When you look for a safe place for a parent with dementia in North Carolina, the first thing to know is that the state calls memory care a Special Care Unit. A Special Care Unit is a wing, hallway, or program inside a licensed adult care home or nursing home, designated for residents with Alzheimer's or another dementia. Your real protection is a document the state forces every such place to hand you before it admits anyone: a Special Care Unit Disclosure Statement that spells out, in writing, exactly how it does dementia care.
This guide explains what a Special Care Unit actually is, what that disclosure statement has to tell you, what memory care costs in North Carolina, and how to use the disclosure to vet a place before you sign anything.
In This Guide
- Key Takeaways
- What Memory Care in North Carolina Is
- Your Protection: the Special Care Unit Disclosure Statement
- What Memory Care Costs
- How to Vet a Special Care Unit
- Frequently Asked Questions
What Memory Care in North Carolina Is
When you start calling places, you'll hear "memory care" used like it's a category of facility. In North Carolina, the state has a more precise name for it: a Special Care Unit, or SCU. It's a designated part of a building, a wing, a hallway, or a defined program, set aside for residents with Alzheimer's, other dementias, or related conditions. The unit sits inside a setting the state already licenses: an adult care home (what North Carolina calls assisted living) or a nursing home.
That distinction matters more than it looks. A place doesn't get to call part of itself a Special Care Unit just because it puts the words on a brochure. To hold itself out to the public as offering an SCU, a facility has to be licensed as such by the North Carolina Division of Health Service Regulation, the agency at NCDHHS that licenses adult care homes and nursing homes, and it has to meet standards set by the North Carolina Medical Care Commission. So the right question on a tour isn't whether a place says it does memory care. It's whether the unit your loved one would live in is a licensed Special Care Unit, and what its disclosure statement says, which is the subject of the next section.
The setting an SCU sits in shapes the level of care and who pays for it:
| Setting | What it is | How it's paid for |
|---|---|---|
| Adult care home | North Carolina's term for assisted living, licensed by DHSR; provides room, board, supervision, and help with daily activities. A small home for 2 to 6 residents is a Family Care Home | Largely private-pay; the State/County Special Assistance program supplements room and board for eligible low-income residents |
| Nursing home | A higher level of care for people who need continuous licensed nursing | Private-pay, then Medicaid for those who qualify |
Most memory care for people who don't yet need skilled nursing is delivered in an adult care home's Special Care Unit. Adult care homes are largely private-pay, though North Carolina's State/County Special Assistance program provides a cash supplement toward room and board for eligible low-income residents who are 65 or older or disabled, and people who qualify for Special Assistance are automatically eligible for Medicaid. Standard Medicaid doesn't pay adult-care-home room and board outside that pathway, so for most families the question is how to budget for private pay.
Your Protection: the Special Care Unit Disclosure Statement
This is the part to hold onto. Before a facility can be licensed to operate a Special Care Unit, and before it admits a single resident to that unit, it has to submit and have approved a written Special Care Unit Disclosure Statement. The statement exists because dementia care is easy to advertise and hard to verify. It forces a place to put its actual practices on paper, in a format the state reviews, where you can read them and compare two places on the same terms.
The disclosure statement has to describe how the unit actually delivers dementia care. Under the rules, it covers:
| The disclosure must describe | What you're looking for |
|---|---|
| Dementia-care philosophy | How the unit thinks about caring for people with Alzheimer's and other dementias, in concrete terms, not slogans |
| Secure environment and safety measures | How the unit keeps residents safe from the hardest parts of dementia: wandering, falls, and aggression |
| Activities | The program of daily activities meant to keep residents engaged |
| Staffing | Who's with your loved one day to day, and how the unit is staffed |
| Family involvement | How families are kept informed and brought into care decisions |
| Added costs and fees | The additional charges for the special care, on top of the base rate |
So when a place tells you it "specializes in memory care," you're entitled to ask for its approved disclosure statement and to read exactly what it commits to on each of those points. That document is the difference between taking a sales pitch on faith and holding a place to something it had to put in writing for the state. Ask for it early, and keep a copy.
What Memory Care Costs
Cost is usually the thing families brace for, and we'll be straight with you: there's no clean single number for memory care in North Carolina. The state doesn't publish one, and because a Special Care Unit isn't its own surveyed category, the industry surveys that track senior-care prices don't isolate memory care the way they isolate assisted living or nursing homes.
What we do have is a solid anchor for the base. Per the Genworth/CareScout 2024 Cost of Care Survey, the most recent state-level data, assisted living in North Carolina runs a median of about $6,354 a month (roughly $76,245 a year). Memory care in a Special Care Unit costs more than that, here as everywhere, because of the heavier staffing, the secured environment built to keep someone from wandering off, and the dementia-specific programming the disclosure statement describes. How much more depends on the setting and the level of care, and it runs higher in metro areas like Charlotte and Raleigh than in rural counties. Treat memory care as a premium on top of the assisted-living base rather than a fixed figure, and be skeptical of any source that quotes one precise statewide number for it.
