Rescheduling Leaves Assisted Living Facilities Sorting Seniors' Cannabis

Two gummies can sit in two rooms of the same assisted-living facility this summer, and federal law treats them as different drugs. One, bought through a state medical-cannabis program, is now a Schedule III substance. The other, bought at an adult-use dispensary, remains Schedule I.

That split is the direct result of the order Acting Attorney General Todd Blanche signed on April 22. Published in the Federal Register and effective April 28, 2026, it moved FDA-approved cannabis drugs and cannabis covered by a qualifying state medical license to Schedule III. Everything else stayed put.^[1]

The order is explicit. "Any form of marijuana other than in an FDA-approved drug product or marijuana subject to a state medical marijuana license remains a schedule I controlled substance," it states.

For assisted-living operators, that language converts a simple ban into a sorting problem. Facilities must now determine which category a resident's product falls into, who may handle it, where it is locked up, and what happens when a resident with dementia can no longer dose herself safely.

Demand is coming from the residents, not the industry

The pressure is demographic. Past-month cannabis use among Americans 65 and older rose from 4.8% in 2021 to 7.0% in 2023, a 46% relative increase in two years, according to a JAMA Internal Medicine analysis of 15,689 older adults.^[2]

We covered earlier this year why edibles dominate this group. In a study of 169 Colorado adults over 60 considering edibles, 56.8% cited sleep difficulty and 49.7% cited pain; a majority chose combined THC/CBD products. The study measured motivations, not whether the products work.

Angela Bryan, a University of Colorado Boulder professor who studies older adults' cannabis use, described the pattern plainly.

"For the most part, we found that these folks aren't really interested in getting high. They just want to feel better," Bryan said.

Most of these users are making the decision without medical input. A Rutgers-led analysis of more than 14,000 adults 65 and older found fewer than one in five past-year users had discussed cannabis with a clinician.

Geriatrician Benjamin H. Han of UC San Diego warned that "cannabis can complicate the management of chronic diseases and be potentially harmful if patients are not educated on its use and potential risks."

Four states, four rulebooks

Assisted living is licensed by states, not by Medicare, and the state answers diverge sharply.

Virginia shields facility employees from prosecution for storing, dispensing or administering cannabis oil to residents with valid certifications.^[4]

Minnesota bars covered health facilities from unreasonably limiting authorized patient access, with exceptions tied to actual federal enforcement or funding consequences.^[5]

California's Ryan's Law requires certain health facilities to permit medicinal cannabis use by eligible patients, but lets them prohibit smoking and vaping, decline to supply the product, and keep staff out of administration.^[6]

Washington's residential-care guidance tells adult family homes to run cannabis through written policies: secured storage, safety assessments, and documentation in each resident's service agreement. A 2026 Washington bill, HB 2152, would require specified health facilities to develop plans permitting non-smoked medical cannabis for terminally ill patients starting in 2027.^[7]

The federal layer offers no template. Neither CMS nor HHS had issued assisted-living-specific guidance on the April order as of late July, which means national chains face a state-by-state policy patchwork with no federal baseline to build on.

The science is moving as fast as the law

The research operators must weigh is arriving in real time. Oxford researchers reported on July 21 that they found no link between prior or occasional cannabis use and faster cognitive decline or dementia across large U.K. and U.S. cohorts.

"Across large UK and US cohorts, and using genetic approaches to explore potential causal relationships, we found no evidence that cannabis use was associated with accelerated cognitive decline or increased dementia risk in older adults," said Anya Topiwala of Oxford Population Health, who cautioned the finding does not establish safety for sustained high-dose use.^[8]

At the July Alzheimer's conference, preliminary results from a trial of 120 hospice-eligible dementia patients showed clinician-reported improvement in agitation for 87.2% of those given a standardized oral THC/CBD formulation, against 23.6% on placebo. The trial is not yet peer reviewed, and its pharmaceutical-grade formulation says nothing about dispensary gummies.^[9]

The federal category could still move again

The April order is one step in a longer proceeding, one we tracked when the expedited DEA hearing opened. A second hearing, on whether the remaining Schedule I marijuana should also move to Schedule III, ran June 29 through July 15 before DEA Chief Administrative Law Judge Derek C. Julius.^[3]

Post-hearing briefs are due August 17. Julius's recommendation will not bind DEA Administrator Terrance Cole, and no decision date has been announced. Three consolidated challenges to the April order are also pending in the D.C. Circuit, where a fully briefed stay motion awaited a ruling as of late July.

There is precedent for a long wait. The last time a DEA administrative law judge recommended moving marijuana out of Schedule I, in 1988, the administrator rejected it. Facilities writing cannabis policies this fall are building on a federal category that the courts, and the DEA itself, could still redraw." }