Alaska assisted living home license: Residential Licensing rules, fees and steps

Where Alaska draws the licensing line

Alaska defines an assisted living home by headcount and by who pays. Under AS 47.32.900, it is a residential facility that “serves three or more adults who are not related to the owner by blood or marriage, or that receives state or federal payment for services regardless of the number of adults served.”⁠¹ The Department of Health treats a facility as an assisted living home if it provides housing and food, offers to provide or obtain help with activities of daily living, offers personal assistance, or does any combination of these.⁠¹ Activities of daily living are defined narrowly: walking, eating, dressing, bathing, toileting, and moving between a bed and a chair.⁠²

That gives three practical cases:

• One or two private-pay residents. The Residential Licensing unit says a home “is allowed to operate unlicensed if it only services one or two residents and does not receive state or federal payment.”⁠⁵ You can still ask for a voluntary license, which the department issues “as time permits”. Every rule in 7 AAC 75 then applies to you, and the fee is $25.⁠³
• Any resident paid through a state or federal program. One Medicaid waiver resident is enough to require a license.⁠¹ If public payers are part of your plan, a voluntary license is not an option. You need the full license.
• Three or more unrelated adults. You need a license before the first resident moves in. 7 AAC 75.080 says you “may not begin operation” without a probationary or standard license.⁠³

AS 47.33 does not cover correctional facilities, alcoholism treatment programs, emergency shelters, nursing homes and other licensed medical facilities, runaway programs, or maternity homes.⁠² A home already licensed under 7 AAC 50 or 7 AAC 57 is also exempt from assisted living licensing.⁠³

7 AAC 75 sets no separate license type for smaller homes. A three-bed home in a house and a 40-bed building apply under the same chapter. What changes with size is fire safety, the administrator’s qualifications and the paperwork, as the sections below show. Assisted living homes also fall outside Alaska’s certificate-of-need program. The statutory list of “health care facilities” covers hospitals, skilled nursing and intermediate care facilities, and several other facility types, but not assisted living homes.⁠⁸

Name and advertising limits

An assisted living home “may not advertise that it is a ‘nursing home’ or that it provides ‘nursing care’” unless it also holds a nursing facility license under AS 18.20. It may advertise housing, food service, help with daily living, and health-related services, including intermittent nursing or short-term skilled nursing.⁠³ If you plan to send nurses into private homes as well, that needs its own license. See the Alaska home health agency license guide.

Decide which population you will serve before you apply

Alaska licenses each home for a population category. Under 7 AAC 75.020(d), a license is issued for a home serving mainly people with a mental or developmental disability, or mainly people who are elderly, have a physical disability or have dementia but are not chronically mentally ill, or roughly equal numbers of both.⁠³ The application form asks you to pick one: “DD/MH” (mental health or developmental disability) or “SS” (physical disability, elderly, or dementia).⁠⁶

The category affects more than one checkbox. Your administrator’s experience has to be “relevant to the population of residents to be served.”⁠³ The application also asks how many residents you expect in each group.⁠³ A new home that has not settled on a population can ask for a license covering both. The department decides based on the home’s services and the purposes of AS 47.33.⁠³

Anchorage, Fairbanks and other local approvals come first

The State will not take an application without a real address. The New Home Application says a physical location “MUST be identified PRIOR to submission of an application,” and changing the location partway through “may require a new application and associated fees.”⁠⁶ You also need written proof that the property owner knows about and allows the use of the property as an assisted living home. Renters should get this from their landlord before applying.⁠⁶

Several local steps have to be finished before you file:

• Municipality of Anchorage. Homes for three or more residents, and buildings with more than one assisted living home, must complete a municipal Change of Use permit or certificate of occupancy first. The packet’s flyer says: “You must complete the process with the Municipality of Anchorage BEFORE applying,” and the approval must go in with the application. The municipal office is at 4700 Elmore Road, Anchorage, (907) 343-8301. It sets its own fees and timeframes.⁠⁶
• Fairbanks. A fire inspection report is required at three or more residents in the Fairbanks municipality. Elsewhere it is required at six or more.⁠⁶
• Kitchen inspection for six or more residents. In Anchorage, contact the municipal Food Safety and Sanitation program at (907) 343-4200. Elsewhere, contact the Department of Environmental Conservation (DEC) Food Safety and Sanitation Program at (907) 269-7501.⁠⁶
• Wells and septic. If the building is on a well, DEC’s Drinking Water Program may monitor it when more than 25 people (residents plus weekly staff) occupy the building in a week. Septic systems must meet DEC’s required separation distance from the water system, and you submit documentation showing this.⁠⁶

The application must include copies of every state or local permit and approval needed to build or operate the home.⁠³

