Memory Care in Washington, DC (2026): Rules, Cost & Who Pays

If your parent needs memory care in Washington, DC, two District rules help: the contract must state any Alzheimer's specialty, and covered staff need at least 8 hours of dementia training.1 In the District, assisted-living memory care is provided by a licensed Assisted Living Residence, and those two rules, one in the residence's written contract and one in D.C. Code § 7-744.02, are your best tools for telling a well-run community from a well-marketed one.1 Below is what the District requires, what care costs, and who helps pay.

In This Guide

• Key Takeaways
• What Memory Care Is in DC
• The Dementia Rules DC Sets
• What Memory Care Costs in DC
• Who Pays for Memory Care in DC
• When Assisted Living Memory Care Isn't Enough
• How to Vet a Memory Care Community in DC
• Frequently Asked Questions
• Learn More

What Memory Care Is in DC

When you start calling places, you'll hear "memory care" used as if it were its own product. In the District, the setting behind that phrase in assisted living is an Assisted Living Residence, the license DC uses for assisted living.1 Knowing that name matters, because it tells you which law protects your parent and which agency you can call.

It is unlawful to operate an assisted living residence in DC without being licensed and in compliance with the Assisted Living Residence Regulatory Act. DC Health says its Community Residence Facilities Branch, within the Health Regulation Administration, regulates these residences, and the detailed rules sit in 22-B DCMR Chapter 101.4

Every DC assisted living residence must provide or ensure:

• 24-hour supervision and oversight for residents' well-being and safety
• three meals a day plus snacks
• at least some help with activities of daily living, such as bathing and dressing, and with everyday tasks
• laundry and housekeeping the resident doesn't do

It must also help residents reach health and social services and arrange scheduled transportation to community services.4

24-hour nurse availability. DC's regulations require an assisted living residence to have at least one registered nurse available 24 hours a day, 7 days a week. "Available" is defined narrowly: reachable in person or by phone, text or video, responding to staff within 1 hour, and coming in person when the nurse judges that a resident's change in health requires it.4 A nurse on call by video meets that rule, so ask each community whether a nurse is physically on site, and during which hours.

Nationally, the Administration for Community Living describes memory care as a specialized form of assisted living for people with Alzheimer's disease and other dementias. It says such settings generally offer supports beyond traditional assisted living, and that specialized staff training, secured exits and enhanced visual cues can be part of one.5 None of those features comes with the label, so ask about each one.

The Dementia Rules DC Sets

DC's dementia-specific rules for assisted living sit in two places in the D.C. Code, and both give you something concrete to hold a community to before you tour.

The special-care disclosure in the contract

Under D.C. Code § 44-106.02, a DC assisted living residence must give the resident a written contract before admission. Among other things, the contract must state "the specific nature of any special care that it holds itself out to provide, such as specialty in Alzheimer's disease or Parkinson's disease."1

In plain terms, if a residence markets itself as offering memory care, the contract has to say what that care actually is. A DC assisted living residence's contract must also spell out the services included and excluded, the admission and discharge criteria, and the full rate structure, including service packages and fee-for-service charges.6 Ask for the contract early, before the deposit, and read the special-care section against what the tour promised.

Dementia training for staff

D.C. Code § 7-744.02 covers skilled nursing facilities, assisted living residences, home care agencies and hospice that have residents or participants with Alzheimer's disease or related dementia. Its rules for those programs:

• Initial training: at least 8 hours of dementia training for covered staff.1
• Every year after: at least 4 hours of continuing education for covered direct service and administrative staff, and 2 hours for other covered staff.1
• Who pays: staff may not be charged for the training and must receive normal pay while attending.1

The DC Law Library records that the provision that had made § 7-744.02 contingent was repealed, so the section has been implemented. The DC Brain Health Initiative, working with DC Health, has developed a dementia training program of six courses, totaling 8 hours, to meet the requirements of D.C. Law 23-201.1

DC's Assisted Living Residence Regulatory Act adds its own training layer: after a staff member's first year, each DC assisted living residence's staff must complete at least 12 hours of in-service training a year, including four hours on cognitive impairments, and the residence's administrator must complete 12 additional hours on cognitive impairments every year.1 When you tour, ask to see the training records for the staff who would care for your parent, not just the policy binder.

What Memory Care Costs in DC

This is often the hardest part to get a straight answer on, and it's worth being honest about what's known.

The benchmark most families and planners use is the CareScout Cost of Care Survey. CareScout's 2025 survey, released for Washington, DC on March 2, 2026, puts the District's median for an assisted living community at $77,934 a year, based on 12 months in a private one-bedroom unit. The national median CareScout reports alongside it is $74,400 a year.2

CareScout's DC figures cover assisted living, nursing home rooms, in-home care, adult day health care and a private duty nurse, so there's no memory-care line to quote.2 The assisted living median is a starting frame, not a price. Federal guidance on memory care notes that the resident pays for the room or apartment and may need to pay extra for any special care.5

Two more cautions about the DC numbers. CareScout collects its rates by metropolitan area, and its regions can include counties from nearby states. And CareScout itself calls DC's costs mixed year over year.2 You'll also see memory-care median prices for DC on directory websites that don't agree with each other. We don't repeat them here because none comes from a survey we can check.

