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Assisted Living in California

The sunny state of California offers miles of sandy beaches, rolling mountains and beautiful weather year-round, making it a top retirement destination. Overall, it ranks 24th in the nation on Caring’s Senior Living Report based on factors such as access to health care, crime statistics and regional air quality. In the Quality of Life category, California is ranked second in the country for its high number of public libraries, parks and public transit options. The state is home to world-class medical facilities, including UCLA Medical Center in Los Angeles and UCSF Medical Center in San Francisco. It also has a range of long-term care options for those who need help with daily activities, including over 7,400 assisted living facilities. For older adults who need long-term residential services, assisted living rates come in several hundred dollars higher than the national average at $5,250.

This guide provides more information on assisted living rates in California and how costs compare throughout the state, to nearby states and to other types of care within California. It also lists some statewide nonprofit and government resources to help older adults obtain care, a summary of Medi-Cal benefits and an overview of the regulations that govern assisted living facilities in the state.

The Cost of Assisted Living in California

When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in California and its 201 cities.

The Cost of Assisted Living in California's Top Cities

Location can be a significant factor in the cost of assisted living. In the capital of Sacramento, average costs are $5,472 per month. Though higher than the state median, these costs are lower than typical rates in Los Angeles ($6,158). San Diego offers a much more affordable option at $4,479. Some cities can be much more expensive, including San Francisco, which sees one of the highest rates in California at $7,777.

California

$4946

Sacramento

$5472

Los Angeles

$6158

San Francisco

$7777

San Diego

$4479

Inflation's Impact on the Cost of Assisted Living in California

Due to inflation, California's assisted living costs have been rising. While the average cost was $4,625 in 2022, rates have increased by 6.9% to $4,946. Fortunately, the state has been impacted to a lesser degree than many other states, as can be seen in the 9.3% increase observed on a national scale.

Like California, Nevada has also been fortunate to see just a 3.6% increase in costs, as rates in Arizona have increased by roughly 10%, and costs in Oregon have risen by over 19%. New Mexico has been impacted even more, with costs rising more than 20%.

Location2022 Cost (Historical)2023 Cost (Current)2024 Cost (Estimated)
California$4,625$4,946 $5,221
U.S. Average$4,070$4,459$4,802
Arizona$4,008$4,420$4,962
Nevada$3,586$3,716$3,957
Oregon$4,681$5,580$5,942
New Mexico$3,465$4,185$4,752

The Costs of Other Types of Senior Living

The type of senior living a senior chooses typically has the greatest influence on cost. There are different services provided to serve individuals of varied levels of needs, as well as different accommodations, amenities and specialty programs included. Both assisted living and memory care offer daily personal care services, though memory care is more specialized to support the needs of individuals with dementia. Therefore, costs are higher at $5,866 compared to $4,946 for assisted living. As independent living doesn't include the same level of personal care, monthly costs are lower at $3,556.

Assisted Living

$4,946

Memory Care

$5,866

Independent Living

$3,556

Does Medicaid Cover Assisted Living in California?

Qualifying seniors in California may be able to pay for assisted living through Medi-Cal, the state’s Medicaid health care program. While Medi-Cal doesn’t cover residential long-term care services directly, it reimburses services for those enrolled in its Assisted Living Waiver. This waiver pays for assisted living services as an alternative to nursing home placement for those who require this level of care.

Unlike Medi-Cal, which is an entitlement that provides guaranteed coverage for everyone who meets eligibility guidelines, ALW has a limited number of participant slots. Up-to-date information on the waitlist is available through the Department of Health Care Services enrollment dashboard.

What Assisted Living Services Are Covered by Medicaid in California?

The Assisted Living Waiver covers a broad range of services depending on the individual’s needs as assessed by a Medi-Cal social worker. These services include:

 

  • Assistance with daily living activities such as bathing, eating and mobility
  • Assistance with instrumental activities of daily living, including medication reminders and transportation
  • Skilled nursing services
  • Social and recreational activities
  • Daily meals
  • Housekeeping and laundry services

Assisted Living Waiver Programs in California

Assisted Living Waiver

The ALW provides a community-based alternative to nursing home care for those who have extensive care needs but want to live in an assisted living facility. This program is open to all California residents. However, to have services covered, participants must live in an assisted living facility that accepts reimbursement from Medi-Cal. Currently, long-term placement is available in the following counties: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma. Additionally, the ALW doesn’t cover room and board, but costs are controlled for those who qualify for Supplemental Security Income.