The house: bedrooms, use of the building, and fire safety by size

Bedrooms. A single room needs at least 80 square feet of open floor space, measured before furniture goes in. A double needs 140 square feet. No bedroom may hold more than two residents.⁠³ Each resident must also have storage, linens and hygiene supplies, reasonable privacy in a shared room, and a signal device if their plan calls for one.⁠³

Exclusive use. The building must be used only for assisted living. A mixed-use building is allowed only if the other use is compatible with the residents’ welfare and the other occupants meet building, fire and environmental health codes.⁠³

Fire and life safety. Requirements step up at six residents. 7 AAC 10.1010 applies the state fire codes (13 AAC 50 and 55) to homes providing 24-hour or nighttime care to six or more adults. These homes also need any required state or municipal building code approval and a fire safety inspection report from the responsible authority, renewed every two years. Any inspection fee is yours to pay.⁠⁴ For homes licensed for five or fewer, the department inspects the home itself at licensing. It may ask a fire authority for an advisory inspection, also at your expense.⁠⁴

Your capacity can never exceed the fire authority’s maximum occupancy. The application form says the number of residents “may not be more than the maximum occupancy allowed by the fire department.”⁠⁶

Evacuation times. Your disaster and evacuation plan must get every resident out within three minutes if the home has no automatic sprinkler system. With a central fire alarm and an automatic retardant sprinkler system, the limit is 13 minutes.⁠⁴ The plan must cover residents with limited mobility or sensory or cognitive impairments. It must also address local hazards, “as appropriate, tsunami, flooding, and earthquake.” Drills are required every three months for each shift, with a full evacuation at least once a year per shift unless the fire authority has approved a different plan.⁠⁴ Before admission, you review the plan with each resident or their representative.⁠⁴

The floor plan you file must show, for every level, the smoke and carbon monoxide detectors, the fire extinguisher, the disaster kit, the first aid kit, the outside meeting place, and evacuation routes marked with arrows.⁠⁶ The department may inspect these same items before licensing, along with exits, combustible waste storage and any portable heaters.⁠⁴

Homes with six or more residents may not have firearms, and they must also file incontinence care procedures with the application.⁠⁶

Who can be the administrator

Every home needs an administrator who is at least 21 and who clears the background check and general requirements in 7 AAC 75.215 and 7 AAC 75.220.⁠³ If the administrator does not run the home day to day, you must appoint a resident manager who meets the same qualifications.⁠³ You also name an administrator designee to cover absences of 24 hours or more. A designee who will cover for 90 consecutive days or longer must meet the full administrator qualifications.⁠³

Experience requirements depend on the licensed capacity of the home, or the combined capacity if you operate several homes. Meeting any one option in your tier is enough:⁠³

A bachelor’s or higher degree in gerontology, health administration or another health-related field can replace all or part of the experience if the department accepts it as equivalent.⁠³ The department assesses the administrator’s own language skills. The administrator assesses those of employees, contractors and volunteers.⁠³

The administrator, the designee and any resident manager each file a questionnaire with the application. Each also files government photo ID, proof of freedom from active tuberculosis, three character references and two employer references, and current CPR and first aid cards.⁠⁶

Staff: ages, checks and training hours

7 AAC 75.210 sets no numeric staff-to-resident ratio. It requires enough trained staff to carry out your staffing plan and meet each resident’s needs as set out in their residential services contract and assisted living plan.⁠³ Your staff plan must say the home is ready to change staffing to meet those contracts and plans.⁠³

• Minimum ages. Supervisors must be 21. Care providers working without direct supervision must be 18. A 16-year-old may work as a care provider if the administrator or another care provider aged 21 or older is available to help.⁠³
• Background checks. Homes are subject to AS 47.05.300-.390 and 7 AAC 10.900-.990.⁠³ After the State receives your application, it asks the Background Check Program to open an account for you. Don’t submit anything until that account email arrives. Checks are required for all employees and every household member 16 or older.⁠⁶ Anyone else living in the home goes on the Household Member Worksheet.⁠⁶
• Tuberculosis. Anyone in direct contact with residents must show they are free of active pulmonary TB before contact, and again every year.⁠³
• CPR and first aid. Someone on duty must hold CPR training from the previous two years and first aid from the previous three, from the American Red Cross, the American Heart Association or an equivalent. If training isn’t regularly offered within 100 miles of the home, every three years is enough.⁠³
• Orientation. Within 14 days of hire, each care provider must be oriented on a list of topics set in rule, including fire safety, resident rights, abuse recognition and reporting, infection control, and medication management.⁠³
• Continuing education. Administrators need 18 clock hours a year and care providers 12. Department-approved in-service training counts. Remote homes without courses within 100 miles or by distance learning may complete it every 18 months.⁠³

What the New Home Application asks for

The State’s packet is the Application for License to Operate an Assisted Living Home (form revised 08/30/2022, posted as a 64-page PDF with handouts).⁠⁶ It must be notarized and include the fee. Residential Licensing returns incomplete applications.⁠⁶ Besides the owner, administrator and designee items above, the packet requires you to write and submit:⁠⁶

1. Ownership and entity worksheets

   These cover every owner, plus the board members of a corporation or association and the chief executive of a government applicant. Attach your business license and corporate documents.

