How to Start an Assisted Living Facility in Indiana

Starting an assisted living facility in Indiana is a licensing project before it is a building or hiring project. The Indiana Department of Health (IDOH), Long Term Care, licenses these facilities, generally as residential care facilities. The Family and Social Services Administration (FSSA) sets a separate layer of rules for Medicaid assisted living waiver payments. FSSA's Assisted Living page states, “Facilities must receive licensing from the Indiana State Department of Health.” Treat the state license as the foundation and Medicaid enrollment as an optional second step.

This guide follows the order that works in practice: form your entity, lock down your administrator and site, file with IDOH, then decide whether to enroll in the Medicaid waiver. It covers the Indiana assisted living license, the indiana residential care application, and the questions that come up when an operator also considers indiana adult day care. Where a fee or rule could not be verified, this guide says so and names the agency to confirm with.

What You Need Before You Start

Gather these items before you file anything. A missing item usually means a stalled or returned application.

• An Indiana business entity, either an LLC or a corporation, formed with the Indiana Secretary of State
• A registered agent with a street address in Indiana
• Site control, meaning a signed lease or purchase agreement for the building
• Local zoning, construction, and fire approvals (these are local, and we did not verify their requirements)
• A Licensed Administrator holding a nursing facility or residential care administrator license
• An Activity Director
• Background checks, a TB test, and proof of liability insurance for the people the agencies require
• The IDOH Long Term Care application packet, plus the change-of-ownership packet if you are buying an existing licensed facility
• A written budget covering build-out, staffing, and the months before your first resident moves in

Step 1: Confirm Your License Path

IDOH licensure is the approval that comes first. FSSA handles Medicaid provider enrollment for assisted living waiver services through its Division of Aging and the Office of Medicaid Policy and Planning (OMPP). These are two separate approvals with two separate document sets, so do not assume one covers the other.

Also check whether your operation is housing with services. Facilities that operate as housing with services file an annual disclosure with the FSSA Division of Aging. The FSSA job aid lists State Form 49028 for that filing. Confirm the current form number with FSSA before you rely on it, because form numbers change.

Step 2: Form Your Business Entity

Indiana has no single comprehensive business license, but you still need a properly formed entity before you sign leases, open accounts, or file with IDOH in the entity's name. Most operators choose an LLC. A corporation also works, and the state filing fee is the same.

For an LLC, file Articles of Organization, Domestic Limited Liability Company (State Form 49459). The filing fee is $95, and you file online through INBiz at https://inbiz.in.gov/.

Your name must include “Limited Liability Company” or an abbreviation of it, and it must be distinguishable from names already in the Secretary of State's records. Entity identifiers such as Inc. and LLC, punctuation, capitalization, and the words “the,” “a,” and “an” do not make a name distinguishable. In practice, “Hoosier Care LLC” and “Hoosier Care Inc.” would conflict. Search the records at https://bsd.sos.in.gov/publicbusinesssearch before you choose a name.

You can reserve a name for $10, which holds it for 120 days, through INBiz at https://inbiz.in.gov/start-business/step-one. Processing time for formations is not published, and no expedite option exists for a domestic LLC formation, so build that uncertainty into your timeline.

A corporation files Articles of Incorporation, Domestic Corporation (State Form 4159), for the same $95 fee.

Every entity must continuously maintain a registered agent and registered office in Indiana. The office must be a street address, and a P.O. Box is acceptable only with a rural route reference. The agent can be an Indiana resident whose business office matches the registered office, or an entity authorized to do business in Indiana. Your business cannot serve as its own agent, and you may have only one agent.

Indiana has no franchise tax. By default, an LLC's income passes through to its owners, who pay the individual adjusted gross income tax of 2.95% for 2026, plus county local income tax. That rate is scheduled to fall to 2.90% in 2027. An LLC that elects corporate treatment pays the 4.9% corporate adjusted gross income tax. Which path fits depends on your ownership and projected income, so run the numbers with a CPA.

The Business Entity Report costs $32 and is due every other year by the end of the month you formed the entity. The first report is due two years after formation. Paper filing costs $50.

If you will operate under a name other than the entity's legal name, file a Certificate of Assumed Business Name (State Form 30353). Online through INBiz it costs $20 per name. Paper filings cost $30 per name for LLCs and corporations.

Many operators use one LLC to own the building and a separate LLC to run the facility. We did not research whether that structure suits Indiana residential care, so ask an attorney before you adopt it.

Step 3: Lock Down the Site and Local Approvals

Zoning, construction, and fire approvals are local, and we did not research those requirements. Treat them as unknown until the city or county confirms them. Call the local planning or zoning office and the local fire department before you sign a lease. Ask whether the building type allows residential care, what occupancy the fire authority will approve, and what construction standards apply to conversion work.

Settle your bed count early. The IDOH licensure fee is calculated per bed, so a count that changes after you apply changes both your budget and possibly your floor plan. Use the number local approvals allow, not the number you hope for.

Step 4: Hire the Licensed Administrator and Activity Director

Your Licensed Administrator needs a nursing facility or residential care administrator license. The Residential Care Administrator application fee is $100, filed through the Health Facility Administrators board of the Professional Licensing Agency. FSSA also requires an Activity Director for Medicaid waiver enrollment. Hire or contract these people before you file the IDOH application. Waiting until after filing makes it harder to meet the documentation requirements in Step 6.

