This study for Wisconsin's Bureau of Assisted Living (BAL) has addressed the question of how to promote and maintain effectiveness in ensuring regulatory compliance and resident protection under such conditions. Using BAL data on non-compliance and complaints, the team identified factors associated with increased odds of a facility committing a serious violation or multiple violations. Interviewing other key states also helped identify best practices. The report recommends an increase in the number of BAL staff, and that BAL conduct random inspections to obtain a more accurate depiction of regulatory compliance and update admissions standards to prevent unsafe resident placements. They provide six additional recommendations designed to streamline the regulatory process, enhance regulatory authority, and increase regulatory consistency across various types of assisted living facilities and BAL regional offices.