In Massachusetts, the license families see for assisted living is "Assisted Living Residence (ALR)", issued by the Massachusetts Executive Office of Aging & Independence (AGE), Assisted Living Certification Unit. Before signing a Residency Agreement and moving in, a person must have an in-person initial assessment arranged by the residence and done by a nurse, which must include an evaluation by the person's physician or authorized practitioner done within the past 90 days. A residence can make a resident leave only through landlord-tenant eviction law (General Laws chapters 186 and 239), with an eviction notice and court proceedings, and the assisted living rules set no fixed notice days or list of reasons.
Key facts
- The median monthly cost of assisted living in Massachusetts was $9,600 in CareScout's 2025 Cost of Care Survey, or $115,200 a year, $3,400 above the national median of $6,200 a month. (CareScout, 2026)
- MassHealth's Group Adult Foster Care (GAFC) program can pay for help with daily activities, nursing oversight and care management for eligible members in assisted living residences that accept it, and not all do. (Massachusetts Executive Office of Aging & Independence, 2025)
- Massachusetts' assisted living rule does not list a tuberculosis test for new residents. (651 CMR 12.04, 2026)
- Unlicensed staff may only help residents take their own medicines (reminders, opening containers, watching), and an employed nurse may give non-injectable medicines if the residence offers that service. (651 CMR 12.04, 2026)
- A residence that advertises or provides special care (memory care) must file an operating plan with the state, alarm and secure its common-area exit doors, and document hourly safety checks in special care units for twelve hours overnight. (651 CMR 12.04, 2026)
Massachusetts calls assisted living an Assisted Living Residence (ALR). The Executive Office of Aging & Independence (formerly Elder Affairs) certifies ALRs under M.G.L. c. 19D and 651 CMR 12.00 rather than licensing them, and the rule was amended effective July 31, 2026. A residence may also hold optional Basic Health Services certification or run a Special Care Residence (memory care), and the facts below cover the main ALR certification.
Rules change and communities can set stricter policies. Before you sign, confirm the details with the community and the Massachusetts Executive Office of Aging & Independence (AGE), Assisted Living Certification Unit. This page is general information, not legal advice.
The rules at a glance
| Medical assessment before move-in | Before signing a Residency Agreement and moving in, a person must have an in-person initial assessment arranged by the residence and done by a nurse, which must include an evaluation by the person's physician or authorized practitioner done within the past 90 days. It is up to the resident or their representative to have the physician's evaluation completed. [3] More on this |
|---|---|
| TB test | Massachusetts' assisted living rule does not list a tuberculosis test for new residents. The required pre-move-in checks are a nurse's assessment and a physician's evaluation within the past 90 days, so ask the residence whether its own policy asks for a TB test. [3] More on this |
| Notice before a move-out | A residence can make a resident leave only through landlord-tenant eviction law (General Laws chapters 186 and 239), with an eviction notice and court proceedings, and the assisted living rules set no fixed notice days or list of reasons. The Residency Agreement must state when either side may end it and the required notice period. [4][5] More on this |
| Who may give medications | Unlicensed staff may only help residents take their own medicines (reminders, opening containers, watching), and an employed nurse may give non-injectable medicines if the residence offers that service. Unlicensed staff may not give insulin or other injections, which come from a licensed clinician at a residence certified for Basic Health Services or an outside certified provider. [6][7] More on this |
| Memory care and dementia | A residence that advertises or provides special care (memory care) must file an operating plan with the state, alarm and secure its common-area exit doors, and document hourly safety checks in special care units for twelve hours overnight. It must offer structured activities with designated staff at least three times in every 24 hours. [8] |
| Long-term care ombudsman | The Massachusetts Long-Term Care Ombudsman Program has Assisted Living Ombudsman Representatives who work with residents to resolve concerns about care and resident rights, and they can be reached at 617-222-7495 or through the local program for the residence's city or town. [9] Official page More on this |
| Medicaid help | MassHealth's Group Adult Foster Care (GAFC) program can pay for help with daily activities, nursing oversight and care management for eligible members in assisted living residences that accept it, and not all do. GAFC payment does not include room and board, and residents may also qualify for the SSI-G subsidy. [10][11] Official page More on this |
What assisted living costs in Massachusetts
The median monthly cost of assisted living in Massachusetts was $9,600 in CareScout's 2025 Cost of Care Survey, or $115,200 a year, $3,400 above the national median of $6,200 a month. [14]
A median is the middle of the rates communities reported, so many charge more or less. Rates differ between regions and by the care a resident needs, so ask each community for its full fee list in writing. More: assisted living costs in every state, a monthly budget and the costs that aren't in the base rate.
How to check a community in Massachusetts
The agency's Assisted Living Residences Locations page lets families search certified residences by city, town or zip code and shows each one's unit counts and whether it has low-income options. Complaints go to ALRhelp@mass.gov, and the agency says it is posting compliance review reports online. Search Massachusetts's records. [2][13][12]
The licensing agency: Massachusetts Executive Office of Aging & Independence (AGE), Assisted Living Certification Unit. [1] Our guide on how to read an inspection report explains what to look for.
