None of the three DC-metro jurisdictions license 'memory care' as its own standalone category — each layers dementia-specific programming onto its existing assisted living framework, but the details differ enough to matter.
By DC Senior Advisor Care Team · May 5, 2026
Across the DMV, memory care is not its own license category anywhere — DC, Maryland, and Virginia each fold dementia-specific care into their existing assisted living licensing structure, just in different ways. In the District, a memory care program operates under DC Health's Assisted Living Residence license (Assisted Living Residence Regulatory Act of 2000), typically with additional dementia-care staffing and programming disclosed in the residency agreement. In Maryland, dementia care is delivered within the OHCQ Level system under COMAR 10.07.14 — most memory care programs operate at Level 2 or Level 3, depending on the intensity of need. In Virginia, memory care operates under a VDSS-licensed assisted living facility (22VAC40-73), often within a distinct secured unit that must meet specific additional requirements for dementia care disclosure and staff training.
As a Certified Dementia Practitioner working across all three jurisdictions, I tell DC-metro families the same thing regardless of which side of the river they're on: the words 'memory care' on a brochure describe a program, not a license. Two communities — one in the District, one in Bethesda, one in McLean — can all use the same marketing language while actually holding meaningfully different licenses, staffing commitments, and secured-unit requirements underneath.
In DC, ask specifically what dementia-care training HRLA requires the facility's staff to complete and how the Assisted Living Residence license covers the secured memory care unit specifically, not just the parent community. In Maryland, ask which OHCQ Level the memory care unit is licensed for — Level 2 or Level 3 — since that determines how much nursing-adjacent care the unit can legally provide as a resident's dementia progresses, and ask what happens if your parent's needs exceed that Level. In Virginia, ask whether the secured unit has any additional VDSS disclosure or endorsement beyond the facility's base assisted living license, and what specific dementia-training hours staff in that unit have completed.
Regardless of jurisdiction, ask about the overnight staff-to-resident ratio in the secured memory care unit specifically — that number often differs meaningfully from the community's overall ratio, and it's one of the clearest indicators of how seriously a facility takes its dementia program day to day, not just during a tour.
Verify the specific facility's license and any inspection findings before committing: DC Health's HRLA for District communities, Maryland's OHCQ for Montgomery and Prince George's County communities, and Virginia's VDSS Division of Licensing Programs for Arlington, Alexandria, and Fairfax communities. Memory care across the DC metro runs $7,500 to $11,000 a month in 2026 — above the $5,500-$8,500 range for standard assisted living — and that premium should reflect real dementia-specific staffing and training, not just a locked door and a higher price tag.
A community that won't show you its current license or becomes defensive when you ask about inspection findings or staff training hours is telling you something important. A free advisor familiar with DC Health, OHCQ, and VDSS licensing across all three jurisdictions can help match a family's needs to the right program and verify the license before a tour is even scheduled, wherever in the DMV the search leads.
Beyond staffing ratios and training hours, ask specifically how a secured memory care unit — in any of the three jurisdictions — handles behavioral symptoms like exit-seeking, agitation, or sundowning, since these are often what determine whether a placement holds up over time, not just whether the unit is locked. A well-run unit should be able to describe its actual approach, not just its physical security features.
It's also worth asking how the unit coordinates with outside geriatric psychiatry or neurology support when behavioral symptoms escalate beyond what onsite staff can manage — MedStar Georgetown University Hospital, George Washington University Hospital, and other DC-metro health systems offer geriatric psychiatry consultation that some memory care communities coordinate with directly. A unit with an established referral relationship tends to manage escalations more smoothly than one handling everything in-house.
When touring a secured memory care unit anywhere in the DC metro, bring a short checklist: the specific license type and Level (in Maryland) or endorsement (in DC or Virginia) covering that unit, the overnight staffing ratio, dementia-training hours completed by current staff, how behavioral escalations are handled, and whether the unit coordinates with outside geriatric psychiatry support.
Write down the answers on the spot rather than relying on memory across multiple tours — DC, Maryland, and Virginia communities can start to blend together after the third or fourth visit, and a written comparison makes the actual licensing and staffing differences much easier to weigh side by side.
Before touring, ask each community — in DC, Maryland, or Virginia — how it handles a resident whose dementia progresses to the point where the current secured unit can no longer safely meet their needs. Some communities have a clear internal pathway to a higher level of care; others will require a family to search all over again at the worst possible time.
Getting a straight answer to this question before move-in, rather than after a crisis, is one of the most useful things a family can do to avoid a second disruptive move down the road.
Free, no pressure, and no one rushing you. We answer to families, not to facilities.