Is a residency agreement with 30 days either side a lease or not?

Removals from a licensed assisted living home are governed by the state's involuntary discharge rules, and in a fair number of states landlord-tenant law also reaches the arrangement, either partly or fully. Which of those applies to your house is a question for an attorney licensed in that state, because the answer changes both the notice period and the forum. The mechanism to understand is that the discharge rule is the binding one in practice. Most states require written notice with a stated reason, a discharge plan, and often an appeal to the licensing agency that pauses everything while it runs. You cannot move someone out because their acuity exceeded your license until you have somewhere compliant for them to go, and finding a receiving facility for a heavy-care resident with a payment problem takes weeks.

So underwrite the tail, not the notice period. A non-paying heavy-care resident can sit in a bed for 60 to 120 days while you keep staffing them. On six beds that's real, and there's no security deposit big enough to cover care labor.

The rate sheet is the document that decides whether this house works. Care levels get repriced off a written assessment, and the operators who lose money are the ones who never reassess. Acuity creeps, a level-two resident becomes a level-three in staffing hours, and the billing stays at level two for a year. Ask to see the assessment dates on all six residents and compare them to the current care plans. Also check your state's rules on notice for rate increases, since many require 30 days or more, which means you inherit today's pricing for at least a quarter after closing.