Assisted Living
Assisted living isn't all about fun. Providers need to be compliant with State regulatory requirements. That's where CMSCG can help.
CMS Compliance Group’s interdisciplinary team of assisted living consultants work with providers to address survey preparedness, post-survey needs and other quality improvement assistance.
Assisted Living Compliance Consulting
Assisted living isn't all about fun — and compliance isn't optional. Unlike nursing homes, assisted living facilities operate without federal oversight, which means every state sets its own licensing requirements, survey process, and standards of care. That state-by-state complexity is exactly where operators get into trouble. CMSCG — CMS Compliance Group, Inc. — has no affiliation with the Centers for Medicare & Medicaid Services. Our name reflects our deep expertise in the regulatory standards that govern post-acute and long-term care. Our interdisciplinary team works with assisted living providers across the country to achieve and maintain compliance with their state's specific regulatory requirements — from pre-survey preparation and mock surveys to post-survey corrective action and ongoing quality improvement. Whatever state you're in, we can help.
The Assisted Living Regulatory Environment Is Changing Fast
Across every state CMSCG serves, assisted living oversight is intensifying. Massachusetts has implemented aggressive regulatory reforms and increased inspection activity following high-profile safety incidents in 2025. Maryland is rapidly catching up on a years-long inspection backlog — annual inspections jumped from 25.7% to 55.6% of facilities in 2024 alone. Pennsylvania enacted new direct care hour mandates in 2024 and is advancing further staffing and documentation requirements. New Jersey has updated administrator and service planning requirements. New York continues to evolve requirements across ALR, EALR, SNALR, and ALP program types. The message across every state is the same: scrutiny is increasing, and facilities that aren’t prepared are getting cited.
Regional Expertise
Deep Roots in the Northeast — Available Nationwide
CMSCG serves assisted living providers across the country. While we work with providers in every region, we have particular depth and concentration of clients in the Northeast — where we understand not just the general principles of AL compliance but the specific regulatory frameworks, survey processes, and enforcement priorities of each state's oversight agency. Below is an overview of the states where our regional expertise runs deepest, as an example of the state-specific knowledge CMSCG brings to every engagement.
New York
New York's assisted living regulatory framework is among the most complex in the country — with four distinct licensed program types, each carrying its own requirements, survey process, and standards of care. CMSCG has deep expertise across all four New York program types and provides dedicated survey support, mock surveys, Plan of Correction assistance, and ongoing compliance consulting to NY providers.
View our New York Assisted Living page →- ALR — Assisted Living Residence
- EALR — Enhanced Assisted Living Residence
- SNALR — Special Needs Assisted Living Residence
- ALP — Assisted Living Program
- NY DOH survey process and requirements
- Mock surveys tailored to NY standards
- Plan of Correction development and implementation
- Ongoing compliance and quality improvement support
New Jersey
NJ Department of Health
New Jersey licenses three AL facility types — Assisted Living Residences (ALR), Comprehensive Personal Care Homes, and Assisted Living Programs — each under distinct requirements. CMSCG assists NJ providers with survey preparation, mock surveys, Plan of Correction development, and compliance monitoring under NJAC 8:36.
Connecticut
CT Department of Public Health
Connecticut licenses assisted living as a service within managed residential communities, with the facility director required to be a registered nurse. CMSCG helps CT assisted living providers navigate DOH survey requirements, strengthen documentation practices, and maintain compliance with Connecticut's unique licensing framework.
Massachusetts
Executive Office of Elder Affairs
Massachusetts certifies rather than licenses assisted living residences, with oversight by the EOEA. Following significant regulatory reforms in 2025-2026 — including heightened emergency preparedness requirements and increased inspection activity — MA providers face an increasingly active oversight environment. CMSCG helps facilities stay ahead of evolving requirements.
Delaware
Division of Health Care Quality
Delaware's Department of Health and Social Services requires licensure through the Division of Health Care Quality and conducts annual surveys. CMSCG provides survey readiness support, mock surveys, and corrective action assistance to Delaware assisted living providers.
Maryland
Office of Health Care Quality
Maryland's OHCQ is actively increasing inspection frequency after years of backlog — a stark shift that AL providers need to be prepared for. CMSCG helps Maryland providers get survey-ready as state oversight intensifies, with updated regulations recently taking effect after a multi-year regulatory revision process.
