ADA and WCAG 2.2 for Senior Living and Nursing Home Websites

Updated 2026-10-16 · 6 minute read

Three different federal rules, and which ones reach you

People talk about “ADA compliance” as one thing. For a care provider it is really three separate federal sources, and which ones apply depends on who owns you and where your money comes from. Here is what each one actually says. This is a summary, not legal advice, so confirm how it applies to your organization with your compliance officer or counsel.

ADA Title III: private providers open to the public

Title III covers places of public accommodation. The statute's list includes the professional office of a health care provider, hospitals, senior citizen centers and other social service center establishments, per 42 U.S.C. 12181(7). In the preamble to its Title III regulations, the Department of Justice says that residential facilities that provide social services, naming nursing homes and residential care facilities, are analyzed as social service center establishments, and that the Fair Housing Act requires its own separate analysis.

Here is the part that surprises people: DOJ has no Title III regulation that sets a technical standard for websites. Its March 2022 guidance on web accessibility says businesses open to the public must make what they offer online accessible, says DOJ does not have a regulation with detailed standards, and calls WCAG and the federal Section 508 Standards helpful guidance. So for a private provider under Title III, the duty is real but the yardstick is not written into a rule. In practice, WCAG 2.1 or 2.2 Level AA is the yardstick everyone uses, because it is the one the federal rules below adopted.

One exception matters in this field. The same Title III regulations say religious organizations and entities controlled by them are exempt from the ADA, and DOJ gives a church that runs a nursing home as an example. Many faith-based communities are structured in ways that make this question less simple than it sounds, so ask counsel. The other rules below can still apply.

ADA Title II: the 2024 DOJ rule for public entities

In April 2024, DOJ published a rule requiring state and local governments to make their web content and mobile apps meet WCAG 2.1 Level AA, according to its fact sheet on the rule. It covers state and local government agencies, special districts and contractors providing services on their behalf. It does not cover private businesses.

This matters to you if a county, city, hospital district, public trust or authority owns or operates your facility.

The dates moved. An interim final rule on April 20, 2026 extended them by a year. Public entities serving 50,000 or more people now have until April 26, 2027, and smaller entities and special districts have until April 26, 2028. The rule has exceptions for archived content, older PDFs that are not used to apply for services, content posted by third parties, individualized password-protected documents and social media posts made before the deadline.

Section 504: the HHS rule many private providers miss

This is the one most private nursing homes and home health agencies should look at closely. HHS's Section 504 rule applies to recipients of HHS federal financial assistance, public or private. Under 45 CFR 84.84, a recipient must make its web content and mobile apps, including those it provides through contractors, meet WCAG 2.1 Level A and AA.

HHS extended these dates in May 2026, as LeadingAge reported. The current text of the rule sets May 11, 2027 for recipients with 15 or more employees and May 10, 2028 for recipients with fewer than 15. The exceptions in 45 CFR 84.85 mirror the DOJ rule: archived content, older documents not used to access your programs, content posted by unrelated third parties, individualized secured documents and old social media posts.

Whether you are a recipient depends on the funding you take. Many long-term care providers receive HHS program dollars, so do not assume you are outside this rule. Ask counsel to confirm, and if you have 15 or more employees, plan as though May 11, 2027 is your date.

WCAG 2.1 or 2.2?

Both federal rules name WCAG 2.1 Level AA. W3C published WCAG 2.2 as a Recommendation on October 5, 2023. According to W3C's What's New in WCAG 2.2, 2.2 adds nine success criteria, six of them at Level A or AA, removes the obsolete 4.1.1 Parsing criterion, and otherwise leaves the 2.0 and 2.1 criteria essentially unchanged.

Our advice is to build to WCAG 2.2 Level AA. It covers what the rules name and adds criteria that matter a great deal to older users, such as larger touch targets and consistent help.

2.4.11 Focus Not Obscured (AA): a focused button or link is not completely hidden behind a sticky header or chat widget
2.5.7 Dragging Movements (AA): anything done by dragging, like a map or slider, also works with a simple click or tap
2.5.8 Target Size (AA): tap targets are at least 24 by 24 CSS pixels, with some exceptions
3.2.6 Consistent Help (A): your phone number or contact link appears in the same place on every page
3.3.7 Redundant Entry (A): a multi-step form does not make people type the same thing twice
3.3.8 Accessible Authentication (AA): logins do not depend on solving puzzles or remembering codes without an alternative

Where most sites fail

WebAIM tests the home pages of the top one million websites each year. Its 2026 report, using February 2026 data, found detectable WCAG failures on about 96 percent of home pages, with an average of about 56 errors per page. The most common problems were low-contrast text (about 84 percent of pages), images missing alt text (about 53 percent), form fields without labels (about 51 percent), links with no text (about 46 percent) and buttons with no text (about 31 percent).