To determine eligibility for the ALW, individuals undergo an assessment that evaluates their care needs. This assessment, which individuals schedule through their local Care Coordination Agency, is conducted by a registered nurse. To apply for this program, seniors call their local agency for a pre-assessment over the phone and schedule an appointment for the actual assessment.

How To Know If You’re Eligible for Medicaid in California

To be eligible for Medi-Cal, applicants must 

  • be legal U.S. citizens or residents and permanent residents of California.
  • be at least 65 years old, blind or disabled
  • meet income guidelines

As of 2023, single applicants can have an annual income of up to $20,124. Coverage is also available for those who reside in skilled nursing or intermediate care homes. Enrollment in certain programs, including Supplemental Security Income and the State Supplementary Payment Programs, guarantees eligibility for Medi-Cal.

2022 Basic Medicaid Income Limits for Seniors in California

Household SizeNumber of ApplicantsIncome Limits Per Year*Asset Limits: Applicant(s)***Asset Limits: Non-Applicants
One Person1$20,364$130,000
Two Person1$20,364**$130,000$148,620
Two Person2$27,468$195,000

*Income limits apply to all Medi-Cal programs except for SSI. For SSI, individual income cannot exceed $13,604.76 and income for couples cannot exceed $23,133.44.

**Income limit is for applicant only.

***Asset limits apply to all Medi-Cal programs except SSI. For SSI, the limit is $2,000 for an individual and $3,000 for a couple. 

How To Apply for Medicaid in California

To apply for Medicaid, seniors must submit an online Medi-Cal application to CoveredCA.com. Alternatively, they may mail a paper copy to Covered California at P.O. Box 989725, West Sacramento, CA 95798 or to their local county office. To request the ALW, contact your local Care Coordination Agency. This process takes approximately three to six months.

What Information You Will Need

  • Proof of age
  • Proof of U.S. citizenship or legal residency
  • Proof of permanent residency in California
  • Social Security number
  • Proof of all annual income, including government benefits, pensions and retirement savings
  • Policy numbers for current health insurance, including TRICARE and Medicare

How To Get Help Applying for Medicaid

Seniors in California have access to several free programs that can help them determine the best Medi-Cal coverage for their needs, enroll in the program and understand their benefits. The following resources can also help seniors resolve issues related to denied services and mishandled claims.

ProgramContactServices provided
Health Consumer Alliance(888) 804-3536Health Consumer Alliance provides free over-the-phone and in-person assistance for those who need help obtaining health insurance or resolving issues related to their coverage. Through this resource, seniors get information on their health insurance rights, find a doctor that takes Medi-Cal, dispute denied health services and resolve billing errors.
Medi-Cal Managed Care Ombudsman(888) 452-8609The Medi-Cal Managed Care Ombudsman Program advocates for Medi-Cal beneficiaries to ensure they obtain the medically necessary services covered by their insurance. The ombudsman provides information and referrals, connects seniors with the correct person or department they need to resolve a problem and helps individuals navigate the managed care system.
Medi-Cal Managed Care Health Care Options(800) 430-4263Medi-Cal Managed Care Health Care helps seniors enroll in, change or leave a Medi-Cal health plan.
Medi-Cal State Fair Hearing(800) 952-5253Medi-Cal State Fair Hearing investigates complaints regarding how an individual’s benefits and health services were handled by Medi-Cal. Seniors can call the toll-free hotline to speak with their local County Welfare Department regarding their complaint, file a discrimination complaint or request a hearing.

Does Medicare Cover Assisted Living in California?

The short answer is that no, Medicare does not cover the cost of assisted living in California Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in California

Other Financial Assistance Options for Assisted Living in California

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

NameHow To ApplyHow It Works
Aid and AttendanceLearn more and apply online at va.gov.Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.
Reverse MortgagesLearn more about your options and how to apply at ftc.govIf you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans you can take out against the value of your home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) InsuranceLearn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living typically won't be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in California

There are many resources in California that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.

Area Agency on Aging

Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.

