By: Jennifer Bohyer, CDP, Executive Director, The Heathers Senior Homes

Reviewed for accuracy by Julie Ortiz, LPN, Director of Nursing.

What Services Are Included in Assisted Living?

By the time most families ask this question, they've already worked through the harder ones. You've decided that living alone isn't working anymore. You've looked at whether Medicare helps pay. You've read enough to know roughly what assisted living is.

The details families compare most often are the day to day services. Is help with medication available? Are meals, housekeeping, and laundry included? What support is available for medical appointments and other routine needs? Understanding those details makes it easier to compare communities accurately.

Those are fair, practical questions, and they deserve clear, specific answers. Here's what services are included in assisted living, what Illinois law actually requires, what usually costs extra, and how to compare communities on the things that matter.

Quick answer

Assisted living includes help with daily activities like bathing, dressing, and mobility, plus three meals a day, housekeeping, personal laundry, 24-hour security, and an emergency response system. In Illinois, those are mandatory services that every licensed assisted living and shared housing establishment must provide or arrange. Medication assistance, higher levels of personal care, therapy, transportation, and companion services are common but often billed separately. Ask any community for a written list of what the base monthly rate covers before you compare prices.

What is assisted living?

Assisted living is residential care for older adults who need daily support but don't need the round-the-clock clinical care a nursing home provides. Residents usually have their own room or apartment, share common spaces, and receive help with the specific things that have become difficult.

The National Institute on Aging describes assisted living residents as having access to up to three meals a day, assistance with personal care, help with medications, housekeeping and laundry, 24-hour supervision and security, and social and recreational activities, with a few levels of care typically offered and residents paying more for higher levels. Exact arrangements vary from state to state.³

Who benefits from assisted living?

Assisted living tends to fit someone who is still very much themselves but is losing ground on the logistics. She's forgetting doses. He's stopped cooking and is living on toast. Showering has become the thing she avoids. The house has gotten too big and too quiet.

It isn't the right setting for someone who needs continuous skilled nursing, and it's often more than someone needs if the only real issue is loneliness. Assisted living works best in that middle ground.

What assisted living is designed to do

The purpose is to lift away the tasks that have become obstacles, so your mother has more energy left for the parts of life she still enjoys. Someone who no longer has to fight with the laundry, the pill organizer, and dinner has a great deal more of themselves left over for a conversation, a walk outside, or a card game.

Assisted living services at a glance

The quick version, before the detail:

Usually included	Often extra
Meals	Medication administration
Housekeeping	Therapy services
Personal laundry and linens	Salon services
Emergency response system	Private companion care
Assistance with daily activities	Transportation, sometimes
24-hour security	Higher levels of personal care

 

The left column is close to universal, and in Illinois most of it is required by law. The right column is where communities often differ, which makes those items especially useful when comparing options.

What services are included in assisted living?

Illinois is more specific about this than many states, which is genuinely useful when you're comparing communities. The Illinois Assisted Living and Shared Housing Act defines a set of mandatory services that a licensed establishment must provide or arrange for.¹

Those mandatory services are:

• Three meals per day available to residents, prepared by the community or an outside contractor
• Housekeeping services, including vacuuming, dusting, and cleaning the resident's unit
• Personal laundry and linen services, provided or arranged for by the community
• Security provided 24 hours a day, including locked entrances or security personnel
• An emergency communication response system
• Assistance with activities of daily living

The Illinois Department of Public Health licenses and surveys assisted living and shared housing establishments through its Division of Assisted Living, and every establishment must submit an annual renewal application.²

That list is the minimum, and many communities offer considerably more. Knowing the minimum is useful because it helps families focus their questions on the services and experiences that vary from one community to another.

Assistance with daily activities

Activities of daily living are the basic tasks of taking care of yourself: eating, dressing, bathing, toileting, transferring from a bed or chair, and personal hygiene. Assistance is meant to be partial and personalized. If your father can dress himself but can't manage buttons, that's what he gets help with, and nothing more.

Ask how a community determines what level of help someone needs, how often that assessment is repeated, and whether the family is part of the conversation.

Medication management

This is the single most common source of confusion, because Illinois treats medication services as optional rather than mandatory. A community isn't required to provide them, and communities that do must follow specific rules.¹

So ask plainly: does this community remind residents to take medications, supervise self-administration, or actually administer them? Those are three different services with three different implications. And ask whether medication services are included in the base rate or billed on top.

Meal preparation and dining

Three meals a day are required. What varies enormously is everything else about them: whether there are real choices, whether the kitchen accommodates a low-sodium or diabetic diet without making it a production, whether someone who sleeps late can still eat, and whether the dining room is a place people want to sit for a while.