Pennsylvania
Department of Human Services
Pennsylvania distinguishes between Personal Care Homes (PCHs) and Assisted Living Residences (ALRs), with different requirements for each. New direct care hour mandates took effect in July 2024, and Electronic Visit Verification enforcement begins in 2026. CMSCG helps PA providers navigate both program types and stay current with evolving requirements.
Our Services
What We Provide
CMSCG's assisted living consulting services cover the full compliance lifecycle — from proactive survey preparation and mock surveys to post-survey corrective action, quality improvement, and ongoing compliance support. All services are tailored to your state's specific regulatory requirements.
Mock Surveys & Survey Preparedness
CMSCG conducts on-site mock surveys tailored to your state's assisted living survey process — evaluating your facility against the specific standards and requirements your state surveyor will apply. We identify vulnerabilities before a surveyor does and provide findings with actionable corrective guidance.
- State-specific mock survey process
- Full facility and documentation review
- Resident and staff interview simulation
- Service plan and medication management review
- Environment and infection control assessment
- Findings with prioritized corrective action
Post-Survey & Corrective Action Support
When survey findings are issued, CMSCG helps you understand the root causes behind each citation, develop a Plan of Correction that meets your state's requirements, and implement corrective actions that prevent repeat deficiencies.
- Deficiency analysis and root cause review
- Plan of Correction development
- Corrective action implementation support
- Staff education related to cited areas
- Follow-up monitoring and compliance oversight
Clinical & Quality Consulting
CMSCG's clinical consultants help assisted living providers develop and strengthen clinical programs — from medication management and service plan compliance to infection control and resident care practices — tailored to your state's specific standards.
- Service plan development and compliance review
- Medication management program review
- Infection prevention and control
- Clinical program development and strengthening
- Quality assurance program support
Environmental & Operations Review
CMSCG assesses your physical environment, dining services, and daily operations against your state's assisted living standards — identifying deficiencies in physical plant, food service, emergency preparedness, and operational practices before they become citations.
- Physical environment assessment
- Dining and food service review
- Emergency preparedness plan review
- Life safety and building compliance
- Operational systems assessment
Education & Staff Training
CMSCG provides targeted education and training for assisted living staff at all levels — from survey process preparation and resident rights to dementia care, behavior management, and medication management. Available on-site and virtually.
- Survey process preparation for staff
- Resident rights and dignity training
- Dementia and memory care education
- Medication management training
- Customized sessions for management staff
Policy & Procedure Development
CMSCG assists assisted living providers with the development and revision of policies and procedures that meet your state's specific regulatory requirements — building the documentation foundation that supports both compliance and consistent operations.
- State-specific P&P development and revision
- Admission criteria and agreement review
- Service plan policy development
- Emergency preparedness planning
- Implementation guidance and staff education
We Work With Your Team — Not Around Them
Many assisted living providers — particularly larger regional operators and national chains — already have internal compliance staff, regional clinical directors, or corporate quality teams. CMSCG isn’t here to replace them. We’re here to make them more effective.
Regional and corporate teams carry large portfolios and can’t always provide the depth of focused attention each individual building needs — especially during a survey cycle, a post-survey corrective action period, or a period of rapid growth or acquisition. CMSCG steps in as an independent complement to your existing team: adding outside perspective, adding capacity where bandwidth is stretched, and bringing the kind of objective, fresh-eyes assessment that internal teams — no matter how experienced — can’t always provide for themselves. We share our findings with your existing team, align our recommendations with what they’re already working on, and reinforce their direction rather than contradict it.
Independent outside perspective
Internal teams become familiar with their buildings and can develop blind spots over time. CMSCG’s consultants arrive with fresh eyes — seeing what your state surveyor will see before they arrive.
Surge capacity when you need it
During a post-survey corrective action period, a complaint investigation, or a period of rapid expansion, regional teams get stretched thin. CMSCG provides the focused capacity your team needs without disrupting existing reporting structures.
Portfolio-level support
For multi-site operators, CMSCG can provide consistent, standardized compliance support across multiple buildings — giving corporate and regional leadership a reliable outside assessment of each facility’s compliance posture.
“We’d never seen a Statement of Deficiencies that was that many pages long before. CMSCG’s consultants helped us address each area of concern and assisted us with monitoring the implementation of our Plan of Correction.”
— Executive Director, CCRCReach out today and let’s get started
Whether you need survey preparation support, post-survey assistance, or ongoing compliance consulting — CMSCG develops a solution tailored to your state’s specific regulatory requirements and your facility’s specific needs. We serve assisted living providers across the country.
Urgent survey concern? Call us directly: (631) 692-4422