Put Massachusetts's paperwork on a date
Parent Move Plan counts every task back from the move-in day, including the medical assessment and TB screening the community will ask for, so nothing lands in the last week.
Get your first 3 days freeFrequently asked questions
How much does assisted living cost in Massachusetts?
The median monthly cost of assisted living in Massachusetts was $9,600 in CareScout's 2025 Cost of Care Survey, or $115,200 a year, $3,400 above the national median of $6,200 a month. A median is the middle of the rates communities reported, so many charge more or less, and rates differ between regions and by the care a resident needs.
What medical assessment does Massachusetts require before moving into assisted living?
Before signing a Residency Agreement and moving in, a person must have an in-person initial assessment arranged by the residence and done by a nurse, which must include an evaluation by the person's physician or authorized practitioner done within the past 90 days. It is up to the resident or their representative to have the physician's evaluation completed.
Does Massachusetts require a TB test for assisted living?
Massachusetts' assisted living rule does not list a tuberculosis test for new residents. The required pre-move-in checks are a nurse's assessment and a physician's evaluation within the past 90 days, so ask the residence whether its own policy asks for a TB test.
How much notice must an assisted living community in Massachusetts give before a move-out?
A residence can make a resident leave only through landlord-tenant eviction law (General Laws chapters 186 and 239), with an eviction notice and court proceedings, and the assisted living rules set no fixed notice days or list of reasons. The Residency Agreement must state when either side may end it and the required notice period.
Who can give medications in assisted living in Massachusetts?
Unlicensed staff may only help residents take their own medicines (reminders, opening containers, watching), and an employed nurse may give non-injectable medicines if the residence offers that service. Unlicensed staff may not give insulin or other injections, which come from a licensed clinician at a residence certified for Basic Health Services or an outside certified provider.
Who can help with a complaint about assisted living in Massachusetts?
The Massachusetts Long-Term Care Ombudsman Program has Assisted Living Ombudsman Representatives who work with residents to resolve concerns about care and resident rights, and they can be reached at 617-222-7495 or through the local program for the residence's city or town.
Does Medicaid pay for assisted living in Massachusetts?
MassHealth's Group Adult Foster Care (GAFC) program can pay for help with daily activities, nursing oversight and care management for eligible members in assisted living residences that accept it, and not all do. GAFC payment does not include room and board, and residents may also qualify for the SSI-G subsidy.
Sources
- Massachusetts Executive Office of Aging & Independence: Assisted Living Residences (2026) (checked October 22, 2026)
- Massachusetts Executive Office of Aging & Independence: Assisted Living Residences Locations (2026) (checked October 22, 2026)
- 651 CMR 12.04(7) and (8), Screening and Assessment; Service Plan Development (Massachusetts Register Issue 1579, effective July 31, 2026), 2026 (checked October 22, 2026)
- 651 CMR 12.08(1)(r) and (2), Resident Rights; Residency Agreement (Massachusetts Register Issue 1579, effective July 31, 2026), 2026 (checked October 22, 2026)
- 940 CMR 40.07(6), Eviction, Attorney General assisted living rule (Massachusetts Register Issue 1578, effective July 17, 2026), 2026 (checked October 22, 2026)
- 651 CMR 12.04(2)(b)2, (4) and (6)(a)7, Self-administered Medication Management; Skilled Care Services; Limited Medication Administration (Massachusetts Register Issue 1579, effective July 31, 2026), 2026 (checked October 22, 2026)
- Massachusetts Executive Office of Aging & Independence: Assisted Living in Massachusetts, A Consumer Guide (2025) (checked October 22, 2026)
- 651 CMR 12.04(5) and (2)(b)3, Special Care; Services (Massachusetts Register Issue 1579, effective July 31, 2026), 2026 (checked October 22, 2026)
- Massachusetts Long-Term Care Ombudsman Program: Find an Ombudsman for an Assisted Living Residence (2026) (checked October 22, 2026)
- Massachusetts Executive Office of Aging & Independence: Assisted Living Residences, cost and subsidy programs (2025) (checked October 22, 2026)
- MassHealth Adult Foster Care Manual: 130 CMR 408.509(A), GAFC Conditions for Payment (Transmittal Letter AFC-21), 2025 (checked October 22, 2026)
- Massachusetts Executive Office of Health and Human Services: Healey-Driscoll Administration Finalizes Assisted Living Safety Reforms (press release, July 10, 2026) (checked October 22, 2026)
- Massachusetts Executive Office of Aging & Independence: File a Massachusetts Assisted Living Residence (ALR) complaint form (2026) (checked October 22, 2026)
- CareScout: Cost of Care Survey 2025, Ranked Median Costs by State (2026) (checked October 22, 2026)