Program NamePhone NumberDescription
California Area Agencies on Aging916-374-7739California's network of Area Agencies on Aging work under the umbrella of the California Department of Aging. These agencies promote healthy living for older residents through a variety of federal and state-funded programs. Some of these programs include supportive services, senior nutrition programs, care management programs, caregiving services and Medicare and insurance counseling. Low-income seniors can become productive community members through volunteer programs, such as the Senior Companion Program and the Senior Community Service Employment Program.

Cash Assistance Programs

Cash assistance programs in California provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.

Program NamePhone NumberDescription
California General AssistanceThe California General Assistance program offers help to low-income adults who don't have sufficient income through other sources. Many seniors on fixed incomes qualify for aid through this program. Seniors apply for this cash assistance program through their county Department of Social Services office. Because this program is county-based, the amount of funding varies from county to county.
California Lifeline ProgramThe California LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones.

Food Assistance Programs

Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help California seniors afford the nutritious food they need.

Program NamePhone NumberDescription
California CalFresh800-777-7575California CalFresh offers food assistance to low-income residents of the state and serves as the state's SNAP program. Seniors and other residents who meet federal income eligibility rules can apply online for assistance paying for healthy food to eat. To apply, seniors need a copy of their ID and income verification. Seniors can use their benefits at most food stores and farmers' markets anywhere in the state.
California Meals on WheelsMeals on Wheels California delivers healthy meals to homebound seniors who can't get to the grocery store or cook independently. The program serves the entire state through local, county-based organizations. In addition to the meal delivery, Meals on Wheels offers a friendly visit from dedicated volunteers to protect seniors from loneliness.

Free Used Medical Equipment

Due to the high cost of purchasing new medical equipment, several organizations in California collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.

Program NamePhone NumberDescription
California Ability ToolsThis project is funded and managed by the California Department of Rehabilitation and Foundation for Independent Living. It helps people with disabilities live happier, healthier and more independent lives by providing access to information and demonstrations of assistive technology as well as offering an online marketplace to buy/sell/borrow or receive free equipment. Financial loans may also be available for eligible residents.
California Dignity At Home Fall Prevention ProgramAdults aged 60+ or those with a disability who have fallen, are at risk of falling or at risk of being institutionalized could qualify for the California Dignity at Home Fall Prevention Program. Eligible seniors must also have a household income of less than 80% of the area's median income. In addition to paying for home modifications and medical equipment to help prevent injury, the program provides information and education on fall prevention.

Home Repair and Modifications

Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in California have different eligibility criteria and often assist retirees by providing grants or loans.

Program NamePhone NumberDescription
California Low-Income Weatherization ProgramCalifornia's Low-Income Weatherization Program provides energy efficiency upgrades at no cost to those who qualify, letting households lower their utility bills to free up limited disposable income for other necessary expenses. This program covers expenses such as installing energy efficient air conditioning and improving insulation. To qualify, seniors must meet income guidelines.
California Section 504 Home Repair ProgramThe Section 504 Home Repair Program makes up to $10,000 in grant funds available to elderly residents living in rural areas. These funds can be used to eliminate health and safety hazards, allowing older adults to remain in their homes. To find out if your home is eligible, visit the United States Department of Agriculture Eligibility Site.

Many organizations offer free or low-cost legal services to California seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.

Program NamePhone NumberDescription
California Helping Elders Live Productively (H.E.L.P.)This nonprofit organization aims to empower older adults and their families by offering information, counseling and advice on elder law, consumer protection, elder care and finances. It offers classes and events and also advises seniors on a one-to-one basis, providing resources and referrals.
California Long-Term Care OmbudsmanThe statewide Long-Term Care Ombudsman Program supports older adults in assisted living by helping them understand their rights, obtain the services in their care plans and resolve issues related to substandard care. The ombudsman can mediate family disagreements regarding their loved ones' care and represent seniors' interests regarding problems with insufficient or excessive services, billing mistakes and unfair intake or discharge procedures. The ombudsman can also investigate concerns about abuse, neglect or exploitation.
The State Bar of CaliforniaThe State Bar of California funds nonprofit legal agencies across the state and maintains a comprehensive database of local offices that provide free civil legal services to those aged 60 and over. Through these offices, older adults can get one-on-one assistance with determining whether they're eligible for public benefits including Supplemental Security Income, Social Security Disability Insurance and Medi-Cal. The State Bar also publishes legal guides with topics such as legal resources for veterans, how seniors can avoid legal fraud and what to know before hiring an attorney.