For each person the agencies require, expect background checks, a TB test, and proof of liability insurance. Confirm with IDOH and FSSA which roles each requirement applies to.

Step 5: File the IDOH License Application

Use the IDOH Long Term Care new residential care facility application and its checklist. The checklist lists a licensure fee of $200 for the first 50 beds and $10 for each additional bed. The checklist's form date is unclear, and we did not find a renewal amount, so treat these as unverified figures. Confirm current fees with IDOH Long Term Care before you budget.

As an illustration only, a 60-bed application at the figures above would cost $200 for the first 50 beds plus $100 for the 10 additional beds, or $300 total. Your number will differ if IDOH's current schedule is different.

If you are buying an existing licensed facility rather than building new, ask IDOH whether the change-of-ownership packet applies instead of the new application.

Step 6: Decide on Medicaid Waiver Enrollment

If you plan to accept residents funded through the Medicaid assisted living waiver, enroll through FSSA. FSSA's documentation requirements include background checks, a TB test, proof of liability insurance, a Licensed Administrator, an Activity Director, and IDOH waiver and licensure documents. Have your license application or license status ready before you start that packet. Medicaid enrollment does not replace the state license.

Step 7: Check the Pending Rule Changes

IDOH has proposed amendments to 410 IAC 16.2-5, the residential care rule, under LSA Document #26-149 in 2026. Proposed text can change before adoption. Before you finalize staffing, floor plans, or resident agreements, pull the current rule text and the status of LSA Document #26-149 from the Indiana Legislative Services Agency, and confirm the requirements with IDOH Long Term Care.

Step 8: Plan for Ongoing Filings

Licensure is not a one-time event. Calendar your Business Entity Report every other year, your FSSA housing with services disclosure if it applies, and any license renewal IDOH requires. We did not find the renewal fee, so confirm it with IDOH as renewal approaches.

Tips and Common Mistakes

• Mistake: naming the LLC before searching the records. Entity identifiers do not make a name distinguishable, so a near-match name can be rejected.
• Mistake: using a P.O. Box as the registered office. It needs a street address unless it includes a rural route reference.
• Mistake: budgeting from a bed count that zoning has not approved. The IDOH fee and your floor plan both depend on it.
• Mistake: treating the Medicaid waiver as automatic. It is a separate enrollment with its own documents.
• Mistake: assuming an older fee is still current. The IDOH checklist date is unclear, so call before you budget.
• Mistake: signing a lease before you have an administrator plan. Your license depends on qualified people as much as on the building.
• Mistake: assuming adult day care falls under the same license. We did not verify indiana adult day care requirements. Confirm with IDOH and FSSA first.
• Tip: get advising early. The Indiana Small Business Development Center is at https://isbdc.org/, and the SBA's Indiana district page is at https://www.sba.gov/district/indiana.
• Tip: keep one document folder. The agencies ask for overlapping documents, so record what you sent, to whom, and when.

Costs at a Glance

Item	Amount	Agency	Notes
Articles of Organization (LLC)	$95	Indiana Secretary of State	Filed online through INBiz; no expedite option
Name reservation	$10	Indiana Secretary of State	Holds the name for 120 days
Assumed name (online)	$20 per name	Indiana Secretary of State	Only if you operate under another name
Business Entity Report	$32	Indiana Secretary of State	Every other year; first due two years after formation
IDOH residential care application	$200 for first 50 beds, $10 per additional bed	IDOH Long Term Care	Unverified; confirm current fee
Residential Care Administrator application	$100	Health Facility Administrators board, Professional Licensing Agency	Check the current amount with the board
Housing with services annual disclosure	Not found	FSSA Division of Aging	Confirm form and fee
Zoning, construction, fire approvals	Not researched	Local	Confirm with your city or county

What Results to Expect

Following these steps in order can help you reach a point where the agencies have a complete file to review. Operators who settle entity setup, administrator hiring, and local approvals before filing often avoid the rework that comes from changing a bed count or floor plan later. These are general patterns, not guarantees. Occupancy, staffing, reimbursement, and timing depend on your market, your local approvals, and agency review, and this guide cannot predict those.

Important Disclaimer

This article is informational content, not legal, tax, or licensing advice. Indiana health-care licensing rules change, and the proposed residential care amendments noted above may change before adoption. Before you form an entity, sign a lease, or file an application, talk with an Indiana attorney who handles health-care licensing and with a CPA who can review your tax election. Confirm every fee and form with the agency that issues it.

Official Resources

• Indiana Secretary of State, Business Services Division: https://www.in.gov/sos/business/
• INBiz online filing: https://inbiz.in.gov/
• Business entity search: https://bsd.sos.in.gov/publicbusinesssearch
• Indiana Department of Revenue: https://www.in.gov/dor/
• Indiana Small Business Development Center: https://isbdc.org/
• SBA Indiana district: https://www.sba.gov/district/indiana
• IDOH Long Term Care and FSSA Division of Aging: search the agency names on in.gov. We did not verify direct URLs for these two agencies for this guide.