Care provider sites tend to fail in the same places, plus a few of their own: light gray text on photos, tiny phone numbers in the header, rotating hero sliders with no pause button, tour request forms built from placeholder text instead of labels, and PDF admission packets that a screen reader cannot read.

Automated scanners help find the easy problems, but they cannot certify a site. W3C says plainly that evaluation tools cannot determine accessibility on their own and that human judgment is required. The same caution applies to overlay widgets sold as one-line fixes. The rules above require the web content itself to meet WCAG, and an overlay does not change the underlying code.

The fix list

These are the fixes that clear most of the failures on a typical care provider site, in roughly the order we would do them. Each maps to a WCAG success criterion.

Contrast (1.4.3): body text at least 4.5:1 against its background, large text at least 3:1. No light gray, no white text over busy photos without a solid overlay.
Text size (1.4.4) and reflow (1.4.10): the page works zoomed to 200 percent and at a 320 CSS pixel width without sideways scrolling. Start body text at 18px or larger for this audience.
Alt text (1.1.1): every meaningful photo describes what it shows. Decorative images are marked so screen readers skip them.
Form labels and errors (3.3.1, 3.3.2): every field has a visible label, and errors are explained in words, not only with a red outline.
Keyboard and focus (2.1.1, 2.4.7, 2.4.11): everything works with a keyboard, the focus outline is visible, and sticky bars do not cover it.
Tap targets (2.5.8): phone numbers, menu links and buttons big enough to hit with an unsteady finger.
Motion (2.2.2): no auto-rotating sliders or videos without a pause control.
Video captions (1.2.2): every tour or testimonial video has accurate captions, not just auto-generated ones left unchecked.
Clear links and buttons (2.4.4, 4.1.2): links say where they go, and icon buttons have names a screen reader can announce.
Page language (3.1.1): each page declares its language. Spanish pages declare Spanish.
Consistent help (3.2.6): the phone number and tour link sit in the same place on every page.
Documents: the admission packet, menus and activity calendars are accessible PDFs or, better, regular web pages.

Then test it with real people. Ask a resident's family member who uses a screen reader or magnification to try the tour request form. You will learn more in twenty minutes than from any report.

Checklist

Ask counsel which apply to you: ADA Title III, ADA Title II, HHS Section 504, or more than one
If you receive HHS funding and have 15 or more employees, put May 11, 2027 on the calendar
If a public body owns you, confirm your Title II date: April 26, 2027 or April 26, 2028
Set WCAG 2.2 Level AA as the written standard in your website contract
Fix contrast, alt text, form labels and focus first
Replace auto-rotating sliders and tiny tap targets
Caption every video and convert key PDFs to web pages
Have a person test the site with a keyboard and a screen reader, not only a scanner
Publish an accessibility statement with a phone number and email for help

Questions

Does the 2024 DOJ web rule apply to my private nursing home?

No. The 2024 DOJ rule under Title II covers state and local governments and those providing services on their behalf. A private provider may still have duties under ADA Title III and, if it receives HHS federal financial assistance, under the HHS Section 504 rule, which uses the same WCAG 2.1 AA standard.

When is the Section 504 web deadline?

Under the current text of 45 CFR 84.84, May 11, 2027 for recipients with 15 or more employees and May 10, 2028 for recipients with fewer than 15. HHS moved these dates by one year in May 2026, so check for further changes.

Will an accessibility overlay make us compliant?

The federal rules discussed here require your web content itself to meet WCAG 2.1 AA, and W3C says automated tools cannot determine accessibility on their own. Overlays do not fix missing labels, unreadable PDFs or poor contrast in your actual code.

Should we target WCAG 2.1 or 2.2?

The federal rules name WCAG 2.1 Level AA. Building to WCAG 2.2 Level AA covers those criteria and adds a few that matter to older users, like minimum target size and consistent help.

Sources

This guide is general information, not legal advice. Confirm regulatory and legal questions with your compliance officer or counsel.

Ready for a better website?

If you want a site built and tested to a written WCAG 2.2 Level AA standard your counsel can review, Census Web Studio can help.

Website accessibility for senior living and care providers