Negotiated Service Agreement Assisted Living

Negotiated Service Agreement Assisted Living: What You Need to Know

As the elderly population grows, so does the demand for quality assisted living facilities. However, with rising costs and limited government funding, some seniors may struggle to find affordable care. Negotiated Service Agreements (NSAs) are one solution that can help seniors and their families access the care they need.

What is a Negotiated Service Agreement?

A Negotiated Service Agreement is a contract between a Medicaid-funded resident and an assisted living facility. Essentially, the resident agrees to pay a portion of their income towards their care, while the facility agrees to provide certain services and amenities. NSAs are optional and are designed to provide flexibility for both the resident and the facility.

What Services are Covered Under a Negotiated Service Agreement?

NSAs vary from state to state, but typically cover a range of services that are not covered by Medicaid. These may include:

– Personal Care

– Assistance with Activities of Daily Living, such as bathing, dressing, and toileting

– Medication Management

– Housekeeping and Laundry Services

– Meal Preparation

– Transportation to Medical Appointments

– Social and Recreational Activities

How Does a Negotiated Service Agreement Work?

To be eligible for a Negotiated Service Agreement, a resident must be enrolled in Medicaid and require assisted living care. The resident and the facility negotiate an agreement that outlines the services to be provided and the amount the resident is willing and able to pay for those services. The agreement must be approved by the state Medicaid agency before it can go into effect.

What are the Benefits of Negotiated Service Agreements?

There are several benefits to NSAs for both the resident and the facility, including:

– Greater Flexibility: NSAs allow both parties to negotiate services and fees that best meet their needs and budgets.

– Affordable Care: NSAs can help make assisted living care more accessible and affordable for seniors who may not be able to afford traditional assisted living fees.

– Increased Revenue: NSAs can help facilities increase their revenue by filling vacant units that may have gone unfilled without this option.

– Enhanced Quality of Life: Residents who are able to access the care they need through NSAs may enjoy a higher quality of life and greater independence.


Negotiated Service Agreements are a valuable option for seniors and their families who need assisted living care but may not be able to afford traditional fees. By negotiating services and fees with the facility, Medicaid-funded residents can access the care they need while maintaining their independence and quality of life. As more seniors enter their golden years, NSAs will likely become an increasingly important tool to enhance access to quality care.