Little Rock Senior AdvisorWho licenses assisted living in Little Rock, Arkansas?
The Arkansas Department of Human Services does, through its Office of Long Term Care (OLTC) in the Division of Provider Services and Quality Assurance; every assisted living facility in Pulaski County and the rest of the state needs an OLTC license under Ark. Code Ann. 20-10-1701 and following.
The statute defines an assisted living facility as a building, or part of one, that takes on assisted living services for more than 24 hours for more than three adults who are not related to the owner or administrator. The City of Little Rock and the county do not license care; they handle zoning and building permits. New beds also need a permit of approval from the Arkansas Health Services Permit Commission, which is why the state can publish an exact bed count for every county each year.
What is the difference between Level I and Level II assisted living in Arkansas?
The dividing line is nursing home level of care: a Level I facility may not house anyone who meets the medical test for nursing home care, while a Level II facility must employ or contract with a registered nurse and may serve residents who meet that test, including people on the Living Choices Medicaid waiver.
| Level I | Level II | |
|---|---|---|
| Nursing home level of care | May not be served | May be served, including Living Choices residents |
| Medications | Staff assist self-administration | Licensed nurses may administer |
| Registered nurse | Not required | Employed or under contract |
| Short-term nursing | Through a licensed home health agency | Through its own nursing staff or home health |
| Beds in the six counties | 276 | 2,166 |
A level is not a grade. A Level I building can be a good fit for a parent who mainly needs meals, housekeeping and someone nearby. What the level tells you reliably is how far care can go before a move is required, and whether Medicaid's Living Choices waiver can ever help pay.
How many assisted living facilities are licensed around Little Rock?
Arkansas's July 2026 Bed Need Book lists 31 assisted living facilities with licensed beds in the six-county Little Rock metro: 27 Level II and 4 Level I, with 2,442 licensed beds in all, 18 of the buildings in Pulaski County.
The large Level II buildings cluster in west Little Rock along the Chenal corridor, in Maumelle, North Little Rock, Conway and the Bryant-Benton stretch of Interstate 30. Lonoke and Grant counties have a handful each, and Perry County has none. Our roster sorts them by level, beds, town and county.
What can a Level I facility not do?
Level I staff help residents take their own medications but do not administer them, and a Level I building must arrange health care through a licensed home health agency when a resident has a short-term need, rather than providing nursing itself.
The Level I rules also say plainly that no person who meets the criteria for Level II care may live in a Level I unit or bed. In practice, a parent whose memory or mobility declines to nursing home level of care must either move to a Level II building or to a nursing home. Ask any Level I administrator how often that happens and how much notice families usually get.
Who may run an assisted living facility in Arkansas?
A full-time administrator, working 40 hours a week, who is at least 21 and certified as an Assisted Living Facility Administrator through an OLTC-approved program, or enrolled in one and expected to finish within 12 months.
The administrator must also pass a criminal background check and have no substantiated finding of abuse, neglect or misappropriation. Larger buildings need a second administrator, part-time or full-time depending on bed count. Ask how long the current administrator has been in the job; turnover at the top often comes before turnover on the floor.
Does a Level II license mean a nurse is always in the building?
No: Arkansas requires a Level II facility to employ or contract with a registered nurse, but the RN does not have to be on site around the clock and may be reachable by phone or pager, with licensed practical nurses and aides covering shifts.
That is the single biggest difference families misread. Level II buildings can give medications and handle more care, but they are not nursing homes. Ask how many hours a week the RN is physically present, who gives medications overnight, and what happens if a resident falls at 3 a.m.
Side by side
| An Arkansas assisted living license is | An Arkansas assisted living license is not | |
|---|---|---|
| Issued by | DHS's Office of Long Term Care, after a permit of approval for the beds | A federal CMS certification |
| Levels | Level I (no nursing home level of care) or Level II (RN, can serve it) | A rating of quality |
| Dementia care | Compatible with an Alzheimer's special care unit with its own rules | Proof that the building runs one |
| Medicaid | At Level II, a possible Living Choices setting | Medicaid payment for rent and meals |
Sources: Arkansas Office of Long Term Care assisted living rules, the Health Services Permit Agency's Bed Need Book, Arkansas DHS waiver and PACE fact sheets, CMS, CareScout and VA rate tables, each cited in the text. Our editorial standards explain how we check them.