If you can, share a meal in the dining room before you decide. A regular mealtime can provide valuable insight into daily life within the community.

Housekeeping and laundry

Housekeeping and personal laundry are both required services. Ask how often, and ask what counts. Weekly light housekeeping and weekly linens is a different arrangement than daily tidying, and both are called housekeeping.

Transportation services

Transportation isn't on the Illinois mandatory list, which surprises many families. Most communities offer it in some form, but the details matter: scheduled group trips only, or individual medical appointments? Within a set radius, or anywhere in McHenry County? Included, or per trip?

What social and wellness services are included?

Engagement isn't a legal requirement, so it's often an area where families notice meaningful differences between communities.

Daily activities

Look for programming that runs every day rather than a calendar that fills weekday mornings and empties out after lunch. Ask who builds it, whether residents shape it, and what happens when someone stops showing up.

Fitness and movement programs

Ask what movement looks like for someone using a walker, and whether it is adapted or simply optional. Balance and strength work matters more with age, not less.

Social events and connection

Ask how new residents are introduced to the group, and how the community handles someone who is naturally private. Helpful answers often include examples of how the community supports individual residents.

What services typically cost extra?

Assisted living is usually priced as a base rate plus care levels, and this is where written answers matter most.

Higher levels of personal care

Most communities define two or more care levels and charge more for each. Ask what moves someone from one level to the next, who makes that determination, how often it is reviewed, and how much notice you receive before a rate changes.

Medication administration

Because Illinois treats medication services as optional rather than mandatory, this is among the most common items billed on top of the base rate. Ask which of the three is offered, reminders, supervision, or administration, and what each one costs.

Everyday extras

Salon services, guest meals, incontinence supplies, and some transportation are commonly billed separately. None of these are unusual. Families should simply understand which services are included and which are billed separately before making a decision.

This article is general information and not financial or legal advice. Ask an elder law attorney or a financial professional to review a residency agreement with you before signing.

What's not included in assisted living?

Some things aren't simply billed separately. They sit outside what assisted living provides at all, and knowing the difference now can spare you a difficult surprise later.

Skilled nursing care

Assisted living does not provide continuous skilled nursing, and that is the defining line between assisted living and a nursing home. A community may have licensed nurses on site or on call, but round-the-clock clinical care is a different level of care in a different setting. If your mother comes to need that level of care, adding services in assisted living won't bridge the gap. It's far easier to know that now than to find it out during a crisis.

Physician services

Primary care, podiatry, dental, vision, and psychiatric care come from outside providers. Many visit communities on a schedule, which is genuinely convenient, but they bill independently and are not part of the monthly rate. Ask which providers come on site, how often, and whether your parent can keep their existing physician.

Specialized therapies

Physical, occupational, and speech therapy are delivered by outside agencies, generally billed through Medicare Part B when medically necessary and ordered by a physician. The community may host the therapist, but it is not providing the therapy. Ask whether therapy happens on site or requires travel, which matters a great deal for someone with limited mobility.

Private duty care

One-to-one companionship, or a dedicated aide for part of the day, is arranged and paid for separately, sometimes through the community and sometimes through an outside agency. Families most often add this after a hospital stay, or during a stretch when someone needs more help than usual. Ask whether the community permits outside agencies, and under what conditions.

None of this means assisted living falls short. It means the model has limits, and understanding those limits early can help you plan for what may come next.

Assisted living compared with living alone

Category	Living alone	Assisted living
Meals	Planned, shopped for, and cooked independently	Three meals a day required in Illinois
Medication support	Tracked alone or by family	Available in most communities, often as an add-on
Housekeeping and laundry	Done yourself or privately hired	Required services under Illinois law
Social engagement	Depends on visitors and mobility	Daily opportunities built into the setting
Safety monitoring	Limited between visits	24-hour security and an emergency response system
Cost structure	Spread across many separate bills	One base rate plus defined care levels

How The Heathers supports residents

Each of our homes serves fewer than 20 residents. The Lake in the Hills and Ringwood houses were designed so that a Care Partner is never more than thirty steps from someone who needs one, which comes from how the buildings are laid out rather than from a goal we work toward.

Size shapes what daily life feels like. A Care Partner notices when your mother skips breakfast, because there aren't eighty other trays to account for, and her care plan can be built around the two things she actually needs help with.

Our ENLIGHT® Lifestyle Enrichment Program is the structured side of that, with daily programming built around cognitive and emotional well-being. And a good deal of what fills a day here isn't programming at all. Folding laundry, setting tables, making cards for someone's birthday. We call this purposeful living, and it describes something ordinary rather than something programmed. Having a way to contribute matters to most people, and that doesn't change with age or a diagnosis.