Senior Centers

Senior centers in California bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.

Program NamePhone NumberDescription
Alzheimer's Association California Chapter866-675-6623The Alzheimer's Association is a large, nationwide group of experts and volunteers providing advocacy and assistance at the local level in various parts of California. The available resources are particularly useful for family members and people who have been recently diagnosed with Alzheimer's and are unsure of how to plan for their future care needs. Seminars, workshops and support groups are available, along with important links, news and updates on clinical trials.
California Assisted Living Association (CALA)800-952-5661CALA calls itself the voice of assisted living, and it provides advocacy, information and education to assisted living residents and providers. Consumer data includes details about residential facilities for the elderly (RCFEs), including a facility search, reviews from residents and a shopping guide for senior services and housing. Although CALA is an industry-oriented organization, it's a useful free resource to help seniors find out about pending legislation that affects seniors and laws related to RCFEs. The association also provides continuing education opportunities for senior living staff members and the opportunity to network and develop best practices for caring for the elderly.
California RegistryCalifornia Registry is a free public service licensed by the State of California Department of Health that provides assisted living resources to area seniors. Seniors can find links to information about assisted living waivers, Medicare, SSI benefits and veteran's pensions on the website, along with an explanation about different types of care.

Senior Engagement

Senior engagement resources and programs in California help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.

Program NamePhone NumberDescription
California Cyber Seniors800-510-2020Founded in 2015, Cyber-Seniors: Connecting Generations Inc. is a nonprofit organization that allows young people to volunteer their time providing free technology assistance to avid learners aged 60 or older. Daily webinars are accessible, such as Online Banking Safety, but seniors who miss them can watch available ones from the archives. Ample cybersecurity information is handy for learning how to avoid getting scammed. Seniors needing tech assistance can book a one-on-one tech call to speak with a qualified volunteer.
California Friendly Phoning Program866-442-2529The California Friendly Phoning Program is part of the homebound adults support program offered by H.E.L.P. (Helping Elders Live Productively). The goal of this program is to help seniors live independently with dignity by staying connected to the community. Volunteers make weekly phone calls to seniors' homes to check in, engage in conversation and provide emotional support, which can help minimize feelings of loneliness and isolation. To sign up, seniors can call H.E.L.P.'s main office at (310) 533-1996.
California Senior Employment TrainingLow-income seniors aged 55 and over can brush up on their skills, learn new ones and access a variety of services designed to get them ready for the job market. They can receive on-the-job training while working at public agencies and local nonprofit organizations as well as get help crafting resumes and developing customized employment plans.

Social Security Offices

Social Security offices in California help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.

Program NamePhone NumberDescription
California Social SecuritySocial Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working.

Tax Assistance

Seniors can apply for tax assistance from several California resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.

Program NamePhone NumberDescription
California Property Tax Postponement (PTP) ProgramThe Property Tax Postponement Program allows an eligible homeowner to defer the current-year property taxes on their primary residence.

Utility & Energy Bill Assistance

Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. California retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.

Program NamePhone NumberDescription
California Low Income Home Energy Assistance Program (LIHEAP)The Low Income Home Energy Assistance Program helps eligible households balance their utility bills, while the LIHEAP Energy Crisis Prevention Program provides financial assistance to low-income households facing energy-related crises. For example, the ECPP may offer assistance to a homeowner who's in danger of having their power shut off.

Veteran's Services

California retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.

Program NamePhone NumberDescription
California Department of Veterans AffairsThe California Department of Veterans Affairs serves the state's 1.6 million veterans by helping them access state health care benefits and the VA Aid and Attendance and veterans' and survivors' pension programs. It provides advocacy and assistance via County Veteran Service Offices throughout the state. It can also help veterans determine whether they qualify for placement in one of California's eight veterans' homes, which may be an affordable alternative to private long-term care services.
California VA Benefits and Health CareCalifornia VA Benefits and Health Care is a dependable source of support for senior veterans in California. The agency offers health care services, disability benefits, guidance on pension arrangements and housing options. It assists with record management as well as planning for burials and memorials. Eligibility for services is determined based on service record, residency and personal circumstances. Through its comprehensive services, the organization prioritizes veterans' well-being.

