World Kindness Week: Little dog helps lonely old man feel happy
In Melbourne, Australia, a puppy named Prinny changes John’s lonely days in a nursing home, bringing him lots of joy and love from all over the world.
Federal health programs Medicare and Medicaid have spent more than $12 billion on assisted living facilities for the elderly and disabled, according to a new federal monitoring report.
A U.S. General Accounting Office report released July 2 revealed detailed findings on federal spending on assisted living facilities, which seniors choose for long-term care. Based on the report’s findings on massive federal spending, Democratic Sens. Elizabeth Warren and Kirsten Gillibrand called for increased oversight of these facilities.
Warren said the report identified “significant oversight gaps.”
“Although assisted living facilities receive billions of federal dollars, there is no role for the federal government to ensure quality care is provided,” Warren said in an email. “Residents in these facilities deserve better treatment, and that starts with making sure assisted living facilities are making better use of taxpayer dollars and not letting seniors sleep rough.”
What is the difference between a special nursing home and a welfare facility?
Assisted living facilities house and provide care for the elderly and some people with disabilities. In these facilities, people typically live independently but can receive support with daily activities such as bathing, eating, and using the toilet.
Nursing homes are often staffed with nursing assistants as well as more highly skilled positions such as certified nurses and registered nurses. Nursing home residents typically have access to 24-hour nursing and rehabilitation services.
Although Medicaid pays for low-income nursing homes in many states, little was known about how much the federal government spends on assisted living facilities. GAO’s report quantified Centers for Medicare and Medicaid Services spending on these households.
The report says Medicare will spend $8.5 billion in 2024 for about 830,000 people in assisted living facilities. Most of the spending went to hospice care, but residents also received “home health” services such as nursing, physical therapy, occupational therapy, and speech therapy. Medicare also paid for home visits to evaluate people, as well as nail care and psychotherapy.
The report also found that federal Medicaid spending for services provided in assisted living facilities in 2024 will be $3.5 billion. The report does not tally up how much each state pays to assisted living facilities.
The $12 billion figure does not include spending from other federal agencies, such as the Department of Housing and Urban Development and the Department of Veterans Affairs, which also pay for room and board and other costs in assisted living facilities, the GAO report said. It also does not include spending by private insurance companies that manage Medicare Advantage plans.
Democrats call for more oversight
Assisted living facilities are typically regulated by the state. Nursing homes are regulated by the federal Centers for Medicare and Medicaid Services and are subject to regular inspections.
Gillibrand, the top Democrat on the Senate Committee on Aging, has vowed to increase regulation and oversight of these facilities.
“Older adults and their families deserve protection and peace of mind when seeking nursing home care,” Gillibrand said in an email. “These facilities receive at least $12 billion in taxpayer funding annually, yet receive little federal oversight to ensure the safety of their residents. This is unacceptable.”
Warren has been pushing for greater oversight of assisted living centers for nearly a decade. She, along with other senators, called for a 2018 GAO report documenting safety problems, including medication errors and deaths, in nursing homes in 22 states.
During President Joe Biden’s administration, Warren called for federal reporting standards for problems in assisted living facilities.
Rashuan Bethea, executive director of the National Center for Assisted Living, an industry group, said assisted living is a quality option for more than 1 million Americans.
Beshear said the GAO report supports the idea that state regulation with a variety of assisted living options and Medicaid waivers is the best approach.
“A one-size-fits-all approach does not fit assisted living residents, each of whom has unique needs,” Bethea said. “States are best equipped to administer Medicaid programs and oversee assisted living communities.”
Affordability concerns remain
According to CareScout’s 2025 Long-Term Care Cost Survey, assisted living facilities are typically less expensive than nursing homes for seniors who need long-term care.
A study found that U.S. families spend an average of $74,400 annually on nursing care. The average annual cost of nursing home care is approximately $115,000 for semi-private care and slightly more for private care.
According to a March report from AARP, middle-class families are struggling to pay for long-term care.
The cost of providing home care and assisted living for seniors and people with disabilities has skyrocketed over the past five years, according to a report from AARP. According to the AARP report, costs for the most common types of long-term services (home care and assisted living services) jumped nearly 50% from 2019 to 2024, far outpacing the median income growth rate of 22% for older households.
