In Response To Gillibrand Request, Watchdog Releases Report Revealing The Need For Federal Oversight Of Assisted Living Facilities

In Response To Gillibrand Request, Watchdog Releases Report Revealing The Need For Federal Oversight Of Assisted Living Facilities

Jul 6, 2026

Government Accountability Office Review Identifies $12 Billion Annually in Federal Medicare and Medicaid Spending in Assisted Living Facilities

Read The Report Here.

Today, in response to an inquiry by Ranking Member Kirsten Gillibrand (D-NY) and other Democrats on the Senate Aging Committee, the Government Accountability Office (GAO) released a report underscoring the need for enhanced federal oversight of assisted living facilities that are being paid billions of federal Medicare and Medicaid dollars each year.

The new report reveals that assisted living facilities are becoming an increasingly important part of the Medicare and Medicaid systems, billing them for at least $12 billion annually. GAO also revealed that because the programs do not track spending at these facilities accurately, the spending figures are most likely an underestimate.

GAO and other investigations have identified widespread problems with quality of care in assisted living facilities, including thousands of "critical incidents" such as sexual abuse, unauthorized use of restraints, patient injuries, and even deaths.

"Seniors and their families deserve protection and peace of mind when seeking care in assisted living facilities," said Senator Gillibrand. "Though these facilities receive at least $12 billion a year in taxpayer funding, they are subject to little federal oversight to guarantee resident safety. That's unacceptable. As the top Democrat on the Senate Aging Committee, I'll keep fighting to strengthen regulation and expand access to quality, affordable care for our seniors."

"This report identifies a huge federal oversight gap. Assisted living facilities receive billions in federal dollars, but there is no federal role in ensuring that they are providing high quality care," said Senator Warren. "Residents of these facilities deserve better, and that starts by making sure that assisted living facilities are making good use of taxpayer dollars and are not leaving our seniors out to dry."

"Assisted living facilities provide care to millions of Americans. We must ensure the federal government carries out its critical role in promoting accountability for proper care as well as for the billions of federal dollars going to assisted living facilities. Our seniors deserve access to affordable, adequate care, and our government must prioritize Americans' health and well-being and do its job to increase transparency and ensure that access," said Senator Blumenthal.

Assisted living facilities, including memory care centers, are state-regulated residences that provide housing, meals, and other services to enable people to live independently. They can be a valuable alternative to nursing homes for thousands of older adults. But currently, despite the high cost to live in assisted living facilities, residents in these facilities have suffered avoidable injuries and death. And despite Medicare and Medicaid paying for services at these facilities, there has historically been a lack of oversight of these assisted living facilities.

This new GAO report reveals that:

• In 2024, Medicare and Medicaid spent at least $12 billion for services provided in assisted living facilities.
• Combined, approximately 900,000 Medicare and Medicaid beneficiaries receive care at these facilities.
• Most of the Medicaid spending was on Hospice and Home Health care - two programs that are known to have problems with fraud.
• Other federal agencies - including Housing and Urban Development and Veterans Affairs - also pay for room and board and other costs in these facilities.
• Medicare and Medicaid do not adequately track spending at these facilities and estimates are likely an undercount because there is no uniformly defined provider type that can be linked to these facilities.
• Demand for assisted living services is likely to grow because of the aging population.

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