2. Staff plan and job descriptions

   , and personnel practices written much like an employee handbook.

3. Disaster preparedness plan and evacuation floor plan

   , as described above.

4. Resident-facing documents

   These are the Notice of Resident Rights, the notice of protection from retaliation, the grievance procedure, house rules, the residential services contract, and the assisted living plan with a physician statement.

5. Safety policies

   These cover universal precautions, restraint (with a restraint assessment), abuse, neglect and exploitation, controlled substances, and an employee orientation form.

6. Conditional items

   These include a policy and resident authorization if you will manage residents’ money, notices for animals or approved poisonous plants, and a communal nonprescription drug policy for homes of three or more that share such medications.

7. A business plan

   for 11 or more residents or more than one home. It covers services, location, management and personnel, and six months of projected monthly expenses.⁠³

The packet includes sample forms for many of these items.⁠⁶

Proving the money: the three-month reserve

Before it approves an application, the department requires you to show “sufficient financial resources to operate for a minimum of three months without considering resident income.”⁠³ The packet turns this into a projected budget worksheet. Most new applicants file three months. You file six months if you already own a licensed home or are applying for 11 or more residents.⁠⁶

You back the budget with paperwork: current bank statements showing the three-month reserve, and current utility bills.⁠⁶ You also attach your mortgage statement or lease showing the monthly rent, homeowner’s or renter’s insurance, workers’ compensation and liability insurance statements or estimates, and vehicle payment and insurance statements for any home vehicles.⁠⁶ Payroll has to be projected at full capacity.⁠⁶

Fees

The fee schedule in 7 AAC 75.100 has a base fee plus $25 per bed above three (small homes) or six (larger homes). The result works out to $25 per licensed bed at any size. The State’s packet gives the five-bed example: $125.⁠³⁠⁶ Pay by check or money order. Fees are nonrefundable.⁠³⁠⁶

Local permits and fire inspections are paid separately: the Municipality of Anchorage sets its own Change of Use fees, and the home pays any fee the fire authority charges.⁠⁴⁠⁶

The order that works in Alaska

1. Attend an orientation

   Residential Licensing runs New Provider Orientations covering the statutes, regulations and the New Home application. Upcoming sessions on its page are a two-day Microsoft Teams webinar on October 22-23, 2026, and a condensed five-hour Teams session on December 17, 2026. Register by email at [email protected]. The two-day version includes presenters from Adult Protective Services, the Long-Term Care Ombudsman, the Department of Labor, Senior and Disabilities Services, the General Relief Program and the Alaska Training Cooperative.⁠⁵ The page describes these as offered. It does not say attendance is required.

2. Lock in the property

   Get landlord permission if you rent. Measure the bedrooms. Confirm the fire authority’s maximum occupancy.⁠³⁠⁶

3. Clear local approvals

   In Anchorage, get the Change of Use permit. If you will have six or more residents, or three or more in Fairbanks, get the fire inspection report. At six or more, get the kitchen inspection. If you are on a well or septic, get the DEC documentation.⁠⁶

4. Qualify the administrator and designee

   Collect their experience records, TB clearance, references, and CPR and first aid cards.⁠⁶

5. Write the policies, budget and plans

   , and fund the three-month reserve.⁠³⁠⁶

6. File the notarized application with the fee

   A supervisor reviews it and assigns a licensing specialist.⁠⁵

7. Complete background checks

   through the Background Check Program account the State sets up after it receives your application.⁠⁶

8. Pass the onsite inspection

   It is part of every application.⁠⁵

9. Receive the probationary license

   , and admit residents only after it is issued.⁠³

The rules and the agency page give no processing time from filing to license. Ask your assigned specialist.

Probationary license, standard license and renewal

Every first-time home gets a probationary license once the department finds that the application and your operating plan meet AS 47.33 and 7 AAC 75.⁠³ It lasts for a period the department sets, up to two consecutive years with a possible one-year extension. Once the home is operating, the department may convert it to a standard license at any time before it expires.⁠³ AS 47.32.050, the general licensing statute, calls this first stage a “provisional” license and caps it at one year plus one extension of up to a year.⁠¹ Ask your specialist which term applies to your license. The standard license runs two years.⁠³

The probationary stage sets your growth pace: “A person may not apply for a license to operate one or more additional homes until each current home has passed the probationary period and been issued a standard license.”⁠³ A license covers only the location, people and organizations named in the application and cannot be transferred.⁠³ Moving, making another major modification, or adding beds all need an approved modification before you act.⁠³ For a capacity increase to 11 or more, include a business plan with the modification request.⁠³

