How to read an assisted living contract before you sign
This guide is general educational information, not medical, legal, or financial advice. Talk with your own attorney, financial advisor, or care professional about your situation. Elder Living Guide provides education and referrals; we are not a care provider, facility, agency, or medical practice.
Short answer: Ask for the full residency agreement, the current fee schedule, and every addendum in writing, then read them in two passes: money first, then care changes, notice, and move-out terms. Write down who signs, who pays, and who gets notices, and get answers to your questions in writing before anyone signs. Assisted living is licensed by each state, so for rules and residents' rights where your parent lives, check with your state's Long-Term Care Ombudsman program, and take legal questions to your own attorney.
What the contract is, and what it isn't
The residency agreement (some communities call it an admission agreement or a lease plus a services agreement) is the document that controls what you pay and what the community promises. The brochure, the tour, and the sales conversation don't. The National Institute on Aging puts it plainly: once you select a facility, "read the contract carefully," make sure all the agreements are clear, ask about anything you don't understand, and "read over the contract again before signing it" (NIA, how to choose a long-term care facility).
Two facts shape everything else on this page:
- Rules differ by state and by community. NIA notes that assisted living services and "exact arrangements vary by facility and by state" (NIA, long-term care facilities). We can't tell you what your state requires a contract to say, and no general guide can. This page shows you what to look for and what to ask.
- Medicare isn't paying the monthly bill. NIA says "Medicare does not pay for assisted living," and most people pay the full costs themselves (NIA). Medicare's own page says it doesn't pay for long-term care because most of it is non-medical (Medicare.gov, long-term care). If anyone suggests otherwise, ask them to put it in writing and check it yourself. Medicaid may cover some parts depending on the state and eligibility, and some long-term care insurance policies pay part of it. Our long-term care insurance guide covers an existing policy.
Step 1: Get the whole packet in writing
Before you decide, NIA recommends visiting several facilities in person and meeting the director, nursing director, or other key staff (NIA, how to choose a long-term care facility). Bring tour notes from our assisted living tour checklist so the packet you request matches what you saw on the floor, not only what you heard in the sales office.
NIA also says each facility is different, so get detailed information about costs and which services are included, and find out if Medicare, Medicaid, or long-term care insurance will pay for any of the costs. The facility may have a financial office that can help you determine what assistance is available (NIA). Then collect everything in writing. Ask the admissions or sales contact to email or hand you:
- The full residency agreement, every page, including signature pages
- The current fee schedule, with the date it took effect
- The care-level, points, or assessment explanation that ties care to price
- Every addendum: deposits or community fees, medication help, memory care, pets, move-out, arbitration, and anything else they plan to have you sign
- The resident handbook or house rules if the agreement refers to them
If the agreement says another document is "incorporated" or "made part of" the agreement, ask for that document too. You're agreeing to it. If you're comparing two communities, give each its own folder so pages don't mix. Put the price sheets side by side with our guide to comparing assisted living fees, and read the legal language separately.
Step 2: First pass, the money
Read once with a highlighter for nothing but dollars. Copy each item onto one sheet (the free worksheet below has a row for each):
- Base monthly rate and exactly what it includes: room, meals, utilities, housekeeping, laundry, activities
- Care charges: care-level or assessment fees, how they're calculated, and how often they can change
- One-time charges: community fee, entrance fee, or deposit, and what part (if any) is refundable, when, and on what conditions
- Add-ons: second-person, pet, parking, storage, transportation, medication management, incontinence supplies
- Increases: when the base rate and care fees can go up, and how much written notice the agreement promises
- Billing: due date, late fees, and what happens to billing during a hospital stay or a short trip away
If a number only came up in conversation, ask for it on the fee schedule. Our page on what care levels mean on a price sheet explains why the care line often moves more than the rent line. For whether the household can carry the total for years, not just month one, use the private-pay care budget.
Continuing care retirement communities work differently. NIA notes most charge a one-time entrance fee and a monthly fee after that (NIA). Those contracts are usually longer and the refund terms matter a lot. This page is about standard assisted living agreements, and a CCRC contract is a good one to take to an attorney.
Step 3: Second pass, what happens when care needs change
This is the section families skim and later wish they hadn't. Read for process:
- Assessments: who assesses your parent, when (at move-in, on a schedule, after a hospital stay, after a fall), and how the family gets the result in writing
- Price changes: how a new care level changes the bill, and how much notice comes first
- Limits: what care the community says it can't provide, and what happens then
- Memory care: whether moving to a memory care unit means a new agreement, a new fee schedule, or a new deposit
- Outside help: whether you can bring in a private aide or hospice, and on what terms
Treat assessment wording as a description of support, not a diagnosis. Medical questions belong with your parent's own clinicians. If a memory care addendum shows up while you're still choosing assisted living, set it aside and read it as its own document. Our guide to touring memory care covers that decision.
Step 4: Notice, discharge, and move-out terms
Find and highlight each of these. If one is missing, that's a question to ask, not a reason to assume it's fine:
- If your family ends it: how many days' written notice, and whether rent runs through the notice period
- If the community ends it: the reasons the agreement lists for asking a resident to leave, how much notice it promises, and whether there's a way to appeal or meet about it
- Hospital stays: whether the apartment is held and what you pay while it's held
- Refunds: how and when any refundable deposit or fee comes back after move-out or death
- Belongings: how long the family has to clear the apartment, and what happens after that
Discharge and residents' rights rules for assisted living come from each state, so the agreement is only part of the picture. If something in this section worries you, or a discharge notice ever arrives, contact your state's Long-Term Care Ombudsman program. Under the Older Americans Act every state has one, and ACL says these programs work to resolve problems related to the health, safety, welfare, and rights of people who live in long-term care facilities, including "board and care and assisted living facilities" (ACL, Long-Term Care Ombudsman Program). The Older Americans Act also requires Ombudsman programs to identify, investigate, and resolve complaints made by or on behalf of residents, and to ensure residents have regular and timely access to ombudsman services (ACL). ACL's page links to a list for finding your state's ombudsman. The Eldercare Locator, a public service of the Administration for Community Living that connects you to services for older adults and their families, can also point you to local help.