The Ringwood house sits on three rural acres. The Lake in the Hills homes are single-story with park-like grounds. Both are family-owned and family-operated, which is why, when you call, you'll reach someone who knows the homes and the people living in them.

Compare assisted living communities side by side

Getting a written list from each community is the first step. Putting those lists next to each other can make differences easier to identify. Fill this in during or shortly after each visit, while the details are still fresh.

Service	Community A	Community B	Community C
Meals included
Medication assistance
Housekeeping frequency
Transportation included
Emergency response system
Care level pricing
Notes

 

Illinois mandatory services will appear on every list, so the rows that actually separate communities are medication assistance, transportation, and care level pricing. Those are the rows worth filling in first.

What should families ask before signing?

Check each item once you have the answer in writing rather than in conversation.

☐  Meals included, and how many choices at each?

☐  Medication assistance included, and at which level: reminders, supervision, or administration?

☐  Housekeeping frequency confirmed, and what it covers?

☐  Transportation included, and does it cover individual medical appointments?

☐  Care reassessment process explained, including who decides?

☐  Rate-increase policy provided, including how much notice?

☐  Written fee schedule received?

☐  Which outside providers come on site, and how they bill?

☐  What happens when care needs increase beyond what this community offers?

Next steps

Choosing assisted living is rarely about finding a community that looks good on a tour. It’s about understanding how daily life works, what support is available when needs change, and whether a place feels right for the person who will call it home.

As you compare communities, ask questions, request information in writing, and give yourself time to process what you’ve learned. The goal isn’t simply to compare monthly rates. It’s to understand what those rates include and how each community supports its residents day to day.

If you’re exploring assisted living in Lake in the Hills, Ringwood, or anywhere in McHenry County, we'd be happy to answer your questions and show you life at The Heathers. Visit for a meal, meet our team, and take the time you need to decide what’s right for your family.

Frequently asked questions

Are meals included in assisted living?

Meals are included. Illinois requires every licensed assisted living and shared housing establishment to make three meals per day available to residents, prepared by the community or an outside contractor. What varies is choice, quality, dietary accommodation, and flexibility around timing, so ask to eat a meal in the dining room before you decide.

Does assisted living include medication management?

Medication services are optional in Illinois rather than mandatory, so it depends on the community. Some offer reminders only, some supervise self-administration, and some administer medications directly. Ask which of the three a community provides, whether it is included in the base rate, and what the fee schedule looks like if it is not.

Is transportation included in assisted living?

Transportation is not among the services Illinois requires, though most communities offer some form of it. Ask whether it covers individual medical appointments or only scheduled group outings, what geographic area it serves, and whether it is included or billed per trip.

What services typically cost extra in assisted living?

The most common extras are higher levels of personal care, medication administration, therapy services, physician and specialty visits delivered on site, private-duty companions, salon services, guest meals, and incontinence supplies. Ask for the full fee schedule in writing rather than a summary.

What is the difference between assisted living and a nursing home?

Assisted living supports people who need help with daily activities but not continuous skilled nursing care. Nursing homes provide a higher level of medical care, with licensed nursing available around the clock. Many people who move to assisted living never need nursing home care at all.

How do I compare what two assisted living communities include?

Ask both for a written list of base-rate services and a written fee schedule for everything else, then compare the two documents rather than the two tours. Illinois mandatory services will appear on both lists, so the meaningful differences will be in medication services, care levels, transportation, and how care level increases are triggered and priced.

Medical disclaimer

This article is intended for general informational purposes only and does not constitute medical, legal, or financial advice, diagnosis, or treatment. Every person’s health and financial situation is different. Please consult a qualified healthcare provider, licensed specialist, or financial or legal professional for guidance specific to your loved one’s individual needs and circumstances.

Sources

[1] Illinois General Assembly, Joint Committee on Administrative Rules.
“Title 77, Part 295: Assisted Living and Shared Housing Establishment Code.”
https://www.ilga.gov/agencies/JCAR/EntirePart?titlepart=07700295.
https://www.ilga.gov.
Accessed July 2026.

[2] Illinois Department of Public Health, Division of Assisted Living.
“Assisted Living.”
https://dph.illinois.gov/topics-services/health-care-regulation/assisted-living.html.
https://dph.illinois.gov.
Accessed July 2026.

[3] National Institute on Aging.
“Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care.”
https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes.
https://www.nia.nih.gov.
Accessed July 2026.