Oversight. Residential Licensing says it inspects all licensed facilities every year.⁠⁵ By rule, the department either monitors each home annually or requires a self-monitoring report. A missing or false report is grounds for enforcement.⁠³ The department notifies you before the license expires.⁠³ Under AS 47.32.060, a renewal application is due at least 90 days before expiration. If the State hasn’t finished its review by then, the license is automatically extended for six months or until a decision.⁠¹ If you are in compliance, the standard license is renewed for two years. If not, you and the department work out a plan of correction, and the department may issue a probationary license instead.⁠³

Penalties. Civil fines can reach $2,500 a day for a continuing violation or $25,000 for a single violation. Intentional or criminally negligent violations affecting health and safety are a class B misdemeanor.⁠¹

How much care an Alaska home may provide

Alaska lets assisted living homes go further clinically than the name suggests, and your services list should reflect what you will actually do:⁠²

• Medications. Any staff member may supervise a resident’s self-administration if it is in the resident’s assisted living plan. Supervision includes reminding, opening containers, reading labels and guiding the resident’s hand on request.
• Intermittent nursing for residents who do not need 24-hour nursing. It must be given by a licensed nurse or by staff to whom a nurse has delegated a task the Board of Nursing allows.
• 24-hour skilled nursing for up to 45 consecutive days, provided through a licensed nurse, to avoid a medical transfer. After that, a resident may stay without it if the physician is consulted and the plan is revised and reviewed by a registered nurse or physician.
• Terminal illness. A terminally ill resident may stay past the 45-day limit if the home agrees and a physician certifies that the resident’s needs are being met.

A home may also apply for a temporary variance to admit a specific, named child, with a safety plan approved by the department, the child’s representative and every resident.⁠³

Residents’ contracts, plans and notices

No one may move in until the home and the resident (or their representative) sign a residential services contract. The contract must list services, rates, advance payments and the refund policy.⁠² Refunds of rent paid ahead for future periods are prorated under 7 AAC 75.330.⁠³ An assisted living plan must be developed and approved within 30 days of admission, with the resident, any service coordinator, service providers and the administrator taking part.⁠²

Rate increases need 30 days’ written notice.⁠² Closing or relocating the home needs 90 days’ notice to the licensing agency, residents, their representatives and service coordinators.⁠² Involuntary discharge is limited to grounds listed in AS 47.33.360. Most of them need 30 days’ written notice and a case conference if the resident asks for one.⁠² Meals are three a day plus at least one snack, and you keep menus on file for a year.⁠³

Getting paid through Alaska Medicaid

Medicaid home and community-based waivers pay for “residential supported-living services” only in an assisted living home licensed under AS 47.32. The services must follow the department’s Conditions of Participation and be approved in the recipient’s support plan with prior authorization.⁠⁷ The setting must be staffed 24 hours a day by on-site personnel. It must serve people who can no longer live alone and would otherwise need a nursing facility.⁠⁷ The rule covers older adults and adults with physical disabilities, and adults with physical and developmental disabilities.⁠⁷

Billing takes two more steps after licensing. The Department of Health must certify your home as a residential supported-living services provider, and you must enroll in Alaska Medicaid under 7 AAC 105.⁠⁷ Remember that accepting even one waiver resident makes licensure mandatory regardless of headcount.⁠¹

Sources

1. 1
   Alaska State Legislature, Alaska Statutes, chapter 47.32 (Centralized Licensing and Related Administrative Procedures) Checked 12 Oct 2026 · Back to text ↑
2. 2
   Alaska State Legislature, Alaska Statutes, chapter 47.33 (Assisted Living Homes) Checked 12 Oct 2026 · Back to text ↑
3. 3
   Alaska State Legislature, Alaska Administrative Code, 7 AAC 75 (Assisted Living Homes) Checked 12 Oct 2026 · Back to text ↑
4. 4
   Alaska State Legislature, Alaska Administrative Code, 7 AAC 10.1000-10.1095 (environmental health and safety standards) Checked 12 Oct 2026 · Back to text ↑
5. 5
   Alaska Department of Health, Assisted Living Licensing and Renewals Checked 12 Oct 2026 · Back to text ↑
6. 6
   Alaska Department of Health, Residential Licensing, Application for License to Operate an Assisted Living Home (New Home Application with handouts, revised 08/30/2022) Checked 12 Oct 2026 · Back to text ↑
7. 7
   Alaska State Legislature, Alaska Administrative Code, 7 AAC 130 (Home and Community-Based Waiver Services), sections 130.220 and 130.255 Checked 12 Oct 2026 · Back to text ↑
8. 8
   Alaska State Legislature, Alaska Statutes, section 18.07.111 (Certificate of need definitions) Checked 12 Oct 2026 · Back to text ↑

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