Assisted Living Laws and Regulations in California

In California, assisted living facilities are licensed by the Department of Social Services, Senior Care Licensing Program, and comply with extensive regulations to ensure high-quality care for residents. The department supports prospective and current assisted living residents via 13 regional offices throughout the state.

TopicRule
Assisted Living Service Plan RequirementsPrior to admission, the facility must conduct a comprehensive appraisal that assesses the prospective resident’s level of functioning, mental condition and social factors such as their interests and hobbies. The facility must also obtain documentation of a medical assessment conducted within the last year and signed by the prospective resident’s primary care doctor. This documentation should include the individual’s height, weight and blood pressure. Based on these factors, facilities create personalized care plans to meet residents’ functional needs and goals. This care plan should be updated whenever the resident has a significant change in their health or status.
Assisted Living Admission RequirementsAssisted living facilities can only admit a resident if the individual or their guardian consents. To be admitted, residents must be able to administer their own medication. If they need services beyond the facility’s scope of care, they must be able to obtain services off-site. The facility isn’t permitted to admit anyone who requires around-the-clock skilled nursing services, care for Stage III and IV dermal ulcers, treatment for serious infections or catheter care. It can’t retain residents who become bedridden, require help with all daily living activities or develop mental conditions with behaviors that may be disruptive to other residents.
Assisted Living Scope of CareAssisted living facilities provide ongoing assistance with daily living activities including personal care, money management and assistance with self-administered medication. Additionally, they provide three meals plus snacks daily, regular observation of residents’ health and condition and planned activities programming.
Assisted Living Medicaid PolicyMedi-Cal, California’s Medicaid program, covers long-term residential care under the Assisted Living Waiver Program. This program covers the services the individual obtains through assisted living, but it doesn’t cover room and board. While it’s open to residents statewide, there's a limited number of assisted living facilities that accept payment from this program.
Assisted Living Facility RequirementsAssisted living facilities must be clean, sanitary and in good repair at all times. Residents must have furnished bedrooms and storage space, and there must be at least one toilet per six people and one shower or bathtub per 10 people. Facilities must also have common rooms including living rooms and dens, recreation and activity rooms and dining rooms.
Medication Management RegulationsAssisted living facilities can provide medication reminders and assist with self-administration of medications in limited circumstances, such as if a resident needs assistance due to arthritis or hand tremors. Assisted living facilities can only admit and retain residents with diabetes if they can perform their own glucose testing and medication administration. For other residents who require intramuscular, subcutaneous or intradermal injections, either the resident or an appropriately skilled professional can administer the medication.
Staffing RequirementsAssisted living facilities must have certified administrators and may hire skilled professionals, including pharmacists or licensed nurses, to provide medication administration or limited medical services. Facilities are expected to have enough direct care staff members on-site to see to residents’ scheduled and unscheduled needs.
Staff Training RequirementsAll staff members who work directly with residents must complete at least 10 hours of training within the first four weeks of their hire date, plus four hours annually. This training may be given on the job and/or in a classroom setting. Topics training covers include the special needs of older adults, techniques for personal care services, residents’ rights, seniors’ psychosocial needs and how to recognize dementia.
Background Checks for Assisted LivingAll administrative staff, direct care staff and employees who have frequent contact with residents are subject to criminal background checks. All facility staff and private-pay personal assistants must be fingerprint cleared before their physical presence at the facility. Anyone with a prior conviction for anything more than a minor traffic violation is ineligible for hire unless the director grants an exemption. Under limited circumstances, volunteers may be exempt from this rule.
Requirements for Reporting AbuseAll assisted living employees are mandated reporters and must report instances of physical, sexual, emotional or financial abuse, neglect or exploitation. Anyone can file complaints regarding suspected abuse to local law enforcement, as well as the Department of Social Services, Community Care Licensing Division by calling 1 (844) LET US NO/1 (844) 538-8766.

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Caring.com is a leading online destination for caregivers seeking information and support as they care for aging parents, spouses, and other loved ones. We offer thousands of original articles, helpful tools, advice from more than 50 leading experts, a community of caregivers, and a comprehensive directory of caregiving services.

 

The material on this site is for informational purposes only and is not a substitute for legal, financial, professional, or medical advice or diagnosis or treatment. By using our website, you agree to the Terms of Use and Privacy Policy

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