medication, or personal care services. There has been controversy generated by reports of neglect, abuse and mistreatment of residents at assisted living facilities in the U.S. Canada In Canada, there are also some differences in how assisted living is understood from one province to the next. In most provinces, the phrase is understood as less independent than it is in the United States. People often require help with more than one of the activities of daily living or the more intensive ADLs like feeding or bathing. In the province of Alberta, "supportive living" is the distinct phrasing used for a type of care that is otherwise synonymous. The province's Supportive Living Accommodation Licensing Act is a comprehensive act with specific prescriptions governing care homes licensing, inspections and more. United States Within the United States assisted living spectrum, there is no nationally recognized definition of assisted living. Assisted living facilities are regulated and licensed at the US state level. These regulations include staffing, training, and quality and safety standards. This is differentiated from nursing homes, which are regulated on a federal level and are generally held to more stringent standards. More than two-thirds of the states use the licensure term "assisted living." Other licensure terms used for this philosophy of care include residential care home, assisted care living facilities, and personal care homes. Each state licensing agency has its own definition of the term it uses to describe assisted living. Because the term assisted living has not been defined in some states it is often a marketing term used by a variety of senior living communities, licensed or unlicensed. Assisted living facilities in the United States had a national median monthly rate of $3,500.00 in 2014, a 1.45% increase over 2013 and a 4.29% increase over a five-year period from 2009 to 2014. Types As widely varied as the state licensing and definitions are, so are the types of physical layouts of buildings in which assisted living services are provided. The average assisted living facility is in a commercial building, yet some assisted living services use large residential buildings, known as Residential Assisted Living homes, or "RAL". Residential Assisted Living homes can vary in price and amenities, and can even be grouped into a separate term known as a Luxury Residential Assisted Living Home, or "LRAL". Assisted living facilities can range in size from a small residential house for one resident