5 Things You Need To Run An Assisted Living Facility


Written by:

Spread the love

As more people live longer, it is becoming apparent that in countries like the USA, there are not enough care homes or assisted living facilities to go around. 

An assisted living facility is, on the face of it, not as intense on the residents or the staff as a care home would be. These settings are aimed at providing care and support to older adults who live in them, and the staff are required to assist them in various activities, such as daily living chores, washing, cooking, and cleaning. 

This is not the same level of medical care that is needed in a care home, but instead, the aim is to create an environment that is similar to a home while also having some staff on hand to help. The aim is also to promote autonomy and well-being while allowing the residents to engage in social and recreational activities. There may be some physical health needs and adjustments around these complexes, but it would be exceedingly odd to meet a person in an assisted living facility who has Alzheimer’s.

If it has always been a passion of yours to provide care to older people, then you may be wondering what you need to do to open and operate an assisted living facility. It is a bit technical and long-winded, but you will be guided here through what you need to do. Read on and enjoy!

Get An RCFE License

Firstly, you will need to obtain the necessary Residential Care Facility for the Elderly or RCFE license. This can be obtained through your state regulatory agency. You will also need to have an assisted living administrator license

Luckily, neither the RCFE or the required assisted living administrator license are hard to obtain, but the process is long and technical. You will need to pass exams, apply for licenses, have the premises where you intend to open the assisted living facility pass an assessment, and you will need to pay some fees. It is also required that you, as the manager of the facility, undertake some medical training to ensure that your care skills are up to speed when opening a setting for older, vulnerable people.

This application will require you to have a high school diploma or equivalent, a clear criminal record, and be over the age of 21. This is not to say that all criminal convictions will prevent you from being able to get an RCFE license. Still, if there is a history of abuse in your criminal or work records, you cannot operate in any care setting in the USA. Similarly, violent crimes and drug-related crimes can also be a problem here.

Trained Staff

Once you have gotten your RCFE License, you will need to turn your attention to the staff that you will need to hire for your assisted living facility to operate correctly.

The staff that you have in your assisted living facility will vary based on the size of the complex, but in general, you will likely need to have the following employees.


This is you and maybe some other people who you have hired to help you. You will be responsible for overseeing the running of the facility, managing the staff, and complying with state regulations. You will also be responsible for ensuring that any damage to the facility is fixed promptly, and you will need to manage the financial side of the setting, too.

Caregivers and/or Personal Care Assistants

Next are the caregivers, or the support workers and care givers. Ideally, you will have one staff member for every three residents in this role. They will need to have some medical training and be able to provide their residents with help in daily living activities, like bathing, clothing, dressing, mobility, and going to the toilet. 


As an assisted living facility is not a nursing home, you will not need many nurses. However, depending on the size of your facility, you will need to make sure that you have enough nurses or nursing assistants on staff to administer medications, coordinate the care of the residents, and provide health assessments. 

Medication Technicians

Medication technicians fall in the realm of being between a nurse and a pharmacist. They will be required to provide medication to the residents under the supervision of the licensed nurses, and, in most cases, they may be in training for their nursing qualification.


In an assisted living facility, you will likely need to employ some therapists to help your residents with their movement and speech. So, an occupational therapist, a physical therapist, and a speech and language therapist may be essential. Why do you need a speech and language therapist? Well, you may have some residents on site who are recovering from a stroke and will need the assistance of these professionals to relearn how to speak. They can also help with assessments for dementia, which can impact speech.

Social Workers

It would be rare if an assisted living facility had an on-site social worker. However, it should be noted that these professionals are needed to liaise with the residents’ family members, and, should the needs of the residents become more complicated, they can coordinate care outside of the setting and help with the residents’ placement in a new facility.

Cooks and Dietary Staff

You are going to need to ensure that all of the residents get their three meals a day and that the staff can cater to the needs of an older adult.

It is best to have an on-site kitchen that cooks and other dietary staff oversee.

Housekeeping and Maintenance Workers

You need to ensure that your assisted living facility is clean and is not crumbling at the seams. Depending on the size of the setting, you may need more staff to help with the cleaning and maintenance of the building and the surrounding grounds.

Recreation Workers/ Activity Directors

In an assisted living facility, you will need to make sure that there are things for the residents to do during the day, such as dancing, games, gardening, and so on. This is where hiring a recreation or activity director comes into play, as they can target the activities to the residents’ needs to ensure they all stay active and mentally healthy.

Transportation Staff

This is, of course, not to say that all activities will need to occur on-site. Your facility will need to ensure that residents can get out and about for day trips and appointments. So, you will need to ensure that you have access to a van that is designed to transport older people, which will likely have a ramp and wheelchair access built in.


Last but certainly not least, you must ensure that the residents in your setting are kept safe. So, you will need to hire security guards to monitor the property’s access and respond to potential emergencies.

You will need to make sure that all of your employees are trained in elderly care, the safety protocols that are in place at the facility, and that they are knowledgeable about the state regulations surrounding health and safety.

Safe and Compliant Facility

To ensure that all of your residents are kept safe, you will need to make sure that it meets the safety and accessibility standards set down by your state. It will need to have fire safety protocols, building codes, and ADA compliance. You will need to make sure that the building also undertakes regular inspections and compliance checks.

Business Plan and Financing

As you saw earlier in the article, you are going to need a lot of staff to run even a small assisted living facility. 

 So, before you even think about opening one, you must develop a comprehensive business plan that addresses the financial aspects of running the facility. This will need to take into account the budgeting, the billing, and the insurance coverage. It will also need to look at how you intend to use the property; are you planning to buy it outright, or will you be leasing it?

Resident Care and Services

Earlier in the article, you will have seen the care staff that is needed to help run an assisted living facility, such as nurses, occupational therapists, and activity coordinators. So, it should come as no surprise that you need to ensure that all of the residents in your care facility have their needs met, as well as being able to have all aspects of their care overseen. This will include access to medication, meal preparation, and social activities. The social aspects are crucial, as they can allow you and other team members to assess the health and cognition of the residents in your care.

There will likely be numerous inspections in the yearly rota of the care facility, which will check aspects like the standard of care, staff training, food safety, and even the health and safety and fire procedures, so you need to ensure that these needs are met, or your facility may be shut down.

Leave a Reply