Can an assisted living facility require a resident to pay for a personal sitter?

If the resident can't be left alone and needs someone with him or her, most assisted living centers would consider that extra, just as any in-home care agency services would be extra. You need to check their policy, but this would not be unusual.
Carol

Yes. The facility has an obligation to make sure their residents are safe. They may request that to continue residing there that additional services be implemented. If not agreed to, they have the right to ask the resident to leave (45 days notice).

More care = more expense. Check into Medicaid Long-Term Care Diversion programs in your state as well as VA non-service connected pensions if the resident is or was married to a veteran.