape is consistent almost everywhere: 1. Pick your population and license type. Adult foster care, IDD group home, mental health residential, or senior assisted living are usually licensed under different statutes or even different agencies in the same state. This decision drives everything else. 2. Check zoning before you sign a lease. Many states have "reasonable accommodation" protections for small group homes under the federal Fair Housing Act, which can override restrictive local zoning for homes serving people with disabilities, but the size, spacing, and definition rules still vary by state and municipality . Confirm with your local planning or zoning department before committing to a property. 3. Apply for your state license. This usually means submitting a formal application, a facility floor plan, proof of financial capacity, background checks for owners and staff, and a policy and procedures manual covering intake, medication management, emergency procedures, staffing, and resident rights. Confirm the exact application form, fee amount, and required attachments with your state licensing agency, since these differ by state and sometimes by county. 4. Meet staffing requirements. States set minimum staff-to-resident ratios, required training hours (often including first aid, CPR, and abuse reporting), and sometimes require a designated administrator to hold a specific credential or complete a state-approved training course. 5. Pass a pre-licensing inspection. A state surveyor or fire marshal (sometimes both) inspects the physical building for fire safety, means of egress, bedroom sizes, bathroom ratios, and general health and safety before your license is issued. 6. Get your license and start intake. Some states require you to wait for a certificate of occupancy or a separate fire marshal sign-off before the health licensing agency will issue the operating license. Building your own policy manual and staffing plan from scratch is where most first-time operators lose the most time, often months of back-and-forth with the state over missing or non-compliant paperwork. A prebuilt, state-specific packet like GroupHomePath's $299 one-time State Group Home Licensing Kit is built to shortcut that: it doesn't replace confirming current requirements with your state agency, but it gives you a realistic starting draft of the policies, forms, and staffing plan structure most states expect, instead of starting from a blank page.
How do I start a group home? (step-by-step checklist)
If you want the condensed version to work from, here's the practical order most operators follow: - Confirm which state agency licenses your population (aging services, developmental disabilities, behavioral health, or a general residential care licensing division; the name varies by state).
- Read the specific licensing statute and administrative code section for your facility type, more than the agency's general webpage.
- Decide on a property and confirm zoning and fire code capacity before signing a lease or mortgage.
- Draft your policy and procedures manual: admission/discharge criteria, medication management, emergency and disaster planning, staff training, resident rights and grievance process, infection control.
- Build your staffing plan: shift coverage, required certifications, background check process, staff-to-resident ratios required by your state.
- Submit your license application with all required attachments and fees.
- Schedule and pass your pre-licensing inspection (health/safety and fire).
- Start intake only after your license is officially issued, not after "conditional approval" language that some states use loosely. Every one of these steps has state-specific fine print. A step that takes two weeks in one state can take four months in another, depending on inspection backlogs and how complete your first submission is.
What's the difference between assisted living and a group home, in practice?
Size and setting are the main practical differences, not the services provided. A group home is typically a single house licensed for a small number of residents (commonly under 10, though the exact cap depends on state law and local zoning), run more like a family-style home. An assisted living facility can range from a similarly small house up to a large, purpose-built community with 100+ units, dining halls, and dedicated activity staff. Some states actually license small assisted living homes under the same category as what's commonly called a group home; others keep them as entirely separate license types with different rules. This is exactly the kind of detail that trips up new operators researching online: the word "group home" might legally mean something different in Texas than it does in Oregon. If you're deciding which model to pursue, start with the population you want to serve (seniors with ADL needs, adults with IDD, people in mental health or substance use recovery) and let your state's specific license categories for that population guide the size and structure, rather than starting with a generic idea of "group home" or "assisted living" and trying to fit a population into it.
What should I read next before I apply?
Before you spend money on a lease or file paperwork, get familiar with your state's exact licensing language. Start with your state's assisted living statute and administrative code, then confirm current fees, forms, and inspection checklists directly with your state licensing agency, since these change and older blog posts (including parts of this one, over time) can go stale. For background on the different license categories you'll run into while researching, see our guides on assisted living, assisted living facility, and assisted living facilities licensing across states, plus facility assisted living rules if you're comparing terms. If you're researching for a family member rather than opening a business, our senior assisted living facilities near me guide and assisted living at home explainer cover the consumer side of these same questions.