For context, the same survey put a semi-private nursing-home room in North Carolina at about $8,821 a month and a private room at about $9,885. These are industry-survey medians, not government figures, so use them to set expectations, then get a specific written quote from any place you're serious about.
One thing to press on with every quote: the advertised figure is almost always a base rate, and the SCU disclosure statement has to spell out the added costs for the special care separately. As dementia progresses and your parent needs more hands-on help, the monthly bill climbs. Ask each place for a written breakdown of what the base rate includes, what the SCU surcharge covers, how care levels get assessed, and how often rates rise. Two places with the same headline price can land far apart once the dementia-care fees are in.
How to Vet a Special Care Unit
You don't have to become an expert in dementia care to make a good decision. You have to read the right document and ask the right questions. The disclosure statement North Carolina requires is your spine for this.
- Confirm it's a licensed SCU, and get the disclosure in writing. Ask whether the unit is a licensed Special Care Unit, and ask for its approved disclosure statement before you tour, not at the signing table. A place that's vague about its license or slow to produce the statement is telling you something.
- Match the disclosure to what you see. On a tour, hold the document against reality. If it describes a certain staffing pattern or activity program, ask to see it on an ordinary weekday, and go once around a mealtime, when staffing and the mood of a place are hardest to stage.
- Press on the secure environment and behavior. This is the area families most often wish they'd asked about. How does the unit respond when a resident is agitated, tries to leave, or becomes aggressive? What keeps a wanderer safe? The disclosure has to address wandering, falls, and aggression; press until the answer is concrete.
- Get the added costs in writing. The disclosure must name the extra fees for the special care. Ask what the SCU surcharge buys, how care levels are reassessed, and what triggers a rate increase, so the bill doesn't surprise you six months in.
- Check the facility's standing and read the discharge terms. You can look up adult care homes and nursing homes, and their inspection history, through the North Carolina Division of Health Service Regulation. Bring the admission agreement home to read the refund and discharge terms without a salesperson in the room. Discharge terms matter more in dementia care, where needs change and a place may decide it can no longer meet them.
Tour at least a couple of places. The goal isn't a flawless one. It's a place whose limits you understand going in, and the disclosure statement is what lets you understand them.
Frequently Asked Questions
Not exactly. North Carolina doesn't license a standalone "memory care facility." It licenses a Special Care Unit, a wing, hallway, or program for residents with dementia, inside an adult care home or nursing home that's already licensed by the North Carolina Division of Health Service Regulation. A facility that advertises an SCU must be licensed for it, meet North Carolina Medical Care Commission standards, and have an approved disclosure statement before admitting residents. So on a tour, the question is whether the unit is a licensed SCU and what its disclosure says, not whether the building holds a separate memory-care license.
It's a written statement a facility must submit and have approved before it can be licensed to run a Special Care Unit and admit residents to it. It has to describe the unit's dementia-care philosophy, its secure environment and safety measures for wandering, falls, and aggression, its activities, its staffing, how families are involved, and the added costs for the special care. It's the one document that lets you compare two places on the things that actually decide quality of life in dementia care, so read it carefully and keep a copy.
There's no reliable single statewide figure for memory care alone. Use the assisted-living base as your anchor, about $6,354 a month per the Genworth/CareScout 2024 survey, and expect a Special Care Unit to run higher because of heavier staffing and a secured setting. Costs run higher in Charlotte and Raleigh than in rural counties, and the advertised rate is usually a base that rises as care needs grow, so get a written breakdown, including the SCU surcharge, from any place you're considering.
For most families in an adult care home, room and board is private-pay. North Carolina's State/County Special Assistance program provides a cash supplement toward adult-care-home room and board for eligible low-income residents who are 65 or older or disabled, and Special Assistance recipients are automatically eligible for Medicaid. Standard Medicaid doesn't pay adult-care-home room and board outside that pathway. In a nursing home, Medicaid can cover care for those who qualify financially and clinically. Confirm a specific facility's situation before you count on any of it.
An adult care home is North Carolina's term for assisted living: room, board, supervision, and help with daily activities for someone who needs more than independent living but not full nursing care. A nursing home provides a higher level of care, for people who need continuous licensed nursing. Both can operate a Special Care Unit. Which one fits depends on how advanced the dementia is and what medical needs come with it, so ask each place to assess your parent honestly before you decide.
Learn More
- Assisted Living in North Carolina
- Nursing Homes in North Carolina
- Home Care vs. Home Health in North Carolina
- Caregiver Burnout: Signs and Support
- Medicaid Planning Strategies
Find personalized help comparing memory care in North Carolina 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.