So price it directly. Ask each community for its base rate and every care-level or memory-care charge in writing, and compare them against the contract's rate structure. Our DC cost of senior care guide sets the assisted living median beside nursing home and in-home care costs.

Who Pays for Memory Care in DC

If you're worried about how long savings will last, you're not alone. Most families start by paying privately, but two public programs in the District can help with assisted living, including memory care in an assisted living residence.

DC Medicaid's EPD Waiver

The EPD Waiver, run through DC Medicaid, can pay for assisted living services. The DC Department of Health Care Finance (DHCF) lists these qualifications:

• a District resident and a U.S. citizen or qualified resident
• DC Medicaid eligible, with income below 300% of Supplemental Security Income (SSI)3
• no more than $4,000 in countable assets3
• needs help with activities of daily living
• 65 or older, or 18 to 64 with a physician-diagnosed physical disability
• meets a nursing home level of care and chooses community care over a facility3

In 2026, 300% of SSI works out to $2,982 a month, the income standard DC applies to its home and community-based waivers.7 To start, the DC Department of Aging and Community Living (DACL) says a DC Medicaid provider completes a Prescription Order Form, and Liberty Healthcare does a face-to-face assessment to establish level of need.3

Here's the part families don't expect. Under the EPD Waiver, DC Medicaid pays an all-inclusive rate for assisted living services, but it does not reimburse room and board.3 The rent-and-meals share still has to come from your parent's income or another source. Ask each residence directly whether it accepts EPD Waiver residents in its memory care rooms. Our guide to the EPD Waiver covers eligibility in more depth.

The Optional State Supplemental Payment (OSSP)

For people on SSI, or who meet SSI's rules, the District's Optional State Supplemental Payment adds a monthly amount for residents of assisted living facilities and certain other settings. Eligibility requires resources within SSI's limits of $2,000 for an individual or $3,000 for a couple, and assisted living residents must submit an OSSP application.3

DHCF groups assisted living facilities with certified residential facilities under "adult foster care" for these amounts. In DC, a person found eligible for OSSP is automatically eligible for DC Medicaid, and in 2026 DC OSSP residents of adult foster care homes keep a $141 personal needs allowance.3 Our guide to paying for assisted living in DC walks through both programs step by step.

When Assisted Living Memory Care Isn't Enough

Dementia changes over time, and it's natural to worry about what happens if your parent's needs grow. DC law answers part of that question, and the timing matters.

At admission, a DC assisted living residence may not admit someone who needs more than intermittent skilled nursing care, treatment of stage 3 or 4 skin ulcers, or ventilator services. A DC assisted living residence also may not admit someone who, at initial admission, is dangerous to themselves or others, or whose behavior significantly harms others' lives, if the residence can't resolve that through appropriate treatment.8 Those are admission rules. They don't, on their own, require a residence to discharge someone whose needs change later.

After admission, a DC assisted living residence must make every effort to avoid discharge. DC's Assisted Living Residence Regulatory Act says the grounds for an involuntary discharge from an assisted living residence may include unpaid fees and the residence's inability to meet the resident's care needs under the individualized service plan, and the residence must give the resident and their surrogate 30 days' written notice.8 DC's facility-protections law, which covers assisted living residences and nursing homes, gives the resident 7 days from receiving a discharge notice to request a hearing.9

If more care is needed, the next step is usually a nursing home. DC defines a nursing home as a 24-hour inpatient facility primarily engaged in providing professional nursing services, and DC Health licenses and inspects them.10 CareScout's 2025 DC medians are $146,730 a year for a semi-private nursing home room and $173,740 for a private room.2

Medicare won't pay for either setting long term. Medicare covers skilled nursing facility care only on a short-term basis, generally after a qualifying hospital stay, for up to 100 days per benefit period, with a $217 daily coinsurance for days 21 through 100 in 2026. The hospital-stay requirement can be waived in some cases, such as by a Medicare Advantage plan or when a doctor belongs to an Accountable Care Organization approved for a waiver, but Medicare does not pay for long-term custodial care.11 Our DC nursing homes guide and our guide to memory care vs. nursing home in DC compare the two settings in detail.

How to Vet a Memory Care Community in DC

You're choosing where someone you love will live, and a brochure can't tell you enough. These steps use the tools DC law gives you.

Inspections and complaints. DC's regulations authorize DC Health to inspect an assisted living residence when it first applies for a license, six months after licensure, at each annual renewal, to investigate complaints, and at the Director's discretion. Complaints of a life-threatening nature, or that represent immediate danger, are to be investigated within 24 hours, and anyone can file one with DC Health.12

The ombudsman. DC's Long-Term Care Ombudsman Program advocates for residents' rights and investigates complaints made by or on behalf of residents. The Centers for Medicare & Medicaid Services (CMS) contacts directory lists the DC program's local number as (202) 434-2120.13

Learn More

Find personalized help comparing memory care options in DC at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.