Nearly every assisted living brochure in the Puget Sound area says some version of "we care for residents with dementia." Far fewer communities hold Washington's actual specialized dementia care endorsement. Here is the difference, and how to check before you sign anything.
By Patricia Nguyen, CDP · August 16, 2026
In Washington, an assisted living facility licensed under RCW 18.20 cannot simply decide to advertise dementia or memory care services because it feels ready to. To admit and retain residents whose primary need is dementia-related care in a distinct program or secured unit, the community has to apply for and hold a specialized dementia care endorsement from the Department of Social and Health Services, administered through Residential Care Services (RCS). That endorsement is layered on top of the base assisted living licence — it is not automatic, and not every licensed assisted living community in the region has it, even ones that use the words "memory care" freely in their marketing.
The practical effect for families: a facility without the endorsement can still care for residents who happen to have a dementia diagnosis, as long as their needs fit within standard assisted living services and the resident isn't in a secured or locked unit. But it cannot lawfully operate a dedicated, locked memory care neighborhood, and it isn't required to meet the endorsement's additional staffing and training standards. If your parent needs a secured environment — because of wandering risk, exit-seeking behavior, or a stage of dementia where general assisted living supervision isn't enough — the endorsement isn't a nice-to-have. It's the difference between a legally appropriate placement and one that quietly isn't.
Getting the endorsement obligates a facility to more than a sign on the door. Endorsed communities must maintain a written philosophy of care specific to dementia programming, staff to a level appropriate for the population, and put staff who work in the dementia unit through additional dementia-specific training beyond what's required for general assisted living caregivers — covering things like communication techniques for residents with cognitive decline, redirection instead of confrontation during agitation, and recognizing and responding to behavioral expressions of unmet needs. Facilities with a secured or locked unit also have to meet physical environment standards intended to prevent elopement while still allowing safe, supervised movement — enclosed courtyards, alarmed doors, and layouts designed to reduce the disorientation that triggers exit-seeking in the first place.
Endorsed facilities are also expected to individualize dementia care plans rather than run a one-size-fits-all program, and to be transparent with families about what "memory care" concretely means in that building — activity programming, staffing ratios during day versus overnight shifts, and how they handle escalating behaviors before considering a discharge. None of this is optional once a facility holds the endorsement; RCS inspects against these standards the same way it inspects general assisted living requirements.
Don't take a marketing brochure's word for it. Washington's Department of Social and Health Services maintains public facility search and inspection records through its Aging and Long-Term Support Administration, and the same fortress.wa.gov inspection-report lookup that shows a facility's licensing history and survey findings will also show whether the specific licence includes the dementia endorsement and whether the facility operates a secured unit. Pull that report before you schedule a tour, not after you've fallen in love with the lobby.
When you do tour, ask directly: "Do you hold the specialized dementia care endorsement, and is this unit secured under that endorsement?" A community that hedges or answers with "we're equipped to handle dementia" instead of a clear yes or no is worth pressing further. Also ask what happens if your parent's needs progress past what the unit is licensed to manage — Washington requires assisted living communities, endorsed or not, to have a negotiated service agreement and discharge criteria, and you want to know those terms before move-in, not during a crisis discharge notice.
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