Step 5: Who signs, who pays, and who gets notices
Look at the signature page and any "responsible party," "guarantor," or "financially responsible" language before anything else in this step. Write down:
- Who the resident is, and whether your parent is signing for themselves
- Whether a family member is being asked to sign, and in what role: as your parent's agent, or personally
- Whether that wording would make the family member personally responsible for paying
- Who receives bills, rate-increase notices, care-change notices, and discharge notices
Signing "as agent" under a power of attorney and signing as a personal guarantor are different things, and the difference matters. If the wording isn't clear, ask the community to explain it in writing and ask your own attorney before you sign. If you're managing a parent's money under a power of attorney or as a court-appointed guardian, the Consumer Financial Protection Bureau has free plain-language guides for each role (CFPB, managing someone else's money). CFPB also has guides for people appointed by a government agency to manage another person's income benefits, such as Social Security or Veterans Affairs benefit checks (CFPB). We can't tell you how your documents or your state's law apply. That's what a lawyer is for.
When siblings are sharing the cost or the paperwork, settle who signs and who pays at a family meeting first, not in the admissions office.
Clause-by-clause: what to look for and what to ask
The middle column is our suggestion for reading the agreement, not a legal standard. Your agreement may use different words.
| Section | What to look for | Question to ask, in writing |
|---|---|---|
| Base rate | A list of what's included, not just a total | "What exactly does the base rate include this month?" |
| Care fees | How care levels are set and how often they're reviewed | "How will we be told, in writing, before a care fee goes up?" |
| Community fee or deposit | Whether any part is refundable, and the timeline | "What part comes back, when, and in what situations?" |
| Rate increases | How often and how much notice | "When was the last increase, and how much notice did residents get?" |
| Ending the agreement | Notice required from the family, and from the community | "For what reasons can you ask a resident to leave, and what's the process?" |
| Hospital stays | Whether the apartment is held and what's billed | "What do we pay while Mom is in the hospital?" |
| Responsible party | Whether a family member signs personally | "Is my signature as her agent, or am I agreeing to pay personally?" |
| Disputes | Any arbitration clause or complaint process | "Is the arbitration addendum required to move in?" Ask your attorney what it means for you. |
| Addenda | Every separate PDF that's "part of the agreement" | "Can you send one complete list of every document we're signing?" |
Free contract review worksheet
Our contract review worksheet (CSV) opens in Excel, Google Sheets, or Numbers. It has one row per item from the passes above, with columns for where it appears in the agreement, what it says, your question, the community's written answer, and the date you got it. It's blank. Fill it in from the agreement in front of you, not from memory of the tour.
When to slow down
Openings can be real, and so can pressure. Slow down if you hear "sign today or lose the apartment" with no paperwork, if fee numbers change between calls without a new fee schedule, if a community won't send the full agreement ahead of time, or if someone says an addendum "doesn't really matter." NIA's advice to read the contract again before signing is the right default (NIA). A day or two to read is a reasonable request.
A made-up example
This example is invented to show the method. It isn't a real family or a real community. Dana's mother picked a community after two tours. Dana asked for the full packet by email and got the agreement plus four addenda. On the money pass she found the care fee was set by an assessment "at move-in and as needed," so she wrote down: "How much notice before a care fee change?" On the second pass she noticed the signature page called her the "responsible party" and asked admissions in writing whether that meant she'd pay personally if her mother's money ran out. She took the answer, the agreement, and the arbitration addendum to her mother's attorney before signing. The move date didn't change.
Questions to bring to admissions
- Can you send every document we'll sign, as one list, before move-in day?
- What exactly is included in the base rate, and what's billed separately?
- How and when are care levels reassessed, and how do we get the result in writing?
- What part of the community fee or deposit is refundable, and on what timeline?
- How much notice do residents get before a rate increase?
- For what reasons can the community ask a resident to leave, and what's the process?
- Is the family member's signature as an agent, or as a personal guarantor?
- Is any addendum (for example, arbitration) optional?
Ask for written answers. A spoken "don't worry about that" isn't part of the agreement.
After you sign
Keep the signed agreement, every addendum, the fee schedule, and the written answers together, with a copy for whoever handles the bills. After move-in, NIA's advice for families is to be an advocate for the older adult's needs and preferences (NIA, long-term care facilities)—bring the signed care and notice terms with you when something doesn't match what you expected. Our moving timeline covers the weeks before move-in, and the first month after move-in covers settling in, including the first care review. For where contracts fit in the bigger picture, see the costs and contracts stage of our senior care planning guide. For a plain-English overview of assisted living and related paths, see the care options overview. Questions about our guides? Contact us.
How this page is made
Carter Hockinson, editor, reviews this guide against official sources: the National Institute on Aging, Medicare.gov, the Administration for Community Living (ACL), the Eldercare Locator, and the Consumer Financial Protection Bureau, each linked where it's used. Sources were first checked on October 9, 2026, and re-checked on October 14, October 15, October 16, and October 17, 2026. The step order, the clause table, the worksheet, and the example are our own suggestions for reading an agreement, not legal requirements. We're not attorneys and we don't review individual contracts. This page doesn't describe any state's law.
Keep reading: How to compare assisted living fees · What care levels mean in assisted living · A practical timeline for moving a parent into care
Elder Living Guide provides education and referrals. We are not a care provider, facility, agency, or medical practice.