Frequently asked questions
What is assisted living?
Assisted living is a licensed residential setting where adults get help with daily activities like bathing, dressing, and medication reminders, along with meals and supervision, but not full-time skilled nursing care. It's licensed at the state level, not federally, and requirements vary significantly from state to state.
What is a group home?
A group home is a small residential facility, often a single house, licensed to serve a limited number of residents who need supervision or personal care support. The term covers senior care, IDD, mental health, and recovery housing models, and the legal license name and rules differ by state and population served.
What is an assisted living facility?
An assisted living facility is the licensed building and program where non-medical residential care happens: housing, meals, and help with daily activities. Some states use "facility" as the formal license name (like Florida's Assisted Living Facility license under Chapter 429), while others use terms like "residential care facility" for the same concept.
What is assisted living vs nursing home?
Assisted living is non-medical supportive housing; nursing homes provide 24-hour skilled nursing care and are federally certified by CMS in addition to state licensing. Nursing homes must have a registered nurse on site at least 8 hours a day and licensed nursing staff around the clock; assisted living has no such federal nursing requirement.
What is the difference between assisted living and nursing home?
The difference is medical intensity and oversight. Assisted living helps with daily activities in a home-like setting with no federal certification requirement. Nursing homes deliver 24-hour skilled nursing care, must meet federal requirements under 42 CFR Part 483, and are certified by CMS if they accept Medicare or Medicaid.
Does Medicare cover assisted living facilities?
No. Medicare does not cover room, board, or custodial care costs in assisted living. It may cover specific medical services a resident receives while living there, like doctor visits or durable medical equipment, but not the facility's housing or personal care charges, according to Medicare.gov.
How do I start a group home?
Confirm which state agency licenses your intended population, check zoning and fire code capacity for your property, draft a policy and procedures manual and staffing plan, submit your license application with required fees and background checks, pass a pre-licensing inspection, and wait for your license to be officially issued before starting intake.
How much does it cost to start a group home?
Costs vary enormously by state, property, and population served, covering licensing fees, building modifications for fire and safety code, staff training, and insurance. There's no reliable national average because requirements differ so much state to state; get exact fee schedules from your state licensing agency before budgeting.
What is "renewity residential assisted living" specifically?
There's no verified state license, statute, or federal program under that exact name. It's likely a misspelling of common terms like "renew" or "serenity" used in senior living branding, or a search for a specific private company. Always confirm any facility's actual state license status with your state's licensing agency directly.
Can Medicaid pay for assisted living instead of a nursing home?
Many states offer Medicaid Home and Community-Based Services (HCBS) waivers that can help cover personal care services (not room and board) in assisted living or residential settings for people who qualify financially and medically. Eligibility and covered services differ by state; check your state Medicaid agency's HCBS waiver page directly.
Do group homes require a nurse on staff?
It depends on the state and the license type. Most assisted living and group home licenses do not require a registered nurse on site 24/7 like nursing homes do; instead, states usually require trained direct care staff and sometimes a licensed nurse or certified medication aide specifically for medication administration.
What size building do I need for a group home?
Minimum room sizes, bathroom ratios, and total occupancy caps are set by your state's residential care licensing code and local fire code, and they vary widely. A home licensed for 6 residents in one state might legally require a different square footage minimum than the same size home in another state; confirm specifics with your state licensing agency before buying or leasing property.
Sources
- CMS, State Operations Manual overview: Federal nursing home certification and inspection standards are administered under CMS, while assisted living licensing is handled at the state level
- CDC/NCHS, National Study of Long-Term Care Providers: Definition of residential care communities and the estimated 31,400 communities with about 1.2 million licensed beds nationally
- Florida Statutes, Chapter 429 (Assisted Living Facilities): Florida's statutory definition of an assisted living facility and its licensing chapter
- eCFR, 42 CFR Part 483 (Requirements for States and Long Term Care Facilities): Federal nursing home requirements including RN staffing minimums of 8 consecutive hours daily and licensed nurse coverage 24 hours a day
- Medicare.gov, Long-term care coverage: Medicare does not cover long-term custodial care or assisted living room and board costs
- Medicaid.gov, Home & Community-Based Services: State Medicaid HCBS waivers can help cover personal care services in residential settings, with eligibility varying by state