Memory Care in Missouri

In Missouri, assisted living and residential care facilities provide memory care to people with dementia. This means memory care units follow the same standards and regulations as the facility that houses them, along with state-mandated memory care policies. The Missouri Department of Health and Senior Services (DHSS) licenses and governs assisted living and residential care facilities, and enforces the state’s memory care regulations.

Facilities with an Alzheimer’s Special Care Unit (ASCU) don’t require any additional licenses, but they must complete a memory care disclosure form. The facility must present the document to the DHSS, who will verify the disclosure’s contents during the next license renewal inspection. Upon admission, the facility must provide the disclosure to the new resident and their next of kin, designee, or guardian.

The form describes how the care the ASCU provides differs from the rest of the facility and must include:^[01]

• A written statement of the unit’s overall philosophy and mission reflecting the needs of residents with dementia
• The admission, transfer, and discharge criteria
• The process used for assessing and establishing a plan of care, as well as how the plan will adapt to changes in the resident’s condition
• Staff training and continuing education practices
• The physical environment and design features to support people with cognitive impairments
• The frequency and types of resident activities
• How families can stay involved and the availability of family support programs
• The cost of care and any additional fees
• Safety and security measures

Prior to admission, assisted living facilities must complete a move-in screening. This includes a community-based assessment within five days of moving in and a physical exam performed by a licensed physician within 10 days. Facilities review the community-based assessment if there is a significant change in the resident’s condition, or at least semi-annually.

Residential care facilities similarly have an admission physical examination within 10 days of move-in. However, they differ from assisted living facilities in that they perform a monthly review of the resident’s medical condition, medication administration/consumption, weight, and any incidents or accidents.^[01]

Memory care staff education and training requirements

Assisted living and residential care facilities have the same staff education and training requirements. Both do not require prior training or education, but employees providing direct care to residents must attend an orientation training that is at least 3 hours long. The orientation includes:^[01]

• An overview of mentally confused residents, such as those with dementia
• Behavior management
• Promoting independence with activities of daily living (ADLs)
• Techniques for creating a safe, secure, and socially-oriented environment
• How to provide stability, structure, and a sense of routine for residents
• Understanding and dealing with family issues

Employees not providing direct care for, but who may have contact with, residents with dementia must undergo at least 1 hour of training. Their training consists of an overview of mentally confused residents and how to communicate with them.

Memory care units also must have a licensed administrator and one licensed nurse working at least eight hours a week for every 30 residents. Additionally, if the memory care unit administers medication, a Level 1 medication aide or a certified medication technician must be available to provide medication to residents. Facilities must maintain a staff-to-resident ratio of one staff member for every 15 residents during the daytime and evenings and one staff member for every 20 residents at night.

Missouri Department of Health contact information

Missouri Department of Health and Senior Services
912 Wildwood
P.O. Box 570
Jefferson City, Missouri 65102

Phone: 573-751-6400

How to look up the latest inspection and complaint reports

The Missouri Department of Health and Senior Services (DHSS) inspects assisted living and residential care facilities twice in a fiscal year. Inspections are unannounced and involve interviewing staff and resident family members, while also evaluating resident care and quality of life, environmental services, dietary services, and fire safety.

Facilities with violations are sent a written Statement of Deficiencies (SOD) and must respond with a written Plan of Correction (POC) describing how they will correct any cited violations. After approving the POC, the DHSS may conduct up to two follow-up visits to confirm the changes. Residents and staff can also submit complaint reports, which will result in an investigation that follows the same procedures as licensure inspections.^[02]

If you’d like to see a facility’s licensure and complaint history, the DHSS has an online long-term care tool that can help. You can find a specific facility by searching for it by its county, city, or zip code.

The DHSS website allows you to request a specific public record for a facility as well. For details about a certain facility’s violation history, you can ask the long-term care ombudsman any questions you may have.